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PubMed1991

Normal length of fetal kidneys: sonographic study in 397 obstetric patients.

This study was done to measure normal lengths of fetal kidneys sonographically during pregnancy. Knowledge of these measurements may allow earlier diagnosis of a variety of abnormalities. The greatest length of each of 498 kidneys in 397 consecutive fetuses between 18 and 41 weeks gestation was measured on sonograms. Gestational ages were determined by last menstrual period and biometry; significant discrepancies led to case exclusion. Abnormal fetuses, twins, offspring of diabetic mothers, and fetuses with renal pelvic dilatation of 4 mm or greater were excluded to avoid any questionable measurements. The results show that mean lengths are greater and confidence intervals are wider than previously reported. Renal lengths are similar to those reported in premature and full-term neonates. Strong correlation exists between renal length and gestational age, determined by biparietal diameter, femoral length, and abdominal circumference, and an average of the three. No significant difference was found between right and left renal lengths in fetuses in whom both kidneys were imaged. Average renal lengths are significantly different when compared across the range of gestational ages (p less than .001). No correlation is seen (r = .00) between parental height or weight and fetal renal length. Our results show that fetal renal lengths are longer than previously reported.

Female↗

PubMedDate not supplied

[The fetal adrenal gland in risk pregnancy].

INTRODUCTION: The role of the adrenal gland in the metabolism of foetus and its role in maturation of foetal organs are the principal motives for paying more attention to this vital organ, which is still a great enigma for gynaecologists. The control of the gland is important in normal as well as in risk pregnancies. Of the entities that most often imperil the growth of foetus and adrenal glands are diabetes and hypertension in pregnancy. A consequence of the maternal diabetes may be macrosomy of foetus manifested by increase in foetal body mass and enlargement of organs sensitive to increased concentration of insulin in the foetal blood [6], i.e., the liver, fat tissue, lungs, adrenal glands, heart. Brown and Singer (1988) [2] established that adrenal glands of foetus are imperiled in pregnancies complicated by mother's hypertension. Their conclusion was derived from pathologic findings in foetuses from unsuccessful pregnancies of patients with hypertension. The glands were of reduced sizes. The way to perform precise measuring of glands, which are of dilapidated composition during post mortem examination, is not quite acceptable, since during the manipulation the size may, to some degree, be altered. By introduction of the ultrasound method in medical practice the problem of biometry has been overcome. Besides measuring, of great importance for the study of physiology of the gland is also the analysis of the foetal fluid and foetal blood. The first successful measuring of the adrenal gland of foetus by ultrasound was performed in mid 80s of the last century by Jeanty and Romero [3] via transabdominal path. The aim of our study is the comparison of foetal adrenal glands in normal and high-risk pregnancies. MATERIAL AND METHODS: During a prospective follow-up carried out at the Institute of Gynaecology and Obstetrics, Clinical Centre of Serbia, 213 patients, aged from 19 to 44 years were examined. Gestation periods were from the 11th to the 40th week. We divided the patients in 3 groups. The first group consisted of 131 patients with no pathologic changes and whose children were born alive. The second group was formed of 75 pregnant women in whom the course of pregnancy was impaired and disorders in the foetal. From these pregnancies the children were born alive. The third group was composed of 7 patients in whom abortion was indicated. The measured values of foetal adrenal glands diameter