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Purpose. The femoral anterior bow is an important factor in matching a femoral implant to a femur. However, its morphology in the Chinese population has rarely been reported. In this study, a three-dimensional measurement approach was adopted to provide accurate data. The aim was to supply a reference for designing a long-stemmed femoral prosthesis that is more suitable for Chinese people. Methods. Computed tomography data were collected from both lower limbs of 96 normal volunteers and reconstructed into a three-dimensional model using Mimics software. The parameters of the femoral anterior bow were measured using medical image analysis software. Statistical analysis was conducted using independent-samples and paired-samples t -tests with SPSS software. Results. All the indexes showed significant sexual difference ( P < 0.05 ). The minimum cross-sectional area of the femoral medullary cavity was larger in men ( 10.77 ± 1.53 mm) than in women ( 9.79 ± 1.27 mm). The distance from the position of the maximum curvature to the lower edge of the lesser trochanter was also larger in men ( 60.93 ± 5.81 mm) than in women ( 56.31 ± 2.80 mm). However, the curvature of the femoral medullary cavity centerline was larger in women ( 883.57 ± 249.74 mm) than in men ( 958.79 ± 266.61 mm). The femoral anterior bow morphological indexes of Chinese subjects were different from the published data for other populations. There were no significant differences between left and right femoral anterior bows in either sex ( P > 0.05 ). Conclusion. The three-dimensional measurement approach adopted in this study is more convenient and accurate than previous conventional methods, with high repeatability. The morphological indexes of the femoral anterior bow in this research suggest that population characteristics should be taken into account. This study will provide references for the design of long-stemmed femoral prostheses in the Chinese population.

Introduction: Entrapment of the lateral femoral cutaneous nerve (LFCN) of thigh results in meralgia paresthetica (MP). Standard electrophysiological tests for MP are technically demanding and unreliable. We aimed to study the role of pain-related evoked potentials (PREP) in the diagnosis of MP. Methods: Patients with MP and normal volunteers were included. PREP was recorded by stimulating the skin over the lateral thigh 20 cm below the anterior-superior iliac spine and recording from the cortex at Cz. Results: A total of 28 subjects and 56 LFCNs were studied. 36 nerves had MP and 20 were normal. The mean PREP latency was 118 (8) ms among normal controls and 164 (10.8) ms in MP. The optimal cut-off point for the diagnosis of MP was 134 ms. Area under receiver operator characteristic curve was 0.97; sensitivity was 91.7% and specificity was 100%. Conclusion: PREP is reliable and easy to use electrophysiological test in establishing the diagnosis of MP.

Background Optic disc melanocytoma (ODMC) was a benign pigmented intraocular tumor with the rare potential malignant transformation. This study was designed to evaluate tumor vasculature with optical coherence tomography angiography (OCTA) in ODMC. Methods Eyes of healthy individuals in a control group and of patients with ODMC were imaged by OCTA systems operating at 840 nm wavelengths and examined. The main outcome measures were OCTA images, qualitative evaluation of optic disc and tumor vasculature, quantitative vascular density (VD) and perfusion density (PD). Results One eye of ten normal volunteers and ten patients with ODMC were imaged. Eyes affected by ODMC as compared to the eyes of the control group (all P P P P > 0.05) between the ODMC and the control eyes. At 840 nm, OCTA could provide sufficient visualization of the tumor vasculature and better penetration through thicker tumors. The full thickness was visualized even in thicker tumors and highly pigmented lesions (> 2 mm). Interpretable OCTA images were obtained in 96% of the participants in whom imaging was attempted. Conclusions OCTA may provide a noninvasive, safe, and efficient technique for evaluating a variety of neoplasms including the growth and vascularity in ODMC. OCTA could facilitate the evaluation of the vascular abnormalities of tumors and the effect of melanin on the penetration of the OCTA beam was not significant.

