PubMed · 16129317
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Vytautas Jasinskas, Arvaidas Galdikas, Reda Zemaitiene. 2005. Novel capsulotomy diameter marking capability.. https://doi.org/10.1016/j.jcrs.2005.07.027
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UNLABELLED: We asked if fetal lung-to-head ratio (LHR) of 1.0 or lower or liver herniation had a statistical effect on survival or need for extracorporeal membrane oxygenation (ECMO), compared with LHR above 1.0 in patients with congenital diaphragmatic hernia (CDH). METHODS: Antenatal records of all patients diagnosed with CDH from January of 2002 to June of 2005 were examined. Inclusion criteria were isolated left-sided CDH and absence of significant cardiac or other anomalies/syndromes, treated solely at this institution. Lung-to-head ratio values were compared based on the value currently proposed for fetal intervention: LHR of 1.0 or lower vs LHR above 1.0. Outcome was assessed as survival (discharge to home) or need for ECMO. RESULTS: Twenty-eight patients met inclusion criteria. Overall survival was 86% (24/28). Postnatal survival in fetuses with LHR of 1.0 or lower (8/11) was not statistically different from LHR above 1.0 (16/17) (73% vs 94%, P = .114). The need for ECMO in the group with LHR of 1.0 or lower (3/11) was not significantly different from those with LHR above 1.0 (1/17) (27% vs 6%, P = .114). Herniation of the fetal liver into the chest did not affect survival or need for ECMO (P = .228). CONCLUSION: Neither LHR of 1.0 or lower nor liver herniation identified a risk factor significant enough to warrant fetal intervention. Multicenter studies may be more appropriate to investigate this clinical problem.
OBJECTIVE: The objective of this study was to gather data on the morphology of the uterus during its development, to provide detailed information regarding the neighboring structures and its variations using anatomical dissections. STUDY DESIGN: Eighty uteri acquired from female fetuses aged 10-40 weeks of gestation were used in this study. Firstly, the relationship between the fetal uterus and the linea terminalis and the position of the uterus within the pelvic cavity was noted. Then the distance between the fundus of the uterus to the promontory and pubic symphysis were measured. Fetal uteri were classified according to their physical appearances. Finally the lengths of the corpus and cervix in three planes and the anteflexion angle were measured. RESULTS: During the fetal period, the fundus of the uterus was above the linea terminalis in 94% and below it in 6% of the cases. The distance between the fundus of the uterus and the promontory significantly correlated with the distance between the fundus of the uterus and the pubic symphysis (p<0.001). This was true for the correlation between the gestational age and the orthogonal lengths of the uterine corpus and cervix (p<0.001). As the gestational age advanced, the anteflexion angle was noted to reduce from 177 degrees to 120 degrees . The shape of the uterus was either cylindrical, pear-shaped, heart-shaped or hourglass-shaped during the fetal period. CONDENSATION: We believe that the data obtained through dissections of the human fetuses in this study will help identifying uterine developmental variations, anomalies and pathologies and will contribute to the studies carried out in obstetrics, perinatology, forensic medicine and fetal pathology departments.
PURPOSE: To identify correlations among intraocular pressure (IOP) measurements obtained using the rebound tonometer (RBT), the dynamic contour tonometer (DCT), and the Goldmann applanation tonometer (GAT). The effects of corneal thickness on the measures obtained using each of the 3 tonometers also were examined. DESIGN: Cross-sectional study. PARTICIPANTS: One hundred forty-six eyes of 90 patients with ocular hypertension or glaucoma. METHODS: Intraocular pressure measurements were obtained in all patients using RBT, DCT, and GAT. Central corneal thickness was determined by ultrasound pachymetry. Patients were divided randomly into 6 groups to vary the order in which the tonometers were used. All IOP measurements were made by the same examiner, who was masked to the readings obtained. MAIN OUTCOME MEASURES: Intraocular pressure and central corneal thickness. RESULTS: There was good correlation between IOP readings obtained using the RBT and GAT (r = 0.864; P<0.0001), between DCT and GAT (r = 0.871; P<0.0001), and between RBT and DCT (r = 0.804; P<0.0001). Rebound tonometer and DCT readings consistently were higher than GAT measurements (RBT-GAT median difference, 1.4+/-2.7 mmHg; DCT-GAT median difference, 4.4+/-2.6 mmHg). A Bland-Altman plot indicated that the 95% limits of agreement between RBT and GAT were -4.3 to 6.4 mmHg (slope = 0.056; P = 0.218), those between DCT and GAT were -0.7 to 9.5 mmHg (slope = 0.016; P = 0.717), and those between RBT and DCT were -3.1 to 9.8 mmHg (slope = -0.041; P = 0.457). Using RBT, the point that best discriminated between patients with an IOP 21 mmHg or less and more than 21 mmHg as determined by GAT was >23.3 mmHg (sensitivity, 66.7%; specificity, 92.1%); using DCT, this point was >22.7 mmHg (sensitivity, 95.6%; specificity, 71.3%). In terms of pachymetry, GAT and RBT behaved similarly. Using these instruments, differences of approximately 3 mmHg were detected between the groups of patients with the thinnest (<531 mum) and thickest (>565 mum) corneas, whereas a significantly lower difference (0.5 mmHg) was noted for the DCT. CONCLUSIONS: Measurements obtained both with the RBT and DCT show excellent correlation with those provided by applanation tonometry. Both tonometers tend to overestimate the IOP measured with the GAT, particularly the DCT. This last tonometer seems to be less affected by the corneal thickness.