in the first group (131 patients), were used for making a nomogram of the glands growth. The measuring was performed with ultrasound apparatus "Toshiba 100 SSA". Transabdominal examination with a probe of 3.75 MHz and transvaginal examination with probes of 5 and 7 MHz were performed. Since the picture of the adrenal gland resembled an ellipse, on the basis of measured diameters and using the formula for circumference of this geometric figure [O = (d1 + d2) x pi/2], we obtained the desired value, which increased with advancement of pregnancy. Patients included in the study were with one-foetus pregnancy, whose last menstruation was precisely dated. Data are presented in a chart. For analysis of the obtained data, in addition to parameter methods, we also used the linear correlation and regression and one-factor analysis of variance. Data base analysis was made in the SPSS for DOS package. RESULTS: In making a nomogram of adrenal glands growth of a foetus old between 11 and 40 weeks, 131 of 213 patients were included, while the other foetuses were excluded as they belonged to high-risk pregnancies. Correlation of the growth of adrenal glands circumference and gestation period of pregnancy are also highly statistically important. The correlation coefficient of the straight line which represents this dependancy, is R = 0.8916, for the significance level of p < 0.01 (GRAPH 1). We observed how the course of pregnancy influenced the growth of foetal adrenal gland in normal pregnancies and in foetuses impaired by a pathological pregnancy course. By the method of one-way variance analysis, we obtained the value of the test, which was F = 2.79; p = 0.07. The graphical presentation of adrenal glands of a foetus in the appropriate week of gestation revealed that dimensions of glands in pregnancies impaired by diabetes were larger than those in normal gestations, and that they were at the top of border value of +2 SD or even over this limit. The statistically obtained value was F = 1.81; p > 0.05 (p = 0.06 and it was close to the border value for the significance level of p < 0.05); however, for glands of pregnancies complicated with hypertension the value was F = 1.61; p = 0.063 and the border value near -2 SD. Data are presented in a chart, regarding nomograms and adrenal glands of risk pregnancies. DISCUSSION: In 1993 Bronstein and colleagues [1] proved that the route of visualization of an adrenal gland was not only transabdominal. They succeeded in detecting the glands by transvaginal ultrasound examination in the 12th week. Jeanty and Romero [3] performed a successful transabdominal visualization in the 23rd week of gestation. By ultrasound prenatal examination we can determine the existence of hyperplasia of adrenal glands (Kelnar 1993) [5]. With ultrasound examination we can also diagnose tumours of the medulla, such as neuroblastoma (Jennings and colleagues 1993) [4]. In our study we reported on the visualization and growth of foetal adrenal glands in the period from the 11th to the 40th week of gestation. We presented the growth of foetal adrenal glands in normal gestations with the growth nomogram. The coefficient of correlation of adrenal glands circumference was R = 0.8916. The level of significance was p < 0.01. In conclusion, we can say that risk factors in pregnancy could impair the growth of adrenal glands. We have found that foetal adrenal glands in pregnancies impaired with maternal diabetes were hypertrophic, while those in pregnancies impaired with hypertension were almost at hypotrophic border. The nomograms of adrenal glands growth were of clinical importance, since they help us to control the state of a foetus in high-risk pregnancies. CONCLUSION: Improvement of the methods used in prenatal diagnosis will contribute to a timely detection of a diseased foetus, and will be the first step in its recovery. Regulating the pathological condition of the mother will surely contribute to decrease the risk of delivering children with an increased risk of morbidity.

