Purpose
To investigate the outcomes of fornix-based trabeculectomy in Japanese patients with glaucoma based on more than five years of preoperative data.
Study design
Retrospective case series
...Methods
This study consisted of 35 eyes of 35 Japanese glaucoma patients (mean age: 60.6, standard deviation (SD) 11.5 years) who received initial fornix-based trabeculectomy from a single ophthalmology clinic, with one or more reliable visual field test results per year from at least five years before and after the surgery. Measurements included postoperative mean intraocular pressure (IOP), standard deviation of IOP, medication scores, mean deviation slope, and total deviation slope were evaluated based on preoperative data. The relationship between mean IOP, SD-IOP and the visual field (VF) deterioration speed was also analysed.
Results
The mean follow-up period before surgery was 6.15 (SD 0.97) years and post surgery it was 5.95 (SD 0.63) years. The preoperative mean IOP of 14.6 (SD 2.3) mmHg significantly decreased to 9.2 (SD 2.2) mmHg (
P
<.001). The preoperative medication score 2.7 (SD 0.5) significantly decreased to 0.1 (SD 0.4,
P
<.001). The preoperative MD slope of −0.52 (SE 0.047) dB/year significantly improved to −0.31 (SE 0.14) dB/year (
P
<.01), with improvement in the superior hemifield (
P
≤.018). Inferior hemifield (
P
>.10) did not follow the trend. Neither mean IOP nor SD-IOP correlated with the VF deterioration speed.
Conclusions
Fornix-based trabeculectomy is an acceptable procedure for initial surgical management of glaucoma, especially for maintenance of superior VF.
We conducted clinical and experimental studies to investigate the effects of image-sharpening algorithms and color adjustments, which enabled real-time processing of live surgical images with a delay ...of 0.004 s. The images were processed with image-sharpening intensities of 0%, 12.5%, 25%, and 50% during cataract surgery, vitrectomy, peeling of epiretinal membrane, and peeling of internal limiting membrane (ILM) with the Ngenuity 3D visualization system. In addition, the images obtained with a yellow filter during the ILM peeling were processed with color adjustments. Five vitreoretinal surgeons scored the clarity of the images on a 10-point scale. The images of a 1951 United States Air Force grating target placed in no fluid (control), saline, and 0.1% and 1% milk solution were evaluated. The results showed that the mean visibility score increased significantly from 5.0 ± 0.6 at 0% to 6.4 ± 0.6 at 12.5%, 7.3 ± 0.7 at 25%, and 7.5 ± 0.9 at 50% (P < 0.001). The visibility scores during ILM peeling improved significantly with color adjustments (P = 0.005). In the experimental study, the contrast of the grating targets blurred by the 0.1% and 1% milk solution increased significantly by the image-sharpening procedure. We conclude that the image-sharpening algorithms and color adjustments improved the intraoperative visibility of 3D heads-up surgery.
Green leaf volatiles are emitted by green plants and induce defence responses. Those with antifungal activities in plants may replace chemicals as natural post-harvest treatments. We investigated the ...postharvest treatment of strawberry with trans-2-hexenal and cis-3-hexenal and observed a decrease in the mould infection rate. To determine the volatiles' functions, we conducted a component analysis of the volatiles released from trans-2-hexenal-treated strawberry and analysed gene expression. Several acetates, which were expected to be metabolites of trans-2-hexenal in fruit, were released from treated strawberry; however, these acetates did not inhibit fungal growth. The gene expression analysis suggested that postharvest strawberries were not protected by jasmonic acid-mediated signalling but by another stress-related protein. Harvested strawberries experience stress induced by harvest-related injuries and are unable to perform photosynthesis, which might result in different responses than in normal plants.
