Multifokale Elektroretinographie bei retinalen Gefäßverschlüssen

To examine and quantify the central retinal function in patients with retinal vascular disorders such as CRVO, BRVO and BRAO using the multifocal ERG. We examined 23 patients (9 patients with CRVO (age 67,2±9,8 years), 7 patients with BRVO (85,7±11,0) and 7 patients with BRAO (65,3±14,0) using a RETI-scan device (Roland Instr., Wiesbaden) and stimulated by an ELSA 20“-VGA-monitor. As resolution we used 61 hexagons within a 24 deg. visual field. We compared the examination results of the affected eyes with the non-affected eyes of the patients and with standard values of a normal collective. CRVO and BRVO: Diminuation of a- and b- wave amplitude tendentially compared with the normal collective and significantly compared to the fellow eye (p<0,0001). BRAO: No significant amplitude changes could be detected in our collective of patients. The latency of the b-wave was significantly delayed in all three groups compared to normal and to fellow eye (p<0,0001). Retinal vascular occlusions lead to characteristical changes in multifocal electroretinography. Future studies have to show if this technique can give prognostic information about neovascularisation risks. The intraindividual comparison of affected and fellow eye promises to be more sensitive than comparison with a normal collective

Multifokale Elektroretinographie bei retinalen Gefäßverschlüssen

To examine and quantify the central retinal function in patients with retinal vascular disorders such as CRVO, BRVO and BRAO using the multifocal ERG. We examined 23 patients (9 patients with CRVO (age 67,2±9,8 years), 7 patients with BRVO (85,7±11,0) and 7 patients with BRAO (65,3±14,0) using a RETI-scan device (Roland Instr., Wiesbaden) and stimulated by an ELSA 20“-VGA-monitor. As resolution we used 61 hexagons within a 24 deg. visual field. We compared the examination results of the affected eyes with the non-affected eyes of the patients and with standard values of a normal collective. CRVO and BRVO: Diminuation of a- and b- wave amplitude tendentially compared with the normal collective and significantly compared to the fellow eye (p<0,0001). BRAO: No significant amplitude changes could be detected in our collective of patients. The latency of the b-wave was significantly delayed in all three groups compared to normal and to fellow eye (p<0,0001). Retinal vascular occlusions lead to characteristical changes in multifocal electroretinography. Future studies have to show if this technique can give prognostic information about neovascularisation risks. The intraindividual comparison of affected and fellow eye promises to be more sensitive than comparison with a normal collective

Visualization of Polypropylene and Polyvinylidene Fluoride Slings in Perineal Ultrasound and Correlation with Clinical Outcome

Introduction and Hypothesis. Complications and malfunctioning after TOT can occur due to several factors, such as the material of the sling. The aim of the present study is to evaluate morphology and functionality of two types of slings (PVDF; polypropylene) in vivo using perineal ultrasound (PUS). Materials. In n=47 women with TOT four criteria for PUS were taken and checked for possible differences: vertical stability of the sling position during Valsalva manoeuvre and contraction; distance “sling to urethra”; width of the sling and condition of the selvedges. Results. We observed an increased vertical displacement of the PP-slings, a significantly smaller variance to the extent of the displacement in PVDF-slings (P<0.01), a significantly larger distance between sling and urethra (P<0.001) in PVDF-slings, and a significantly smaller width of the PP-slings (P<0.0001). Conclusion. Significant differences were found between the slings according to the four criteria. There was no difference established between the slings in the improvement of continence and no significant influence of the parameters was found for the resulting state of continence. In future studies, PUS may help to link differences in the morphology and functionality of in vivo slings to their material properties

Perianal ultrasound (PAUS): visualization of sphincter muscles and comparison with digital-rectal examination (DRE) in females

Abstract Background The aim of this study was to determine the reproducibility and tolerance of perianal ultrasound (PAUS) and detect differences in sphincter muscles between various measuring positions and different maneuvers. PAUS was compared to digital-rectal examination (DRE) to see if sphincter contraction is visible and gradable in ultrasound volumes. Methods Fifty women underwent a medical history, DRU and PAUS by two uro-gynecologists in a prospective trial. PAUS volumes were measured via different parameters in different maneuvers. Examiners’ DRE impressions of sphincter tone were scaled with the DRESS-score. All patients completed a questionnaire. Results Thirty-five patients with complete PAUS and DRE were included in the study. Fifteen patients were excluded due to poor ultrasound volume quality or sphincter defects. Comparison of sphincter muscle thickness at different positions in PAUS showed significant differences between 6 and 12 o’clock positions (12 > 6 o’clock) and diameters (horizontal > vertical). No difference was found between the examiners. In comparison of rest and contraction only the vertical diameter changed. There was a negative but not significant correlation between PAUS measurements and DRESS-scores. Twenty-six patients completed the questionnaire that revealed women preferred PAUS over DRE. Conclusion PAUS is a reproducible and good tool to visualize the anal canal. It is comfortable for patients and easily handled by examiners. Sphincter muscle contraction is iso-volumetric. Vertical diameter changes during contraction leading the anal canal change its shape to oval due to external influence. PAUS is the ideal additional tool to visualize relevant structures that are palpable on DRE

Anxiety in women referred for colposcopy: a prospective observational study

Purpose!#!To evaluate the occurrence of anxiety in women attending a colposcopic examination within the new cervical cancer screening in Germany.!##!Methods!#!One hundred and fifty-six patients were asked to fill out Spielbergers STAI inventory form prior to their colposcopic examination. For the statistical analysis, a two by two between-group design was applied including the following group factors: the repeat factors included patients, who presented to our centre of dysplasia for the first time (new) and patients who have had an examination in our centre before (repeat). Further, the factor diagnosis included two groups: first, patients with cervical dysplasia and second, patients with vulva diseases.!##!Results!#!The analysis of the STAI results showed that patients presenting with cervical dysplasia for the first time had the highest levels of anxiety, directly followed by new patients in the vulva group. The ANOVA revealed a main effect of the repeat factor, F(1,140) = 7.53, p = 0.007. There was no significant effect of diagnosis.!##!Conclusion!#!Regardless of the diagnosis, patients being transferred for a colposcopy within the cervical cancer screening program for the first time have very high anxiety levels. The prospect of a potentially painful examination seems to be a key factor. Only a scientific evaluation of the new cervical cancer screening will be able to show if the rising numbers of colposcopic examinations is really worth the risk of exposing so many more women to the emotional distress of a colposcopy