Videoflurographic swallowing study in asymptomatic volunteers.The purpose of this study was to investigate the relationship between the severity of dysphagia and various parameters of the subjects.Occipitocervical fixation is associated with several potential complications. Malalignment of craniovertebral junction and associated dysphagia have been well described in the literature. However, there has been little attention given to investigate the association between the degree of swallowing dysfunction and various patient's parameters.Thirty-nine healthy asymptomatic volunteers, 18 males and 21 females, were enrolled in this study. Based on videofluorographic swallowing study (VFSS), two scoring systems of swallowing dysfunction (dysphagia rating scale [DRS], dysphagia outcome and severity scale [DOSS]) were measured in neutral and retraction position. Multiple linear regression analysis was performed to evaluate the relationship between the degree of swallowing dysfunction and various factors of the subjects such as radiological and clinical parameters.There was statistically significant correlation between DRS and DOSS (r = -0.354, P 0.05). Multiple regression analysis showed that there was a significant association of the dysphagia severity (DRS and DOSS) with the percentile change of the narrowest oropharyngeal diameter (OD) (%dn OD) (r = 0.121, P 0.01 and r = 0.020, P 0.01, respectively). Percentile change of OD (neutral and retraction position) was positively associated with the difference of C0-2 angle (r = 1.676, P 0.01). None of the other variables such as age, sex, C0-1 angle, C1-2 angle, and C2-7 angle were significantly associated with the degree of dysphagia or %dn OD.This study demonstrated that the severity of dysphagia is significantly associated with the percentile change of OD and the C0-2 angle has considerable effect on the OD after O-C fusion. Therefore, C0-2 angle could be the most critical radiological parameter not only for predicting the stricture of oropharyngeal space but also for preventing postoperative dysphagia.4.

Purpose: Vertical reading is an adaptive reading strategy sometimes used in homonymous hemianopia. This study aimed to measure horizontal and vertical reading speeds in visually normal volunteers using the Radner Reading Chart.\ud \ud \ud \ud Methods: Fifteen orthoptic students, mean age 19.7 years, took part in this repeated measures study. Participants read sentences aloud from the Radner Reading Chart horizontally and rotated vertically, to read up and down the line. Words read correctly and the time taken to read each sentence were recorded.\ud \ud \ud \ud Results: Reading speeds were calculated (words read correctly per second) for horizontal text (2.95 words per second) and for vertical text, reading up the line (1.73 words per second) and reading down the line (1.57 words per second). Reading horizontal text was significantly faster than reading vertical text. Reading horizontal text was 1.22 words per second faster than reading text vertically up (p < 0.0001) and 1.38 words per second faster than text vertically down (p < 0.0001). There was no statistically significant difference between reading text vertically up the line and vertically down the line (0.16 words per second, p = 0.42).\ud \ud \ud \ud Conclusion: Horizontal reading speed, measured with the Radner Reading Chart, was significantly faster than both vertical reading speeds. There was no significant difference between reading vertically up the line and reading vertically down the line. The slower time taken to read the vertically orientated sentences had a greater effect on reading speed than the number of errors made.

Aim and objective Evaluate the short-term safety and efficacy of dexmedetomidine (0.0055%) drops on intraocular pressure (IOP) in healthy eyes. Materials and methods In this randomized controlled trial, patients with normal eye exams were randomly assigned to receive, in a randomly selected eye, one drop of either balanced salt solution (BSS) or dexmedetomidine (0.0055%). Goldmann applanation tonometry was performed at baseline and then 30 minutes, 4 hours, and 24 hours after drop instillation. Results Forty-nine eyes of 49 normal volunteers were enrolled in the study, with 21 eyes (group I) receiving BSS and 28 (group II) dexmedetomidine. Both groups were comparable at baseline as far as age and IOP (p = 0.55 for both parameters). Intraocular pressure significantly decreased from baseline in group II at 30 minutes and 4 hours (p = 0.001 and 0.05, respectively). Maximum IOP decrease was obtained at 30 minutes after dexmedetomidine instillation, with a 9% decrease from baseline (mean decrease: 1.15 mm Hg). The percentage of IOP decrease was significantly higher in group II at 30 minutes compared with group I (9 vs 1.1%; p = 0.05). No side effects were recorded. Conclusion In this pilot study, dexmedetomidine 0.0055% drops have shown good safety and efficacy in lowering IOP in normal healthy volunteers with no history of glaucoma. This medication has a short onset of action, with a 10% reduction of IOP occurring 30 minutes post-instillation. Trial registration number NCT03690622. How to cite this article Fakhoury H, Abdelmassih Y, El-Khoury S, et al. The Effect of Topical Dexmedetomidine (0.0055%) on Intraocular Pressure in Healthy Eyes: A Randomized Controlled Trial. J Curr Glaucoma Pract 2021;15(2):58-63.