Adrenal Glands↗

PubMedDate not supplied

[Correction of presbyopia in pseudophakic patients under 60 years of age].

Objective of the study was to show the mean values of correction for near vision and to discuss the presbyopic correction in pseudophakic patients. Setting was the Eye department where authors work. Inclusion criteria for 55 patients were native or corrected distant vision of 0.8-1.0 on Snellen's chart; 0,6 on Jagger's chart for near vision; round pupil and good position of the implant. Biometry of the anterior chamber depth with Alcon biophysics during distant and near vision was performed in our study. "Hi square" test was carried out and it was concluded that patients younger than 59 years (41 eyes) had median correction of +2.0 dsph, while patients older than 60 years (36 eyes) had correction of +3.0 dsph, but it was not statistically significant. There was no statistically significant difference of the correction between pseudophakic (41) and phakic (19) eyes in patients younger than 59 years. The anterior movement of the IOL was 0.18 mm in the younger group and 0.15 mm in the older group. With good IOL movement and new materials which could have changeable refractive power, the problem of pseudophakic correction for near vision might be solved.

Accommodation, Ocular↗

PubMedDate not supplied

The WHO multinational study of vascular disease in diabetes: 2. Macrovascular disease prevalence.

14 national groups have collaborated under WHO auspices to select, from local defined populations of individuals with clinical diabetes, groups of approximately 500 within the age range 35--55 yr stratified by age, sex, and known duration of diabetes. In each center, the selected patients were submitted to a standardized study protocol, which included systematic inquiry (WHO questionnaire) for the presence of symptoms of angina pectoris, history of myocardial infarction, presence of intermittent claudication, and cigarette smoking history. Examination included standard biometry, blood pressure measurement, 12-lead (centrally Minnesota coded) electrocardiography, and central laboratory measurement of serum cholesterol and creatine. Ophthalmoscopic and urinary examinations were also included. The prevalence of arterial disease symptoms and electrocardiographic abnormalities show very large variation between countries, the lowest rates generally being found in the Oriental samples and the highest in the European. "Risk factors" for arterial disease (blood pressure, serum cholesterol, and cigarette smoking) also vary widely between diabetic groups. Although data are not yet complete, these differences appear unlikely to explain the variation in the atherosclerotic morbidity observed. Diabetic women were at least as vulnerable to arterial disease as diabetic men. A high prevalence of nonspecific abnormalities of the repolarization phase of the ECG was found, even in groups where ischemic abnormalities were rare. The origin of these is uncertain; they may represent variable local changes or possibly diabetic cardiomyopathy. This preliminary report confirms and quantifies previous indications that the impact of atherosclerotic disease on persons with diabetes varies considerably between national groups, in broad terms, running parallel with the variations in prevalence in the populations in general and suggesting that cultural and/or ethnic factors are more important determinants of atherosclerosis in diabetic individuals than is the diabetic state per se.

Adult↗

PubMed2001

Third-trimester maternal glucose levels from diurnal profiles in nondiabetic pregnancies: correlation with sonographic parameters of fetal growth.

OBJECTIVE: To assess the 24-h glucose levels in a group of nondiabetic, nonobese pregnant women and to verify the presence of correlations between maternal glucose levels and sonographic parameters of fetal growth. RESEARCH DESIGN AND METHODS: A total of 66 Caucasian nonobese pregnant women with normal glucose challenge tests (GCT) enrolled in the study; from this population, we selected 51 women who delivered term (from 37 to 42 weeks completed) live-born infants without evidence of congenital malformations. The women were requested to have three main meals and to perform daily glucose profiles fortnightly from 28-38 weeks without modifying their lifestyle or following any dietary restriction. All subjects were taught how to monitor their blood glucose by using a reflectance meter. Fetal biometry was evaluated by ultrasound scan according to standard methodology at 22, 28, 32, and 36 weeks of pregnancy. RESULTS: The overall daily mean glucose level during the third trimester was 74.7 +/- 5.2 mg/dl. Daily mean glucose values increased between 28 (71.9 +/- 5.7 mg/dl) and 38 (78.3 +/- 5.4 mg/dl) weeks of pregnancy. We found a significant positive correlation at 28 weeks between 1-h postprandial glucose values and fetal abdominal circumference (AC). At 32 weeks, we documented positive correlations between fetal AC and maternal blood glucose levels 1 h after breakfast, 1 and 2 h after lunch, and 1 and 2 h after dinner. At 36 weeks, there was a positive correlation between fetal AC and 1- and 2-h postprandial blood glucose levels. In addition, there was a negative correlation between head-abdominal circumference ratio and 1-h postprandial blood glucose values. CONCLUSIONS: This longitudinal study first provides a contribution toward the definition of normoglycemia in nondiabetic, nonobese pregnant women; moreover, it reveals significant correlations of postprandial blood glucose levels with the growth of insulin-sensitive fetal tissues and, in particular, between 1-h postprandial blood glucose values and fetal AC.

Adult↗

PubMed2004

Does the association of habitual physical activity with the metabolic syndrome differ by level of cardiorespiratory fitness?