The aim of this study was clarify the effects of reducing various functional pressures essential for the maintenance of bone homeostasis. Femoral bone mineral density (BMD) and biological apatite ...(BAp) crystallite alignment were measured in conventionally reared and hindlimb-unloaded mice. The femur was divided into 10 equal segments perpendicular to the longitudinal axis of the bone and measurements were performed on the cortical bone in the five segments closest to the midpoint of the femur. Significantly lower BMD and BAp alignment in the longitudinal (Z-axis) direction were observed in the hindlimb-unloaded group. The present findings suggest that unloading by tail suspension significantly decreases not only mouse femoral bone mass but also BAp crystallite alignment, although minimal uniaxial preferential alignment is retained.
Purpose
To investigate how the central visual field would be changed after fornix-based trabeculectomy with mitomycin C in Japanese normal-tension glaucoma (NTG) patients monitored for more than ...10 years including before surgery.
Methods
This is a retrospective cohort study. We identified twenty-eight eyes of 28 NTG cases regularly monitored for more than 5 years and examined static visual field (VF) tests for more than five times before and after fornix-based trabeculectomy (including combined surgery). Based on preoperative data for 6.3 years, we evaluated postoperative changes for 6.0 years in 10–2 VF and 30–2 VF.
Results
Six patients were male and 22 females, the mean age was 57.9 years, and the mean deviation was − 13.7 decibels. After surgery, mean IOP decreased from 13.9 to 9.0 mmHg (
P
≤ 0.01), and medication score also did. The rate of 10–2 VF deterioration was significantly suppressed from − 1.0 dB/year preoperatively to − 0.4 dB/year postoperatively (
P
≤ 0.01). And when 30–2 VF was divided into six relevant sectors, the rate of deterioration at cecocentral and arcuate areas of the superior hemifield was suppressed postoperatively (
P
≤ 0.01 and
P
= 0.042, respectively).
Conclusion
Based on long-term preoperative data, a significant positive change in 10–2 VF was observed after fornix-based trabeculectomy with mitomycin C in Japanese NTG patients with a mean IOP of 13.9 mmHg. Central vision could be expected to be maintained for NTG patients even if its preoperative IOP is low after successful trabeculectomy.
We propose a method that detects vehicles from in-vehicle monocular camera images captured during nighttime driving. Detecting vehicles from their shape is difficult at night; however, many vehicle ...detection methods focusing on light have been proposed. We detect bright spots by appropriate binarization based on the characteristics of vehicle lights such as brightness and color. Also, as the detected bright spots include lights other than vehicles, we need to distinguish the vehicle lights from other bright spots. Therefore, the bright spots were distinguished using Random Forest, a multiclass classification machine-learning algorithm. The features of bright spots not associated with vehicles were effectively utilized in the vehicle detection in our proposed method. More precisely vehicle detection is performed by giving weights to the results of the Random Forest based on the features of vehicle bright spots and the features of bright spots not related to the vehicle. Our proposed method was applied to nighttime images and confirmed effectiveness.
Reexpansion pulmonary edema is a serious complication of minimally invasive cardiac surgery through the right minithoracotomy. As reexpansion mechanical injury and ischemia reperfusion injury to the ...collapsed lung are possible mechanisms, we introduced a preventive protocol that consists of intermittent ventilation of the right lung, restoration of bilateral ventilation, administration of mannitol before unclamping the aorta, and institution of mild hypothermia. Among 469 patients who underwent minimally invasive cardiac surgery, we used this protocol in 379 patients. Reexpansion pulmonary edema incidence decreased significantly from 7.8% to 2.1% (P = .006). Although further evaluation is required, our protocol may be effective in preventing reexpansion pulmonary edema.
Purpose
To analyze the vessel density around the optic nerve head (ONH) by optical coherence tomography angiography (OCTA) in patients with retinitis pigmentosa (RP), and to evaluate its correlation ...with visual functions.
