Small Intercondylar Notch Size Is Not Associated with Poor Surgical Outcomes of Anatomical Single-Bundle Anterior Cruciate Ligament Reconstructions.

Background: Although many studies have been conducted on the association between the intercondylar notch size and the risk of anterior cruciate ligament (ACL) injury, few studies have examined its relationship with the condition after surgical treatment. Therefore, this study aimed to investigate the surgical outcomes of anatomical single-bundle ACL reconstruction according to intercondylar notch volumes. Methods: Medical records of patients who underwent anatomical single-bundle ACL reconstruction using a tibialis anterior allograft between 2015 and 2019 were retrospectively reviewed. For each sex, eligible patients were classified into two groups based on their percentile of intercondylar notch volumes, which were measured using postoperative three-dimensional computed tomography images (group S, ≤ 50th percentile of included patients; group L, > 50th percentile of included patients). Additional grouping was performed based on the group's percentiles of normalized values of intercondylar notch volumes to body heights. Between-group comparative analyses were performed on the perioperative data and surgical outcomes in both objective and subjective aspects. Results: One hundred patients were included in the study. For male patients, there were no differences in the overall surgical outcomes between groups, whereas group L showed a significantly greater knee anteroposterior (AP) laxity than group S at the final follow-up (p = 0.042 for the side-to-side differences [SSD] at the maximum manual force). Similarly, there were no differences in the female patients in the overall surgical results between the groups, whereas group L showed a significantly greater knee AP laxity at the final follow-up (p = 0.020 for the SSD at 134 N; p = 0.011 for the SSD at the maximum manual force). Additional analyses based on the normalized values of the intercondylar notch volume showed consistent results for male patients, and additional grouping for female patients was identical to the existing grouping. Conclusions: The surgical outcomes of anatomical single-bundle ACL reconstruction in patients with relatively small intercondylar notch volumes were comparable to those with large notch volumes, but rather showed favorable outcomes in postoperative knee AP laxity.

Visible-Light-Induced Three-Component Selenofunctionalization of Alkenes: An Aerobic Selenol Oxidation Approach.

A photocatalyst-free visible-light-induced selenofunctionalization of alkenes has been developed using a variety of nucleophiles. The homolytic scission of diselenides under visible-light conditions coupled with the aerobic selenol oxidation to diselenides allowed the successful implementation of three-component selenofunctionalization under visible-light irradiation in open-air conditions. The mechanistic studies revealed the critical role of oxygen content in a reaction medium, where the electron transfer process from the carbon-based radicals to either molecular oxygen or selenyl radicals was controlled.

In vivo detection of acute ischemic damages in retinal arterial occlusion with optical coherence tomography: a "prominent middle limiting membrane sign".

PURPOSE: To describe characteristic findings of acute retinal ischemic damage in optical coherence tomography. METHODS: Eighteen cases of acute retinal arterial occlusion with available fundus photography, optical coherence tomography, and/or fluorescein angiography in the early phase (<1 month) with more than 2 months follow-up were reviewed. A site-to-site analysis between optical coherence tomography morphology and correlating fundus images were done on each visit. RESULTS: Retinal opacities at first presentation were vague to mild opacity in four eyes, moderate (affecting visibility of underlying choroidal vessels) in seven, severe (yellow to whitish) in five, and very severe (chalky white) in two. These changes eventually disappear within 1 month (8 of 9 eyes). Inner retinal hyperreflectivity and a "prominent middle limiting membrane" in optical coherence tomography were consistently noticed up to 1 month showing regional correlation with the retinal opaque areas and was readily identified even in areas with vague or disappeared retinal opacities. Later, inner retinal atrophic changes replace these ischemic optical coherence tomography signs. CONCLUSION: A prominent middle limiting membrane sign is a useful indicator of acute ischemic retinal damage, especially in cases showing subtle or resolved retinal opacities before the onset of atrophic changes.

New insights into the pathoanatomy of diabetic macular edema: angiographic patterns and optical coherence tomography.

