Outcomes of External Dacryocystorhinostomy and Effects of the Incision Type on Cosmetic and Functional Outcomes

 Aim: Evaluation of external dacryocystorhinostomy surgery in patients with nasolacrimal canal obstruction and the effects of the incision type on the functional and esthetic outcomes. Material and Methods: Outcomes of 49 patients who underwent external dacryocystorhinostomy and bicanalicular silicon tube intubation(when necessary) for nasolacrimal canal obstruction between 2004 and 2008 were evaluated retrospectively. The effects of oblique incision, used between 2004-2005, and the vertical incision, used between 2006-2008, on the functional and cosmetic outcomes were evaluated. The patients were asked to complete a survey on preoperative symptoms, functional outcomes of the operation, and the patient satisfaction with the scar tissue and cosmetic outcomes. The results were compared statistically. Results: Mean age of the 49 patients (35 females and 14 males) was 42.63±15.57 (19-72). Except for the 2 patients operated in other centers, first operations of 47 patients were performed in our clinic. Five patients required revision surgery due to functional failure. Jones’ tube implantation was performed in 1 of the 3 patients with persistant epiphora. No serious complications were observed postoperatively, except for mild nasal hemorrhage. Three patients, (2 of witch had persistent epiphora), were not satisfied with the surgery. Silicon intubation was performed to 21 patients during surgery. Outcomes were satisfactory in 46 patients. In each of the 2 incision groups, 7 patients had noticeable scars but they were satisfied esthetically. It was observed that the type of incision used, either oblique or vertical, had no effect on the functional outcome of surgery. On the contrary, it was determined that vertical incision yielded better cosmetic outcomes.Conclusion: External dacryocystorhinostomy is a successful surgery for patients with nasolacrimal canal obstruction. Incision type does not affect the functional outcomes of the surgery but it does affect the cosmetic outcomes

Network characterization of packing architecture for condensed matter systems

Networks have currently been used to model real life complex systems and they have provided additional understanding for characterizing structure-functiondynamics relationships of these complex architectures. Here we investigate statistical and spectral properties and the connections between local motifs and global behavior of networks that are formed from condensed matter systems, particularly proteins, as well as micelles, polymeric melts and Lennard-Jones clusters. Proteins are considered as interacting residue networks. Pathways for information transfer manifested in the average path lengths are analyzed, where the energy of residue-residue interactions are imposed as edge weights in networks. Systematic removal of ''low energy'' interactions reveals that the network contains significant number of redundancies that provide high local clustering. The information transfer is achieved by a small number of highly clustered groups of residues, which makes the hub architecture different from that of scale-free networks. This result is then extended to protein complexes, where two proteins (ligand and receptor) interact, in order to identify essential pair-wise interactions between two proteins. In the presence of local clustering, establishing a relationship between local structure and global properties is far from trivial. But for certain cases, applying a bottom-up approach, a relation between nearest neighbors and next-to-nearest neighbors is obtained and this relation is observed in different networks formed from condensed matter systems, as well as perfect lattice models. To further investigate the association between local order and global structure, residue networks are considered in further detail. To outline local order, we compared residue networks to perfect lattice systems by creating self-avoiding chains on chains via Metropolis Monte Carlo method that capture three dimensional structure of protein chains as much as possible. Results show that, proteins conform to close packed ordered structures with significant voids irrespective of the underlying lattice bases. Finally, we analyzed the spectral properties of networks used throughout the thesis. Spectral changes while breaking and rewiring the edges revealed the importance and roles of short and long-ranged contacts in determining the network structure. Comparison of spectra distributions of different networks constructed from condensed matter systems supported the result from statistical parameters that these systems have structural similarities

Assortative mixing in close-packed spatial networks

Background In recent years, there is aroused interest in expressing complex systems as networks of interacting nodes. Using descriptors from graph theory, it has been possible to classify many diverse systems derived from social and physical sciences alike. In particular, folded proteins as examples of self-assembled complex molecules have also been investigated intensely using these tools. However, we need to develop additional measures to classify different systems, in order to dissect the underlying hierarchy. Methodology and Principal Findings In this study, a general analytical relation for the dependence of nearest neighbor degree correlations on degree is derived. Dependence of local clustering on degree is shown to be the sole determining factor of assortative versus disassortative mixing in networks. The characteristics of networks constructed from spatial atomic/molecular systems exemplified by self-organized residue networks built from folded protein structures and block copolymers, atomic clusters and well-compressed polymeric melts are studied. Distributions of statistical properties of the networks are presented. For these densely-packed systems, assortative mixing in the network construction is found to apply, and conditions are derived for a simple linear dependence. Conclusions Our analyses (i) reveal patterns that are common to close-packed clusters of atoms/molecules, (ii) identify the type of surface effects prominent in different close-packed systems, and (iii) associate fingerprints that may be used to classify networks with varying types of correlations

