Is the Pupil Involved in Duane Syndrome?: Static and Dynamic Pupillometry Characteristics

Objectives:Duane syndrome (DS) is typically characterized by abduction and/or adduction deficiency accompanied by eyelid and ocular motility disturbances. Maldevelopment or absence of the sixth nerve has been shown to be the causative factor. The aim of the present study was to investigate static and dynamic pupillary characteristics in patients with DS and compare the results with those of healthy eyes.Materials and Methods:Patients with unilateral isolated DS and no history of ocular surgery were enrolled in the study. Healthy subjects with a best corrected visual acuity (BCVA) of 1.0 or higher were assigned to the control group. All subjects underwent complete ophthalmological examination and pupillometry measurements (MonPack One, Vision Monitor System, Metrovision, Perenchies, France) including static and dynamic pupil evaluation.Results:A total of 74 patients (22 with DS and 52 healthy subjects) were included in the study. The mean age of the DS patients and healthy subjects was 11.05±5.19 and 12.54±4.05 years, respectively (p=0.188). There was no difference in sex distribution (p=0.502). Mean BCVA differed significantly between eyes with DS and healthy eyes, and between healthy eyes and the fellow eyes of DS patients (p0.05 for all).Conclusion:In the light of the results of the present study, the pupil seems to be not involved in DS. Larger studies including more patients with different types of DS in different age groups or comprising patients with non-isolated DS may reveal different findings

The importance of diffusion apparent diffusion coefficient values in the evaluation of soft tissue sarcomas after treatment

Purpose: In our study, we aimed to show the efficiency of diffusion-weighted images at different b-values and apparent diffusion coefficient (ADC) values in the differentiation of recurrent tumours from post-treatment tissue changes. Material and methods: The conventional and diffusion magnetic resonance images (MRIs) of 42 patients operated for soft tissue sarcomas between June 2012 and March 2015 followed up with MRIs that were evaluated by 2 radiologists retrospectively. Diffusion MRIs were acquired at 4 different b-values (50, 400, 800, 1000 s/mm2). The lesions were classified according to conventional MRI findings as post-treatment changes and recurrent tumours. Results: When the patient group with recurrent tumours was compared with the patient group with postoperative changes the ADC calculations were statistically significantly lower for the recurrent tumours at all b-levels (p < 0.001 for all b-levels). The sensitivity of b-50 values lower than 3.01 × 103 mm²/s in showing recurrent tumours was 100% and the specificity was 77.78%. The sensitivity of b-400 values lower than 2.1 × 103 mm²/s in showing recurrent tumours was 80% and the specificity was 96.3%. The sensitivity of b-800 values lower than 2.26 × 103 mm²/s in showing recurrent tumours was 100% and the specificity was 88.89%. The sensitivity of b-1000 values lower than 2 × 103 mm²/s in showing recurrent tumours was 93.3% and the specificity was 92.5%. Conclusions: The ADC values obtained from diffusion-weighted images have high sensitivity and specificity in differentiating recurring soft tissue sarcomas during monitoring after treatment from postoperative changes

A Novel Medical Image Enhancement Algorithm for Breast Cancer Detection on Mammography Images Using Machine Learning

Mammography is the most preferred method for breast cancer screening. In this study, computer-aided diagnosis (CAD) systems were used to improve the image quality of mammography images and to detect suspicious areas. The main contribution of this study is to reveal the optimal combination of various pre-processing algorithms to enable better interpretation and classification of mammography images because pre-processing algorithms significantly affect the accuracy of segmentation and classification methods. In this study, the effect of combinations of different preprocessing methods in differentiating benign and malignant breast lesions was investigated. All image processing algorithms used for lesion detection were used in the mini-MIAS database. In the first step, label information and pectoral muscle resulting from the acquisition of mammography images were removed. In the second step, median filter (MF), contrast limited adaptive histogram equalization (CLAHE), and unsharp masking (USM) algorithms with different combinations of the resolution and visibility of images are increased. In the third step, suspicious regions are extracted from the mammograms using the k-means clustering technique. Then, features were extracted from the obtained ROIs. Finally, feature datasets were classified as normal/abnormal, and benign/malign (two class classification) using Machine Learning algorithms. Test performance measures of the classification methods were examined. In both classifications made in the study, lower classification performance values were obtained when the CLAHE algorithm was used alone as a pre-processing method compared to other pre-processing combinations. When the median filter and unsharp masking algorithms are added to the CLAHE algorithm, the performance of the classification methods has increased. In terms of classification success, Support Vector Machines, Random Forest, and Neural Networks showed the best performance. It was found by comparing the performances of the classification methods that different preprocessing algorithms were effective in detecting the presence of breast lesions and distinguishing benign and malignant