PURPOSE: To describe the pathoanatomy of diabetic macular edema in optical coherence tomography and its correlation with fluorescein angiography patterns. METHODS: Sixty eyes of 56 patients were analyzed. Diabetic macular edema was classified into typical focal leakage (from microaneurysm), typical diffuse leakage (the capillary plexus), or combined/questionable leakage using fluorescein angiography and retinal thickness profiles. The leakage and pooling patterns in fluorescein angiography were matched to the corresponding optical coherence tomography images and analyzed. RESULTS: Focal leakage shows swelling predominantly in the outer plexiform layer (OPL). Deeply located microaneurysms directly leak into the loose fiber portion of OPL (Henle layer) through the "fluid conductivity barrier" (synaptic portion of OPL). Diffuse leakage caused swelling predominantly in the inner nuclear layer and secondarily in the OPL. The deep capillary plexus is located between the two "fluid barriers" (inner plexiform layer and OPL); thus, diffuse leakage is primarily related with swelling in the inner nuclear layer. In the combined/questionable leakage, partial sections consisting of inner nuclear layer swelling and much larger areas of OPL/outer nuclear layer swelling are noticed. CONCLUSION: Based on the concept of the fluid conductivity barrier, we revealed a correlation between the intraretinal location of the leakage source and where the fluid accumulated within the retinal layers.

Unilateral recession-resection surgery with inferior displacement combined with augmented anterior transposition of inferior oblique muscle.

We report the effects of unilateral recession-resection surgery of the horizontal recti muscles with inferior displacement and augmented anterior transposition of the inferior oblique muscle with a posterior intermuscular suture in a patient with large exotropia and considerable hypertropia.

Contrast sensitivity measurement with 2 contrast sensitivity tests in normal eyes and eyes with cataract.

PURPOSE: To assess the reliability of and correlation between 2 contrast sensitivity tests in normal eyes and eyes with cataract. SETTING: Department of Ophthalmology, Yonsei University Hospital, Seoul, Korea. METHODS: The Vision Contrast Test System (wall-chart test) and Optec 6500 system (view-in test) were used to measure contrast sensitivity in normal eyes at 2 visits separated by 2 weeks and in eyes with cataract before and 2 months after cataract surgery. The test-retest reliability and correlation were calculated by the intraclass correlation coefficient (ICC), coefficient of repeatability (COR), and 95% range of difference using the Bland-Altman method. RESULTS: The study evaluated 40 normal eyes of 20 subjects and 44 eyes of 38 cataract patients. The repeatability of the 2 test methods was generally acceptable. The view-in test performed better than the wall-chart test in the ICC analysis (0.85 versus 0.65) but not in the COR analysis (+/-0.20 log versus +/-0.27 log). Correlation between the 2 tests was poor in both groups of eyes. The ceiling effect was greater with the wall-chart test. The floor effect occurred mainly in patients with cataract, in which it was greater preoperatively than postoperatively; at high frequency; and with the view-in test. CONCLUSION: Based on the ceiling and floor effect, the view-in test is better for detecting subtle contrast sensitivity changes in normal or near-normal eyes and the wall-chart test is useful in eyes with compromised vision. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Acute syphilitic posterior placoid chorioretinitis following intravitreal triamcinolone acetonide injection.

BACKGROUND: We describe the ophthalmic features and clinical course of two cases of acute syphilitic posterior placoid chorioretinitis (ASPPC) that developed after intravitreal triamcinolone acetonide (IVTA) injection. METHODS: Case report. RESULTS: Two patients with ocular inflammation of unknown origin developed severe chorioretinitis after IVTA injection. Multiple retinal infiltrates, placoid subretinal lesions, and ground-glass opacity of the retina with hyperemic optic discs were observed in both patients. The etiology of the chorioretinitis was confirmed by serology to be syphilis. Appropriate treatment for neurosyphilis was instituted. Both eyes became atrophied and had poor visual outcome: 10/200 in one patient and no light perception in the other at 6 months after IVTA injection. CONCLUSIONS: The fundus picture shown in these cases may be typical of ASPPC after IVTA injection. Clinical suspicion of ASPPC upon observation of these characteristic features is crucial for early diagnosis and treatment.