Assortative Mixing in Close-Packed Spatial Networks

Background: In recent years, there is aroused interest in expressing complex systems as networks of interacting nodes. Using descriptors from graph theory, it has been possible to classify many diverse systems derived from social and physical sciences alike. In particular, folded proteins as examples of self-assembled complex molecules have also been investigated intensely using these tools. However, we need to develop additional measures to classify different systems, in order to dissect the underlying hierarchy. Methodology and Principal Findings: In this study, a general analytical relation for the dependence of nearest neighbor degree correlations on degree is derived. Dependence of local clustering on degree is shown to be the sole determining factor of assortative versus disassortative mixing in networks. The characteristics of networks constructed from spatial atomic/molecular systems exemplified by self-organized residue networks built from folded protein structures and block copolymers, atomic clusters and well-compressed polymeric melts are studied. Distributions of statistical properties of the networks are presented. For these densely-packed systems, assortative mixing in the network construction is found to apply, and conditions are derived for a simple linear dependence. Conclusions: Our analyses (i) reveal patterns that are common to close-packed clusters of atoms/molecules, (ii) identify the type of surface effects prominent in different close-packed systems, and (iii) associate fingerprints that may be used t

DETERMINATION OF NUTRITION KNOWLEDGE LEVELS OF 9–12 AGE GROUP TENNIS ATHLETES

Objective: This study was aimed to determine the nutritional knowledge levels of 9–12 age group tennis athletes according to the variables of age, gender, year of sports and parental education.Material and Method: Based on this purpose, the research sample consists of a total of 171 tennis athletes in the 9–12 age group, competitors n: 91 girls and n: 80 boys. In the collection of the data and determination of the nutritional knowledge levels of the athletes, a 5-scale form consisting of 26 questions that Laurie et al. (2003) used in their research was taken into consideration. The obtained data were transferred to electronic media and analyzed in SPSS 22.0 package program

Anatomical and visual outcomes of ranibizumab injections in retinal pigment epithelium tears

ABSTRACT Purpose: To report the anatomical and visual results in patients diagnosed as having retinal pigment epithelium (RPE) tears after receiving ranibizumab injections. Methods: Eyes diagnosed as having RPE tears with a minimum 6-month follow-up were retrospectively evaluated. Each eye was treated with at least three doses of ranibizumab at monthly intervals. Best-corrected visual acuity (BCVA), anterior segment findings, intraocular pressure, and fundus examination results were evaluated during control visits. Color fundus photography, fundus fluorescein angiographies, fundus autofluorescence, and spectral domain optical coherence tomography (SD-OCT) images were obtained. The height of pigment epithelial detachment (PED) was measured by SD-OCT. Results: Twelve eyes with RPE tears were studied. Nine eyes (75%) developed RPE tears during ranibizumab injections for choroidal neovascularization (eight eyes with vascularized PED and one eye with choroidal osteoma), and tears occurred in three eyes before any injections. The median number of ranibizumab injections after diagnosis of RPE tears was 3 (min 2, max 5). In the most recent follow-up visit, there was no statistically significant correlation between the grade of RPE and logMAR of BCVA (p>0.05, r=0.112). Eight of twelve eyes had PED, and seven of these had irregular PED contours before injection therapy. The mean PED height was 447 ± 122 µm. Conclusions: In this series, RPE tears developed mostly after intravitreal anti-VEGF injections for vascularized PED. Increased vertical height and irregular contours of the PEDs can be risk factors for the formation of RPE tears. The continuation of anti-VEGF therapy after tear formation is beneficial for vision improvement in eyes with RPE tears

Primary cutaneous adenoid cystic carcinoma of the eyelid and literature review

ABSTRACTPrimary cutaneous adenoid cystic carcinoma (PCACC) is a rare malignant epithelial tumor most commonly observed in the scalp and skin of the chest and originating from the palpebral portion of the lacrimal gland in the orbit. Here we describe the diagnosis and treatment of a rare case of PCACC in an eye of a 52-year-old male. The patient presented with a mass lesion of the right lower eyelid. During incisional biopsy, lack of encapsulation and a secretion pattern different to that of chalazion was observed, which differentiated the lesion from chalazion. Pathological analysis revealed the diagnosis of PCACC. This case highlights the importance of careful inspection for macroscopic differentiation of PCACC from chalazion after initial surgery and pathological evaluation of all surgically removed mass lesions for accurate diagnosis and treatment

Macular Findings Obtained by Spectral Domain Optical Coherence Tomography in Retinopathy of Prematurity