OBJECTIVE: Cardiovascular fitness (VO(2max)) and physical activity are both related to risk of metabolic disease. It is unclear, however, whether the metabolic effects of sedentary living are the same in fit and unfit individuals. The purpose of this study was, therefore, to describe the association between physical activity and the metabolic syndrome and to test whether fitness level modifies this relationship. RESEARCH DESIGN AND METHODS: Physical activity was measured objectively using individually calibrated heart rate against energy expenditure. VO(2max) was predicted from a submaximal exercise stress test. Fat mass and fat-free mass (FFM) were calculated using impedance biometry. A metabolic syndrome score was computed by summing the standardized values for obesity, hypertension, hyperglycemia, insulin resistance, hypertriglyceridemia, and the inverse level of HDL cholesterol and was expressed as a continuously distributed outcome. To correct for exposure measurement error, a random subsample (22% of cohort) re-attended for three repeat measurements in the year following the first assessment. RESULTS: The relationship of VO(2max) (ml O2.kg(FFM)(-1).min(-1)) and the metabolic syndrome score was of borderline significance after adjusting for age, sex, physical activity, and measurement error (beta = -0.58, P = 0.06). The magnitude of the association between physical activity (kJ.d(-1).kg(FFM)(-1)) and the metabolic syndrome was more than three times greater than for VO(2max) (standardized beta = -1.83, P = 0.0042). VO(2max), however, modified the relationship between physical activity energy expenditure and metabolic syndrome (P = 0.036). CONCLUSIONS: This study demonstrates a strong inverse association between physical activity and metabolic syndrome, an association that is much steeper in unfit individuals. Thus, prevention of metabolic disease may be most effective in the subset of unfit inactive people.

Adipose Tissue↗

PubMed1999

Do pre-, early, and mid-pregnancy life events influence gestational length?

The aim of this study was to determine whether the frequency and quality of reported life events during the 6 months before pregnancy to mid-pregnancy influence gestational age at birth. Seventy nulliparous women were studied at 12 and 25 gestational weeks with a 64-item self-rated life event questionnaire developed for obstetric groups. Life events were categorised into eight psychosocial areas according to the diagnostic and statistic manual (DSM-III-R). The women rated each experienced event as strainful or not strainful. Gestational age was determined by ultrasound biometry before 20 gestational weeks. The number of life events during the following periods was recorded from 6 months before pregnancy to 12 gestational weeks, from 12 gestational weeks to 25 gestational weeks, from 6 months before pregnancy to 25 gestational weeks. No significant relationships were found between the number of reported life events and pregnancy duration. Life events in different psychosocial areas also did not influence gestational age at birth. A non-significant relationship (p = 0.06) was found between pregnancy duration and the number of strainful events reported from 6 months before pregnancy to 25 gestational weeks, shorter pregnancy duration being found in women reporting many strainful events. Our findings suggest that life events in general do not influence pregnancy duration. However, if they are perceived as strainful, pregnancy length tends to decrease.

Adult↗

PubMed1992

Autosomal dominant congenital miosis with megalocornea.

A family with AD congenital miosis is presented. The ocular symptoms were: megalocornea, iris translucency, microcoria with poor pupillary dilatation and goniodysgenesis with anterior insertion of the iris. This observation confirms that in congenital miosis abnormal development of the whole anterior eye segment may occur. The patients have an increased risk to develop glaucoma. If retinoscopy is impossible due to pin-point pupils, ultrasonic biometry to determine the axial length is recommended. An optical iridectomy could improve visual performance at low illumination; the complaints of photophobia, which are related to the iris translucency, persist.

Adolescent↗

PubMed2001

Myocardial stereological adaptations in wistar rats fed with different high-fat diets during 18 months.

This study has the purpose of investigating the influence of different high-fat experimental diets on myocardial structure in rats. Twenty-seven male rats were fed from 21 d old (postnatal age) until 18 mo old with one of the following supplemented diets: soybean oil (S) (n= 6), canola oil (CA) (n= 8), or lard and egg yolk (LE) (n= 6) or canola oil+ lard and egg yolk (CA+LE) (n=7). The blood pressure (BP) was measured, and after the sacrifice the cardiac biometry and the myocardial stereology were determined: cross-sectional area of cardiomyocyte (A), volume density (Vv), surface density (Sv), and length density (Lv) in relation to the cardiomyocytes (cm), connective tissue (ct), and blood vessels (v). The CA group rats had lower BP, A[cm], and Vv[ct]; they had greater Vv[cm], Sv[cm], Vv[v], Lv[v], and Sv[v] than the other groups. The S rats had intermediary values for the myocardium and blood vessel parameters between the CA and LE group rats. These results support the notion that the long-term use of canola oil in the diet is better to preserve the myocardium structure, including microvascularization, than soybean oil or lard and egg yolk.

