Automatic characterization and segmentation of human skin using three-dimensional optical coherence tomography

A set of fully automated algorithms that is specialized for analyzing a three-dimensional optical coherence tomography (OCT) volume of human skin is reported. The algorithm set first determines the skin surface of the OCT volume, and a depth-oriented algorithm provides the mean epidermal thickness, distribution map of the epidermis, and a segmented volume of the epidermis. Subsequently, an en face shadowgram is produced by an algorithm to visualize the infundibula in the skin with high contrast. The population and occupation ratio of the infundibula are provided by a histogram-based thresholding algorithm and a distance mapping algorithm. En face OCT slices at constant depths from the sample surface are extracted, and the histogram-based thresholding algorithm is again applied to these slices, yielding a three-dimensional segmented volume of the infundibula. The dermal attenuation coefficient is also calculated from the OCT volume in order to evaluate the skin texture. The algorithm set examines swept-source OCT volumes of the skins of several volunteers, and the results show the high stability, portability and reproducibility of the algorithm.This paper was published in Optics Express and is made available as an electronic reprint with the permission of OSA. The paper can be found at the following URL on the OSA website: http://www.opticsinfobase.org/abstract.cfm?URI=oe-14-5-1862. Systematic or multiple reproduction or distribution to multiple locations via electronic or other means is prohibited and is subject to penalties under law

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A randomized controlled trial comparing the effects of dapagliflozin and DPP-4 inhibitors on glucose variability and metabolic parameters in patients with type 2 diabetes mellitus on insulin

Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose co-transporter 2 (SGLT2) inhibitors improve hyperglycemia, and the usefulness of co-administration of DPP-4 inhibitors and insulin therapy has been well established. However, it has been still uncertain whether combination therapy of SGLT2 inhibitors and insulin is superior to that of DPP-4 inhibitors and the latter. Therefore, we investigated the superiority of dapagliflozin on glucose fluctuation compared with DPP-4 inhibitors in patients with type 2 diabetes mellitus (T2DM) on insulin using a continuous glucose monitoring (CGM) system. Methods: In this prospective, randomized, open-label controlled trial, 36 patients with T2DM and treated with DPP-4 inhibitors and insulin therapy, were enrolled and allocated into two groups. The patients either switched their DPP-4 inhibitors to dapagliflozin 5 mg for 12 weeks, or continued their DPP-4 inhibitors for the same period. CGM analyses and metabolic markers were assessed before and after treatment periods. Results: In total, data from 29 patients were analyzed. There were no significant differences in the mean amplitude of glycemic excursions and other CGM profiles in either group after treatment. Within the dapagliflozin treatment group, significant reductions of body mass index and albuminuria, and increases of HbA1c, hemoglobin and hematocrit were observed, but improvement of albuminuria was not significant if compared with the DPP-4 continuation group. Conclusions: Combination therapy of dapagliflozin and insulin was not superior in glucose fluctuation to DPP-4 inhibitors on insulin. However, dapagliflozin may in part provide favorable effects on metabolism in patients with T2DM treated with insulin therapy

Intérêts de l’utilisation des mini-vis orthodontiques en tant qu’ancrage indirect dans la correction de l’égression d’incisives mandibulaires pour un patient présentant une classe II hypodivergente

Les anomalies dento-alvéolaires du sens vertical sont un problème commun chez les patients orthodontiques, mais restent souvent difficiles à traiter avec des mécaniques traditionnelles. Le cas décrit dans cet article illustre un traitement réalisé avec succès permettant la correction de l’égression d’incisives mandibulaires par l’utilisation de mini-vis en tant qu’ancrage indirect. Une femme (âgée de 22 ans et neuf mois) a consulté parce que ses incisives supérieures étaient protrusives et encombrées. Sa courbe de Spee excessive était causée par l’égression des incisives mandibulaires. Cette patiente présentait une sévère classe II, division 1 et une supraclusion importante. Après l’extraction des premières prémolaires mandibulaires et la successive phase de nivellement, les incisives égressées ont été ingressées par une nouvelle méthode, qui est une combinaison de l’utilisation d’arcs orthodontiques sectionnels et de mini-vis insérées dans la région des prémolaires. Après cette procédure, les incisives mandibulaires ont été ingressées de 6,5 mm sans effet indésirable. La durée totale du traitement actif était de 42 mois. L’occlusion obtenue et le profil facial satisfaisant ont été maintenus après 30 mois de contention. Notre nouvelle approche de l’ingression nous montre de nouvelles potentialités quant à la correction de supraclusions importantes