Role of Comorbidities as Limiting Factors to The Effect of Hyperbaric Oxygen in Diabetic Foot Patients: A Retrospective Analysis

Introduction The effectiveness of hyperbaric oxygen therapy (HBOT) on selected diabetic foot wounds continues to be controversial. A holistic approach to diabetes and its comorbidities may be beneficial in the discussion of the proper application of this treatment modality. The aim of the current study is to evaluate the efficacy of HBOT on diabetic foot wounds and provide clinical data that may support this knowledge. Methods The present study was a retrospective analysis of the effect of HBOT on diabetic foot lesions ranging 3–5 on the Wagner Grading System. Patients had been treated with HBOT and monitored for 12 months. The results were analyzed in relation to age, gender, diabetes duration and type, microangiopathic complications, peripheral arterial disease (PAD), history of coronary artery disease, stroke, hypertension, smoking habits, glycated hemoglobin, blood sedimentation rate, C-reactive protein, and number of HBOT sessions. Microangiopathies were evaluated as retinopathy, nephropathy, and neuropathy. PAD was determined by available color Doppler ultrasonography and/or angiographic data depending on a modified scoring system. The data of arteries from the aorta to the dorsal pedal artery were scored singly. Average scores of aorto-iliac, femoral, popliteal and pedal levels were also evaluated with this system to compare the healing results in relation to PAD. Results One hundred and seventeen patients with 126 diabetic foot wounds were treated. Histories of coronary artery disease, stroke, and non-proliferative or proliferative retinopathy had negative effects on HBOT (P = 0.002, P = 0.015, P = 0.022, respectively). Depending on the scorings of PAD, the single arterial scores and average scores of aorto-iliac, popliteal and pedal levels had no relation to outcomes, while the average scores of the femoral arterial level affected the results (P = 0.048). Conclusions Diabetic foot patients with histories of coronary artery diseases or stroke and non-proliferative or proliferative retinopathy might resist HBOT. PAD at the femoral arterial level has been shown to have a significant negative effect on HBOT outcomes that should be first considered for surgery. In contrast, PAD below the knee does not seem to be an obstacle to the efficacy of HBOT. Electronic supplementary material The online version of this article (doi:10.1007/s13300-014-0085-8) contains supplementary material, which is available to authorized users.PubMedWoSScopu

Application of Draw an Engineer Test (DAET) for a Better Understanding of Middle School Students’Conceptions of Engineering

Engineering is a discipline in STEM, an educational approach that consists of Science, Technology, Engineering and Mathematics. Engineering applications are favoured in Turkey according to 2017 Science curriculum to improve students’ 21st century skills. To integrate engineering applications to Turkish Science curriculum efficiently, we must understand students’ conceptions of engineering. This study was done to understand middle school students’ conceptions of engineering. Total 75 students from 2 public schools, 43 female and 32 male who are 25 of each 6th, 7th and 8th grade were applied “Draw-An-Engineer-Test(DAET)”. DAET is a research tool for examining students’ conceptions by interpreting their drawn and written reflections. Some outstanding results show male students do not consider engineering as career for women while female students think that engineering is a profession for both genders, students have tendency to civil engineering, and as grade gets higher the conception of engineering is getting narro

Severe Preeclampsia Versus Hellp Syndrome: Maternal and Perinatal Outcomes At <34 And >= 34 Weeks' Gestation

Background: Preeclampsia and Hemolysis, Elevated Liver enzymes, Low Platelet (HELLP) syndrome are important disorders affecting the health of both the mother and fetus. Prediction of the maternal and perinatal outcomes at early and late gestational age is important for the management of both disorders. Aims: The purpose of the study was to investigate adverse maternal and perinatal outcomes in severe preeclampsia and HELLP syndrome cases according to gestational age. Study Design: Retrospective cross-sectional study. Methods: One hundred and ninety-seven pregnancies with severe preeclampsia and 56 pregnancies with HELLP syndrome were included the study. Clinical characteristics and adverse maternal and perinatal outcomes were noted from medical records. Participants were divided into two groups at = 34 weeks' gestation: the severe preeclampsia group and the HELLP syndrome group. The differences between the outcomes in the groups were investigated. Statistical analysis was performed using the Student t test, Fisher Exact test and Yates' Chi-square test. Results: Eclampsia was more common in HELLP syndrome cases at = 34 weeks' gestation. The requirement for blood products transfusion was higher in the HELLP group at all gestational weeks. No statistical difference was found in perinatal outcomes between severe preeclampsia and HELLP groups at less than and more than 34 weeks' gestation. Conclusion: Eclampsia risk increases in HELLP syndrome, especially at gestations less than 34 weeks. Perinatal morbidity at less than 34 weeks' gestation and mortality were similar in severe preeclampsia and HELLP syndrome cases at the same gestational age.WoSScopu