Shunya Tatara,1,2 Fumiatsu Maeda,1,3 Yoshinosuke Tsukahara,4 Tomoya Handa,2,5 Kiyoshi Yaoeda3,6,7 1Department of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata, Japan; 2Department of Vision Science, Faculty of Sensory and Motor Control, Kitasato University Graduate School of Medical Science, Sagamihara, Kanagawa, Japan; 3Field of Orthoptics and Visual Sciences, Major in Medical and Rehabilitation Sciences, Niigata University of Health and Welfare Graduate School, Niigata, Japan; 4Department of Ophthalmology, University of Yamanashi, Chuo, Yamanashi, Japan; 5Orthoptics and Visual Science, Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan; 6Department of Ophthalmology, Yaoeda Eye Clinic, Nagaoka, Niigata, Japan; 7Division of Ophthalmology and Visual Sciences, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JapanCorrespondence: Shunya TataraDepartment of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, 1398 Shimami-cho, kita-ku, Niigata-shi, Niigata, 950-3198, JapanTel/Fax +81 25 257 4752Email tatara@nuhw.ac.jpPurpose: Intraocular pressure (IOP) measured using a noncontact tonometer is evaluated by performing multiple measurements because IOP is affected by the ocular pulse. We investigated the relationship between value fluctuations in multiple measurements during noncontact tonometer measurements and cardiac rate.Materials and Methods: Forty-two healthy subjects were included and IOP was measured using a noncontact tonometer. The measurement was performed three times each for the right eye and the left eye, for a total of six times. Blood pressure and cardiac rate were measured at the same time as the IOP measurement. Using repeated-measures analysis of variance, we examined whether the measured IOP and cardiac rate fluctuate throughout the day over the course of 4 days.Results: There was a fluctuation in the IOP in a sequence only on day 1 of the four measurement days (P < 0.001). The IOP on day 1 tended to be high for the first and second measurements (P = 0.0111– 0.0015). Systolic blood pressure and diastolic blood pressure did not fluctuate over the 4 days (P = 0.6247 and 0.7132), but cardiac rate was high only on day 1 (P = 0.0276).Conclusion: The IOP on day 1 tended to be high in the first and second measurements. The IOP measured on days 2– 4 did not fluctuate during the sequence of measurements. The cardiac rate measured at the same time as the IOP was high only on the first day.Keywords: intraocular pressure, noncontact tonometer, blood pressure, cardiac rate, repeated measurement