Animals↗

PubMed2004

Strategy for decentralised prevention of angle closure glaucoma in Greenland.

In 1962 a blindness survey showed glaucomas to be responsible for 64% of all blindness in Greenland. In 1968 primary angle closure glaucoma was found to be the major glaucoma problem. Population studies using gonioscopy, optical anterior chamber depth, corneal thickness, diameter- and curvature measurements as well as ultrasound biometry were gradually performed. Prevalence was estimated at 5.1% in women and 1.6% in men aged 40+. Main findings were eye traits associated with increased risk of angle closure glaucoma: shallow anterior chamber depth and small corneal diameters. A high heritability (70%) was found. Surgical iridectomies and later YAG-laser iridotomies were introduced as routine procedures by travelling consultants and at the referral centre Rigshospitalet in Copenhagen. Eventually, in 1993-96 a surgical eye clinic was established in the capital Nuuk, also introducing phakoemulsification cataract surgery. Blindness due to glaucomas had fallen to about 9% of the registrations in Greenland per 1999. In 1999 an outreach model had to be established again, including consultants covering the 16 districts in 45 weeks and surgical teams of 2 surgeons 3 x 3 weeks per year. In 2002 the coverage was reduced to 31 weeks and only two surgical tours.--The possible consequences for glaucoma blindness will be discussed.

Glaucoma, Angle-Closure↗

PubMedDate not supplied

Posterior chamber intraocular lenses: long-term results in pediatric cataract patients.

Major problems in pediatric cataract patients include noncompliance with contact lenses resulting in amblyopia. Advances in intraocular cataract surgery have provided a better environment to perform intraocular lens (IOL) implantation in children. We prospectively analyzed the results of 34 consecutive pediatric patients who underwent cataract removal and insertion of an IOL. Operative technique performed was posterior scleral beveled or frown incision and IOL endocapsular fixation. Subgroups included 10 eyes with traumatic cataract, and 24 eyes with developmental cataracts. Six patients had bilateral IOLs. Data presented in each subgroup included initial and final visual acuity, age, sex, type of cataract, A and B scan biometry, early and late postoperative complications, time of YAG capsulotomy, postoperative refractive correction, and state of binocular vision. Preoperative visual acuity ranged from 20/70 to light perception. The success rate for postoperative visual acuity of 20/40 or better occurred in 29 of 34 eyes, or 85.3%. In the traumatic cataracts, 8 of 10 eyes (80%) obtained 20/40 vision or better. In developmental cataracts, 21 of 24 eyes (88%) achieved visual acuity of 20/40 or better. Amblyopia (three patients) or macular scar (two patients) accounted for reduced visual acuity in the five eyes with vision less than 20/40. Early complications included posterior synechiae and lens deposits. The primary late complication was opacification of the posterior capsule in 18 of 34 eyes. The average time for YAG capsulotomy post-cataract removal was 17 months. None of the 28 patients (34 eyes) developed glaucoma, IOL dislocation, or other significant postoperative problems related to IOL insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

Near-work activity and myopia in rural and urban schoolchildren in China.

PURPOSE: To examine the prevalence of myopia in rural and urban schoolchildren in Xiamen, China, and to assess the impact of environmental factors on rates of myopia. METHODS: Second-grade children attending either a city (n=119) or rural (n=91) school in Xiamen, China, were examined using cycloplegic autorefraction and biometry. Detailed questions on socioeconomic status, near-work activity, reading and writing habits, and family histories of myopia were asked in a face-to-face interview using a standard questionnaire. RESULTS: The prevalence of myopia was 19.3% (95% confidence interval [CI], 12.3, 29) in the city and 6.6% (95% CI, 2.4, 14.3) in the countryside. The average hours per day children spent reading and writing outside of school was 2.2 hours in the city compared with 1.6 hours in the countryside (P<.0001). In both schools, the odds ratio for total reading and writing, adjusted for parental history of myopia, was 2.2 (95% CI, 1.1, 4). CONCLUSION: These data suggest the prevalence of myopia is higher in the city than in the countryside. One possible explanation for these different rates could be that schoolchildren in the city spend more time reading and writing outside of school compared with children in the countryside. Myopic children in both the city and the countryside spent more time reading and writing compared with nonmyopic children. This increased near-work activity may contribute to the prevalence of myopia.