The Performance Of Hemoglobin A1C Against Fasting Plasma Glucose And Oral Glucose Tolerance Test In Detecting Prediabetes And Diabetes

Background: In recent years, hemoglobin A1c (HbA1c) is accepted among the algorithms used for making diagnosis for diabetes and prediabetes since it does not require subjects to be prepared for giving a blood sample. The aim of this study is to assess the performance of HbA1c against fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) in detecting prediabetes and diabetes. Materials and Methods: A total of 315 subjects were included in this study. The success of HbA1c in distinguishing the three diagnostic classes was examined by three-way receiver operating characteristic (ROC) analysis. The best cut-off points for HbA1c were found for discriminating the three disease status. Results: The performance of HbA1c, measured by the volume under the ROC surface (VUS), is found to be statistically significant (VUS = 0.535, P < 0.001). The best cut-off points for discriminating between normal and prediabetes groups and between prediabetes and diabetes groups are c1 = 5.2% and c2 = 6.4% respectively. Conclusion: The performance of HbA1c in distinguishing between the prediabetes and diabetes groups was higher than its ability in distinguishing between healthy and prediabetes groups. This study provides enough information to understand what proportion of diabetes patients were skipped with the HbA1c especially when the test result is healthy or prediabetes. If a subject was diagnosed as healthy or prediabetes by HbA1c, it would be beneficial to verify the status of that subject by the gold standard test (OGTT and FPG).PubMe

Histopathological Findings of Cystic Endometrial Morphology Based on Ultrasonographic Imaging in Premenopausal Women

Objective: To evaluate the histopathological findings of cystic endometrial morphology based on ultrasonographic imaging in premenopausal women. Study Design: The medical records of 3607 premenopausal women that underwent ultrasonographic examination at a tertiary care center were reviewed, as were endometrial biopsy findings in 816 of the women. These 816 women were divided in 2 groups according to ultrasonographic endometrial findings: the cystic group and the non-cystic group. Clinical and histopathological findings in the 2 groups were compared. Statistical analysis was performed using independent samples t test, chi-square test, and binary logistic regression analysis. Results: Three hundred and eighty one (46.7%) of the women that underwent endometrial biopsy had cystic endometrium, whereas 435 (53.3%) had non-cystic endometrium. The most common histopathological finding in the cystic group was endometrial hyperplasia without atypia (44.6%). Cystic morphology was nearly 8-fold more common in the women with endometrial hyperplasia without atypia (95% CI: 5.43-11.67). The premalignant and malignant pathology rates in the cystic group and non-cystic group were similar (1.1% vs. 0.5% [p=0.426] and 0.8% vs. 0.5% [p=0.669], respectively). Secretory endometrium was less common in the cystic group than in the non-cystic group (5.0% vs. 37.9% [p< 0.001]) Conclusion: Cystic endometrial morphology based on ultrasonographic imaging was more common in women with endometrial hyperplasia without atypia. There wasn’t an association between cystic endometrium and other endometrial pathologies or functional endometrium. Keywords: Cystic endometrium, Endometrium, Endometrial hyperplasia, Premenopausal, Ultrasonograph

Upper Airway Features Of Unilateral Cleft Lip And Palate Patients In Different Growth Stages

Objectives: To compare growth-related changes of skeletal and upper airway features of unilateral cleft lip and palate subjects (UCLP) with non-cleft control (NCC) subjects by using lateral cephalograms. Materials and Methods: The sample comprised 238 subjects, collected cross-sectionally, divided into 2 groups: 94 with UCLP, and 144 NCC, subdivided into 4 groups according to their growth stages by using cervical vertebral maturation stage (CVMS). The subgroups were defined as early childhood (stage 1), prepubertal (stage 2: CVMS I and II), pubertal (stage 3: CVMS III and IV), and postpubertal (stage 4: CVMS V and VI). Results: The maxilla was more retrognathic at stages 2, 3, and 4 in females with UCLP. The mandible was more retrognathic in UCLP at stage 1 in males, and stages 2 and 3 in females. ANB (angle between NA plane and NB plane) was significantly smaller in UCLP subjects at stage 4 for both sexes. A vertical growth pattern was seen in UCLP subjects except males at stages 2 and 3, and females at stage 2. Posterior airway space was significantly narrower at all stages in males and after stage 1 in females. Middle airway space was significantly wider at all stages in females and after stage 1 in males. Epiglottic airway space was significantly narrower in males at stage 3. Conclusions: Age-and sex-dependent differences in skeletal morphology and upper-airway widths of the UCLP subjects were identified when compared with controls.WoSScopu