Positron emission tomography (PET) scans of imaging receptors require 60–90-min dynamic acquisition for quantitative analysis. Head movement is often observed during scanning, which hampers the reliable estimation of quantitative parameters. This study evaluated image-based motion correction by frame-to-frame realignment for PET studies with [11C]raclopride and [11C]FLB 457 acquired by an Eminence SET-3000GCT/X and investigated the effect of this correction on the quantitative outcomes. First, an optimal method for estimating motion parameters was evaluated by computer simulation. Simulated emission sinograms were reconstructed to the PET images with or without attenuation correction using a µ-map of the transmission scan. Six motion parameters were estimated frame-by-frame by registering each frame of the PET images to several types of reference images and the reliability of registration was compared. Next, in [11C]raclopride and [11C]FLB 457 studies in normal volunteers, six motion parameters for each frame were estimated by the registration method determined from the simulation results. Head movement was corrected by realigning the PET images reconstructed with a motion-included µ-map in which a mismatch between the transmission and emission scans was corrected. After this correction, time-activity curves (TAC) for the striatum or cerebral cortex were obtained and the binding potentials of the receptors (BPND) were estimated using the simplified reference tissue model. In the simulations, the motion parameters could be reliably estimated by registering each frame of the non-attenuation-corrected PET images to their early-phase frame. The motion parameters in the human studies were also obtained using the same method. After correction, a discontinuity of TACs in the striatum and cerebral cortex was remarkably improved and the BPND values in these regions increased. Compared to the motion-corrected PET images reconstructed using the measured µ-map, the images reconstructed using the motion-included µ-map did not result in a remarkable improvement of BPND in the striatum of [11C]raclopride studies, while the BPND in the cerebral cortex changed in some [11C]FLB 457 studies in which large head movement was observed. In PET receptor imaging, head movement during dynamic scans can be corrected by frame-to-frame realignment. This method is easily applicable to clinical studies and provides reliable TACs and BPND.

Based on its high affinity for μ opiate receptors and reported half‐life after oral administration, the pharmacokinetic properties of intranasal naltrexone were examined to evaluate its potential to treat opioid overdose. This study was prompted by the marked rise in overdose deaths linked to synthetic opioids like fentanyl, which may require more potent, longer‐lived opiate antagonists than naloxone. Both the maximum plasma concentration (Cmax) and the time (Tmax) to reach Cmax for intranasal naltrexone (4 mg) were comparable to values reported for a Food and Drug Administration‐approved 4‐mg dose of intranasal naloxone. The addition of the absorption enhancer dodecyl maltoside (Intravail) increased Cmax by ∼3‐fold and reduced the Tmax from 0.5 to 0.17 hours. Despite these very rapid increases in plasma concentrations of naltrexone, its short half‐life following intranasal administration (∼2.2 hours) could limit its usefulness as a rescue medication, particularly against longer‐lived synthetic opioids. Nonetheless, the ability to rapidly attain high plasma concentrations of naltrexone may be useful in other indications, including an as‐needed dosing strategy to treat alcohol use disorder.

BackgroundMost of our decisions involve a certain degree of risk regarding the outcomes of our choices. People vary in the way they make decisions, resulting in different levels of risk-taking behavior. These differences have been linked to prefrontal theta band activity. However, a direct functional relationship between prefrontal theta band activity and risk-taking has not yet been demonstrated.ObjectiveWe used noninvasive brain stimulation to test the functional relevance of prefrontal oscillatory theta activity for the regulatory control of risk-taking behavior.MethodsIn a within-subject experiment, 31 healthy participants received theta (6.5 Hertz [Hz]), gamma (40 Hz), and sham transcranial alternating current stimulation (tACS) over the left prefrontal cortex (lPFC). During stimulation, participants completed a task assessing their risk-taking behavior as well as response times and sensitivity to value and outcome probabilities. Electroencephalography (EEG) was recorded before and immediately after stimulation to investigate possible long-lasting stimulation effects.ResultsTheta band, but not gamma band or sham, tACS led to a significant reduction in risk-taking behavior, indicating a frequency-specific effect of prefrontal brain stimulation on the modulation of risk-taking behavior. Moreover, theta band stimulation led to increased response times and decreased sensitivity to reward values. EEG data analyses did not show an offline increase in power in the stimulated frequencies after the stimulation protocol.ConclusionThese findings provide direct empirical evidence for the effects of prefrontal theta band stimulation on behavioral risk-taking regulation.