Child↗

PubMedDate not supplied

Use of optical coherence tomography in myopia.

PURPOSE: To measure retinal thickness and retinal nerve fiber layer thickness using optical coherence tomography in patients with myopia. PATIENTS AND METHODS: Thirty patients (13 girls and 17 boys) 14 to 18 years old were included in the study. The control group consisted of 15 patients. Each patient was subjected to routine ophthalmic investigations, which included the assessment of visual acuity for near and distant objects, autorefractometry, measurement of intraocular pressure, biometry, and assessment of the static visual field. The foveal retinal thickness and the peripapillary nerve fiber layer thickness were measured using optical coherence tomography. RESULTS: The mean foveal retinal thickness was 231.0 microm in eyes with low myopia, 218.0 microm in eyes with medium myopia, and 178.0 microm in eyes with high myopia. The mean thickness of the retinal nerve fiber layer was 150.0 microm, 140.0 microm, and 152.0 microm, respectively. Statistically significant differences were revealed between patients with high myopia and the control group. CONCLUSION: Optical coherence tomography can be employed to assess the retinal thickness and thus facilitate the detection of the evolution of alterations in myopia.

Adolescent↗

PubMedDate not supplied

Distribution and determinants of intraocular pressure in a normal pediatric population.

PURPOSE: To examine the intraocular pressure (IOP) of a normal pediatric population under topical anesthesia without sedation and its correlation with other ocular parameters. SUBJECTS AND METHODS: The IOP of 810 eyes of 405 patients with ages ranging from 0 to 12 years was measured using the Perkins applanation tonometer. Cooperative patients also underwent pachymetry, refraction, and biometry measurements. RESULTS: The mean (+/- standard deviation) age was 6.68 (+/- 3.28) years, with a mean (+/- standard deviation) IOP of 12.02 (+/- 3.74) mm Hg. IOP showed an increasing trend with age (correlation coefficieit [r] = 0.49) and tended to approach adult levels by 12 years of age. The IOP correlated directly with refraction (r = 0.69) and pachymetry (r = 0.39) and inversely with axial length (r = -0.1). CONCLUSIONS: The IOP in children is much lower than that in adults. It was noted to increase with age, hyperopia, and corneal thickness and was inversely proportional to axial length.

Age Factors↗

PubMedDate not supplied

Bilateral cataract after phakic posterior chamber top hat-style silicone intraocular lens.

BACKGROUND: New strategies have been developed for surgical treatment of high myopia. Recently, implantation of minus power posterior chamber intraocular lenses (IOL) into phakic eyes has been introduced. METHODS: We report a 37 year-old female patient who developed bilateral anterior subcapsular cataract 7 years after minus-power, top hat-style silicone posterior chamber IOL implantation in Russia. The corrected visual acuity was right eye 20/200 and left eye 20/63. Because of the high myopia and the posterior chamber IOL in her phakic eyes, biometry for IOL calculation gave contradictory results. Both posterior chamber IOLs were found to be adherent to the crystalline lenses. After posterior chamber IOL explantation and phacoemulsification, intraoperative retinoscopy was performed. With this aphakic refraction, the IOL power was calculated and implanted. The explanted posterior chamber IOLs were examined by scanning electron microscopy. RESULTS: After bilateral operation the corrected visual acuity increased to right eye 20/32 and left eye 20/40, respectively. On scanning electron microscopy, a membranous structure of unknown origin was noted on the entire surface of the explanted posterior chamber IOLS. CONCLUSION: There is a potential risk of cataract formation after implantation of this top hat-style silicone posterior chamber IOL. If cataract extraction in this specific situation is needed, a different approach for calculating the aphakic IOL power is necessary, such as intraoperative retinoscopy.