Prognostic factors for visual outcome after intravitreal bevacizumab for macular edema due to branch retinal vein occlusion.

PURPOSE: To evaluate the prognostic factors for visual outcome after intravitreal bevacizumab injection to treat macular edema due to branch retinal vein occlusion (BRVO). METHODS: Fifty eyes of 50 consecutive patients treated with intravitreal bevacizumab for macular edema due to BRVO with minimum follow-up of 3 months were retrospectively reviewed. Patients were categorized into two groups according to the final visual acuity. Group 1 consisted of eyes with 5 or more ETDRS letters gain, and group 2 consisted of eyes with less than 5 letters improvement or which had worsened at last follow-up visit. Comparative clinical and fluorescein angiographic characteristics were analyzed between the two groups. RESULTS: Of 50 eyes, 28 (56%) had improved vision after intravitreal bevacizumab injections and were categorized as group 1; 22 eyes (44%) were categorized as group 2. The number of early VA gainers, who showed visual improvement at 1 month after bevacizumab injection, was significantly higher in group 1 (P < 0.001, chi-square test). The early gainers tend to maintain significantly better visual outcome until last follow-up. The number of eyes with angiographically documented macular ischemia was significantly higher in group 2 (P < 0.001). In group 2, the decrease in central macular thickness was not accompanied by visual acuity improvement. CONCLUSION: Preoperative presence of macular ischemia can be useful in predicting the outcome of visual acuity after intravitreal bevacizumab for macular edema due to BRVO. The early gainers who favorably responded to the initial intravitreal bevacizumab injection are most likely to benefit from the bevacizumab treatment.

Enantioselective reductive coupling of 1,3-enynes to glyoxalates mediated by hydrogen: asymmetric synthesis of beta,gamma-unsaturated alpha-hydroxy esters.

Catalytic hydrogenation of 1,3-enynes 1a-8a in the presence of ethyl glyoxalate at ambient pressure and temperature using a rhodium catalyst modified by (R)-(3,5-tBu-4-MeOPh)-MeO-BIPHEP results in highly regio- and enantioselective reductive coupling to furnish the corresponding alpha-hydroxy esters 1b-8b. As demonstrated by the elaboration of alpha-hydroxy ester 1b, the terminal and internal olefin moieties embodied by the diene side chain are subject to selective manipulation, one over the other.

Catalytic enantioselective Friedel-Crafts alkylations of indoles with alpha'-phosphoric enones.

The C2-symmetric bis(oxazoline) copper(II) complex proves to be an excellent catalyst in the Friedel-Crafts alkylation of indoles with alpha'-phosphoric enones. The enantioselectivities of this reaction are obtained in up to 98% ee.

A convenient synthesis of alpha-methylene-gamma-butyrolactones from allenyl carbonyl units mediated by Mo(CO)6 through intramolecular cyclocarbonylation.

A novel procedure for the synthesis of cis-fused bicyclic alpha-methylene-gamma-butyrolactones from allenyl carbonyl functionalities via the molybdenum-mediated cyclocarbonylation is described. The use of Mo(CO)(6) with DMSO to promote reaction results in an efficient and convenient protocol through the three-component assembly in high yields.

Highly diastereoselective Prins-type cyclisation of cyclopropylvinylic aldehydes mediated by TiCl4.

A novel intramolecular Prins type cyclisation of cyclopropylvinylic aldehydes promoted by TiCl(4) under mild reaction conditions to form cis-cyclic products in high yields has been accomplished.

Silylative carbocyclization of allenyl-carbonyl units with Et3SiH catalyzed by rhodium: cis-stereoselective synthesis of homoallylic cycloalkanols.

[reaction: see text] A new procedure for the synthesis of cis-2-triethylsilylvinyl-cyclopentanols and -cyclohexanols from allenyl-aldehydes and -ketones with Et(3)SiH through rhodium-catalyzed silylative carbocyclization is described. The use of Rh(acac)(CO)(2) (1 mol %) to promote the reaction results in a mild and convenient protocol for the three-component assembly.