Purpose. To examine the macular findings obtained with spectral domain optical coherence tomography (SD OCT) in infants with retinopathy of prematurity (ROP). Materials and Methods. The macular SD OCT images of 190 premature infants were analyzed. Data regarding central foveal thickness (CFT), cystoid macular edema (CME), and cyst grading were compared. The relationships of CFT with gestational age and birth weight were investigated. Results. The results were obtained from 358 eyes of 179 infants (81 females and 98 males) of a mean gestational age of 30.9±2.7 weeks and a mean birth weight of 1609±477 g. ROP was diagnosed in 126 eyes and CME in 139 eyes. A significantly greater percentage of eyes with ROP were found to have CME (54%) compared to eyes without ROP (31%; P=0.001). The incidence of CME was 46.3% for stage 1 ROP, 57.1% for stage 2, and 87.5% for stage 3. There was a weakly inverse correlation between CFT, gestational age, and birth weight (P=0.025, r=-0.227; P=0.002, r=-0.182, resp., Spearman correlation test). Conclusions. High-quality SD OCT images can be obtained from premature infants using the iVue system. Severity and frequency of CME in premature infants increase as stage of ROP increases

Choroidal Thickness in Patients with Mild Cognitive Impairment and Alzheimer’s Type Dementia

Aim. To asses both choroidal thickness differences among Alzheimer’s type dementia (ATD) patients, mild cognitive impairment (MCI) patients, and healthy control (C) subjects and choroidal thickness relationships with cognitive performance. Methods. A total of 246 eyes of 123 people (41 ATD, 38 MCI, and 44 healthy C subjects) were included in this study. Complete ophthalmological and neurological examination was performed in all subjects. Choroidal thicknesses (CT) were measured at seven locations: the fovea, 500-1500-3000 μm temporal and 500-1500-3000 μm nasal to the fovea by enhanced depth imaging optical coherence tomography (EDI-OCT). Detailed neurological examination including mini mental state examination (MMSE) test which evaluates the cognitive function was applied to all participants. Results. The ages and genders of all participants were similar in all groups. Compared with healthy C subjects, the CT measurements at all regions were significantly thinner both in patients with ATD and in patients with MCI than in healthy C subjects (p<0.05). The MMSE scores were significantly different among ATD patients, MCI patients, and healthy C subjects. They were 19.3±1.8, 24.8±0.9, and 27.6±1.2 in ATD, MCI, and healthy controls, respectively (p<0.001). There were also significant correlation between MMSE score and choroidal thickness at each location (p<0.05). Conclusions. CT was reduced in ATD patients and MCI patients. Since vascular structures were affected in ATD patients and MCI patients, they had thin CT. Besides CT was correlated with degree of cognitive impairment. Therefore CT may be a new biomarker in diagnosis and follow-up of MCI and ATD patients

Cognitive performance of primary open-angle glaucoma and normal-tension glaucoma patients

ABSTRACT Purpose: To assess cognitive performance differences among primary open-angle glaucoma (POAG) patients, normal-tension glaucoma (NTG) patients, and healthy control (C) subjects. Methods: A total of 60 participants (20 POAG, 20 NTG, and 20 C subjects) were included in this study. A detailed ophthalmologic examination was performed on all participants. A spectral domain-optical coherence tomography (SD-OCT) system was used to measure the ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) thicknesses. To assess the cognitive performance of all participants, detailed neurological examinations, including the mini-mental state examination (MMSE), were performed by the same neurologist. Results: There were no significant differences among the groups in terms of age (p =0.348) or gender (p =0.935). The mean RNFL thicknesses were significantly different among the groups (85.2 ± 14.7, 76.8 ± 10.3, and 91.4 ± 7.7 µm in the POAG, NTG, and C subjects, respectively; p <0.001). The mean GC-IPL thicknesses were 77.5 ± 9.7 µm in the POAG group, 73.4 ± 7.8 µm in the NTG group, and 78.8 ± 3.8 µm in the C group. Differences among the groups were not statistically significant (p =0.085). MMSE scores were 26.1 ± 1.4, 25.7 ± 2.3, and 28.8 ± 0.9 in the POAG, NTG, and C groups, respectively. There were significant differences among the three groups (p <0.001). Specifically, there were significant differences between the NTG and C groups (p <0.001), and between the POAG and C groups (p =0.001). There was no significant difference between the POAG and NTG groups (p =0.595). Conclusions: There appear to be similar risk factors in glaucoma and neurodegenerative disorders that cause deterioration in cognitive performance. Comparing the low MMSE scores of the POAG and NTG patients with the scores of healthy C participants supports our hypothesis. Consequently, it is recommended that a neurologist should also examine glaucoma patients