Adult↗

PubMedDate not supplied

Pseudo-accommodation with intraocular lenses implanted in the bag.

PURPOSE: To evaluate the accommodation potential in eyes after intraocular lens in-the-bag implantation. METHODS: Fifty-one consecutive patients were included in the study. Group 1 included 26 eyes that had phacoemulsification with continuous curvilinear capsulorhexis and in-the-bag implanted foldable IOL. Twenty-five eyes in Group 2 had capsulotomy with extracapsular cataract extraction and were implanted with polymethylmethacrylate IOL. Time elapsed from surgery was at least 6 months. There was no significant difference for age or gender between groups (P > .05). We measured accommodation amplitude and depth of the anterior chamber at distance and near fixation with an ultrasonic biometry device. The results were compared using the unpaired Student t-test. RESULTS: The anterior chamber depths while fixating at a distant object were not significantly different between groups (P>.05), however, at near the difference was statistically significant (P=.008). The change in depths between far and near fixation was significantly different (P=.002) and was more pronounced in the the capsulorhexis group (P < .001). The accommodation amplitudes in this group were significantly greater than in the capsulotomy group (P = .025). CONCLUSION: Patients who had uncomplicated small incision phacoemulsification surgery with continuous curvilinear capsulorhexis and in-the-bag implanted lens seemed to preserve some pseudo-accommodation after surgery.

Accommodation, Ocular↗

PubMed2004

[Corneal asphericity in a young adult population. Clinical implications].

PURPOSE: To determine the relevance of the different ocular optical components in the refractive state of young adults, paying special attention to the corneal topography represented by the asphericity value. SUBJECTS AND METHODS: Corneal topographies and ultrasonic biometries were obtained from 109 university students with different refractive errors (spherical equivalent range: +3.25 D to -11.00 D). A regression study was performed in order to establish the relationships between corneal asphericity and refractive error, as well as other ocular optical components related to the emmetropization mechanism of the eye. RESULTS: The mean asphericity values were -0.23 (SD 0.08, range: -0.42 to -0.03). All the values correspond to the mathematical description of the prolate ellipse, most commonly accepted for the normal human cornea. The statistical correlation between asphericity and equivalent refractive error was not significant, but a significant correlation was found for the asphericity with respect to the radius of curvature, vitreous chamber depth and axial length. CONCLUSIONS: 1) The asphericity values support the generalised morphology of the prolate cornea as the standard. The influence of this configuration on the contact lens fit, refractive surgery or the visual performance of the eye are discussed. 2) Results suggest that, although a relationship between axial length and corneal topography actually exists, it is not likely that the latter has implications for the emmetropization mechanisms which determine the refractive state of the adult eye.

Adult↗

PubMed2006

Fetal growth curves for an ethnically diverse military population: the American Institute of Ultrasound in Medicine-accredited platform experience.

OBJECTIVE: To determine which fetal growth curve provided the best estimates of fetal weight for a cohort of ethnically diverse patients at sea level. METHODS: The study consisted of a population of 1,729 fetuses examined at sea level between January 1, 1997, and June 30, 2000, at 18 weeks, 28 weeks, and term. Gestational age (GA) based on menstrual dates was confirmed or adjusted by crown-rump length or early second-trimester biometry. Fetal weight was estimated by using biparietal diameter, head circumference, abdominal circumference, and femur length. Our fetal growth curves were analyzed with fourth-order polynomial regression analysis, applying four previously defined formulae for fetal growth. RESULTS: Fetal growth curves for estimated fetal weight demonstrated the expected parabolic shape, which varied according to the formulae used. Our curve best fit the following equation: estimated fetal weight = 4.522 - 0.22 x GA age + 0.25 x GA(2) - 0.001 x GA(3) + 5.248 x 10(-6) x GA(4) (R2 = 0.976). SD increased in concordance with GA. CONCLUSION: Madigan Army Medical Center serves a racially mixed, culturally diverse, military community with unrestricted access to prenatal care. Determination of the optimal population-appropriate growth curve at the correct GA assists clinicians in identifying fetuses at risk for growth restriction or macrosomia and therefore at risk for increased perinatal morbidity and death.

Cultural Diversity↗