Inter-Segmental Coordination Pattern in Patients with Anterior Cruciate Ligament Deficiency during a Single-Step Descent.

Anterior cruciate ligament injury is a debilitating pathology which may alter lower limb coordination pattern in both intact and affected lower extremities during activities of daily living. Emerging evidence supports the notion that kinematic variables may not be a good indicator to differentiate patients with anterior cruciate ligament deficiency during step descent task. The aim of the present study was to examine alterations in kinematics as well as coordination patterns and coordination variability of both limbs of these patients during a single step descent task. Continuous relative phase technique was used to measure coordination pattern and coordination variability between a group of anterior cruciate ligament deficient (n = 23) and a healthy control group (n = 23). A third order polynomial Curve fitting was utilized to provide a curve that best fitted to the data points of coordination pattern and coordination variability of the healthy control group. This was considered as a reference to compare to that of patient group using nonlinear regression analysis. The results of the present study demonstrated an altered coordination pattern of the supporting shank-thigh and the stepping foot-shank couplings in anterior cruciate ligament deficient subjects. It was further noticed that there was an increased coordination variability in foot-shank and shank-thigh couplings of both supporting and stepping legs. There was no significant difference in the hip, knee and ankle joints kinematics in either side of these patients. Anterior cruciate ligament deficient individuals showed altered strategies in both intact and affected legs, with increased coordination variability. Kinematic data did not indicate any significant difference between the two groups. It could be concluded that more sophisticated dynamic approach such as continuous relative phase would uncover discrepancies between the healthy and anterior cruciate ligament deficient individuals.

Vector analysis of cross cylinder LASIK with the NIDEK EC-5000 excimer laser for high astigmatism.

PURPOSE: To evaluate visual outcomes of LASIK in eyes with high astigmatic refractive errors with low spherical component. METHODS: We prospectively evaluated cross cylinder LASIK in patients with high astigmatic eyes with low spherical component over a 2-year period. All laser surgeries were performed with the NIDEK EC-5000 excimer laser. We used power vectors (M [spherical equivalent] and J(0), and J(45) [cylinder]) to analyze the astigmatic results. Main outcome measures were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, and complications. RESULTS: Thirty-four eyes of 22 patients were included. Patients were followed for 21.8+/-3.7 months. At the last examination, UCVA of 20/40 or better was observed in 33 (97.1%) eyes. Best spectacle-corrected visual acuity after LASIK improved significantly in comparison to BSCVA before surgery (P<.005). Mean preoperative cylinder was -4.73+/-0.89 diopters (D) (range: -4.00 to -7.00 D), which decreased to -0.29+/-0.47 D (range: 0.00 to -1.50 D) at last follow-up (P<.001). Reduction in the magnitude of power vectors was 92.4% for M, 103.2% for J(0), and 76.4% for J(45). No cases of post-operative astigmatic regression or corneal haze were observed. CONCLUSIONS: Cross cylinder LASIK with the NIDEK EC-5000 excimer laser is a successful procedure for correcting high astigmatism and improving vision.

Granular corneal dystrophy manifesting after radial keratotomy.

PURPOSE: To report a case of granular corneal dystrophy after radial keratotomy (RK). METHODS: A 32-year-old man presented with white radial lines in both corneas. He had a history of uncomplicated RK in both eyes 8 years ago. Preoperative refraction had been OD -3.5-0.75 x 180 and OS -3.0-0.5 x 175. The cornea was reported to be clear on postoperative examinations. RESULTS: Postoperative uncorrected visual acuity was OD 20/30 and OS 20/40. Best-corrected visual acuity was 20/25 in both eyes with OD -0.5-0.5 x 60 and OS -0.75-0.5 x 80. Slit-lamp examination revealed discrete well-demarcated whitish lesions with clear intervening stroma in the central anterior cornea consistent with granular dystrophy. Similar opacities were present within the RK incisions. CONCLUSIONS: Production and deposition of such abnormal material could be due to keratocyte activation after RK or proliferation and migration of epithelial cells with a tendency to express abnormal keratoepithelin.

Novel genetic-neuro-fuzzy filter for speckle reduction from sonography images.

Edge-preserving speckle noise reduction is essential to computer-aided ultrasound image processing and understanding. A new class of genetic-neuro-fuzzy filter is proposed to optimize the trade-off between speckle noise removal and edge preservation. The proposed approach combines the advantages of the fuzzy, neural, and genetic paradigms. Neuro-fuzzy approaches are very promising for nonlinear filtering of noisy images. Fuzzy reasoning embedded into the network structure aims at reducing errors while fine details are being processed. The learning method based on the real-time genetic algorithms (GAs) performs an effective training of the network from a collection of training data and yields satisfactory results after a few generations. The performance of the proposed filter has been compared with that of the commonly used median and Wiener filters in reducing speckle noises on ultrasound images. We evaluate this filter by passing the filter's output to the edge detection algorithm and observing its ability to detect edge pixels.Experimental results show that the proposed genetic-neuro-fuzzy technique is very effective in speckle noise reduction as well as detail preserving even in the presence of highly noise corrupted data, and it works significantly better than other well-known conventional methods in the literature.