Methods
Thirty-eight eyes with RP with visual field constriction within the central 10° were enrolled. The mean (± SD) age of the patients was 43.7 ± 15.1 years. In addition to visual acuity (VA) measurements and visual field tests (Humphrey Field Analyzer 10–2 test), we also measured the vessel density at the macula by OCTA (superficial and deep vessel density: sVD(m) and dVD(m)) and in multiple layers around the ONH (vessel density in the radial peripapillary capillary RPC layer and in the nerve head NH layer: VDrpc and VDnh). The vessel density was calculated by binarizing the OCTA images. The associations between the logMAR VA and mean deviation (MD) values and the variables of central retinal thickness (CRT), sVD(m), dVD(m), VDrpc, VDnh, and also the size of the foveal avascular zone were investigated.
Results
The mean logMAR VA was 0.16 ± 0.34 and the MD value was − 17.2 ± 10.3 dB; the MD value was significantly related to the logMAR VA (
p
= 0.0028). Multivariate analysis with AICc model selection suggested only dVD(m) was associated with logMAR VA. On the other hand, the optimal model for the MD value included the CRT, dVD(m), and VDnh.
Conclusion
The vessel density in the deep layer around the ONH was significantly associated with the visual field deterioration in patients with RP.
Background The aim of this study was to compare the predictive accuracy of acute kidney injury (AKI) after cardiac surgery using cardiopulmonary bypass for the largest area under the curve (AUC) ...below the oxygen delivery (DO
) threshold and the cumulative AUC below the DO
threshold. Methods and Results From March 2017 to October 2019, 202 patients who had undergone cardiac surgery with cardiopulmonary bypass were enrolled. The perfusion parameters were recorded every 20 seconds, and the DO
(10×pump flow index L/min per m
×hemoglobin (g/dL)×1.36×arterial oxygen saturation (%)+partial pressure of arterial oxygen (mm Hg)×0.003) threshold of 300 mL/min per m
was considered to define sufficient DO
. The nadir DO
, the cumulative AUC below the Formula: see text, and the largest AUC below the Formula: see text were used to predict the incidence of AKI. Postoperative AKI was observed in 12.4% of patients (25/202). By multivariable analysis, the largest AUC below the Formula: see text ≥880 (odds ratio OR, 4.9; 95% CI, 1.2-21.5
=0.022), preoperative hemoglobin concentration ≤11.6 g/dL (OR, 7.6; 95% CI, 2.0-32.3
=0.004), and red blood cell transfusions during cardiopulmonary bypass ≥2 U (OR, 3.3; 95% CI, 1.0-11.1
=0.041) were detected as independent risk factors for AKI. Receiver operating curve analysis revealed that the largest AUC below the Formula: see text was more accurate to predict postoperative AKI compared with the nadir DO
and the cumulative AUC below the Formula: see text (differences between areas, 0.0691
=0.006 and 0.0395
=0.001). Conclusions These data suggest that a high AUC below the Formula: see text is an important independent risk factor for AKI after cardiopulmonary bypass, which could be considered for risk prediction models of AKI.
Several reports demonstrated positive effects of processing residual cardiopulmonary bypass volume using a cell salvage device in conventional open heart surgery via sternotomy on hemostasis. The ...present study aimed to investigate whether cell salvage processing has the same effects on postoperative blood loss and transfusion in minimally invasive cardiac surgery. Between July 2015 and April 2018, 80 consecutive patients undergoing minimally invasive aortic valve replacement via right anterolateral minithoracotomy were enrolled in the present study. Perioperative outcomes and coagulation data of 40 patients who were retransfused with processed cardiopulmonary bypass volumes were compared with those of 40 patients receiving unprocessed residual blood (control group). Postoperative blood loss in patients receiving processed residual blood was significantly less than that in the control group at 6 h (115 ± 50 vs. 73 ± 33 ml,
p
< 0.001) and 12 h (167 ± 70 vs. 125 ± 67 ml,
p
= 0.009) after surgery, and the rate of fresh frozen plasma use after surgery was significantly reduced in patients receiving processed residual blood (18 vs. 0%,
p
= 0.012). In conclusion, processing of residual cardiopulmonary bypass volume reduced postoperative blood loss and postoperative use of fresh frozen plasma and could be useful for hemostasis in minimally invasive cardiac surgery.
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