Introduction. Patients with epilepsy associated with focal cortical dysplasia (FCD) may be associated with autism spectrum disorder (ASD). Therefore, the purpose of this study was to compare surgically treated patients with epilepsy secondary to FCD and normal volunteers without epilepsy and to review the neuropathological findings of patients with FCD. Methods This study involved 38 patients with medically intractable focal onset epileptic seizures who underwent epilepsy surgery (Group 1). All patients had epilepsy associated with FCD. These patients and 38 normal volunteers without epilepsy (Group 2) were administered the autism spectrum quotient (AQ) test, and the groups were compared. Results The 38 patients in Group 1 included 16 females and 22 males (age range 20–60, mean age, 33.0; standard deviation (SD), 11.8 years). The normal volunteers in Group 2 included 22 females and 16 males (age range 20–57, mean age, 30.6 years; SD, 8.8 years). Total AQ scores were significantly higher in Group 1 than Group 2 (p = 0.027). Patients with FCD I showed a higher AQ score than those with FCD II in the AQ test (p ≤ 0.001). Conclusion Patients with epilepsy secondary to FCD were associated with higher ASD score than normal volunteers. This tendency was seen more strongly in patients with FCD I than FCD II.

Aims: Alzheimer’s disease (AD) is a gradually progressive neurodegenerative disease that ultimately results in total loss of cognitive and functional independence in older adults. This study aimed to examine the safety and tolerability of APOE disclosure in community-dwelling, cognitively normal (CN) older adults from the Butler Alzheimer’s Prevention Registry (BAPR), and to determine whether APOE disclosure impacted participant’s decisions to participate in AD clinical research. Methods: 186 (N = 106 ∊4 non-carriers, 80 ∊4 carriers) CN older adults aged 58-78 from the BAPR completed 2 visits: one for psychological readiness screening and genotyping and one for APOE disclosure. Online follow-ups were completed 3 days, 6 weeks, and 6 months post-disclosure. Primary outcomes were scores on self-report measures of depression, anxiety, impact of events, and perceived risk of AD, along with enrollment in AD clinical trials. Results: ∊4 carriers and non-carriers did not differ significantly on measures of depression, anxiety, or suicidal ideation over the 6-month follow-up period. ∊4 carriers reported higher impact of disclosure than non-carriers immediately after disclosure, but both groups’ scores on impact of events measures remained sub-clinical. ∊4 carriers and non-carriers were equally likely to participate in AD research after disclosure, with genotype-dependent differences in type of clinical trial enrollment. Conclusions: APOE genotyping and disclosure was safe and well tolerated in a group of CN, community-dwelling older adults, who were pre-screened after volunteering for AD research through BAPR. Implications for the inclusion of APOE genotyping and disclosure at AD clinical trial sites are discussed.

PURPOSE: The aim of this study was to confirm our clinical observation that a pseudo-tear appearance of the Achilles tendon is commonly seen on MRI and is of no clinical relevance. MATERIALS AND METHODS: Forty-one ankles were imaged on a 3 T MR system, and PD weighted images with fat saturation were obtained in three orthogonal planes (TR, 2969 ms; TE, 30 ms; NA, 2; slice thickness, 2.5 mm). Volunteer exclusion criteria were symptoms of Achilles tendon pathology (such as acute or chronic posterior heel pain), history of trauma or surgery of the Achilles tendon. Internal signal of the Achilles tendon on axial and sagittal images was assessed independently by two observers. Internal signal of the Achilles tendon was classified from homogenously dark to different degree of hyperintense signal, where 0 means no internal hyperintensity, 1-minimal hyperintensity, 2-moderate and 3-marked. Descriptive statistics were calculated. Correlation between the two readers was also assessed. Two fresh cadavers were used in this study, one specimen being sliced in the sagittal plane and one specimen being dissected by an experienced anatomist. RESULTS: Twenty one volunteers (8 men, 13 women), mean age of 24.7 years (19-43 years) were included in the study. On sagittal images both raters appreciated any degree of hyperintense signal in 59% of tendons. On axial images any degree of hyperintensity was seen in almost half of the cases (46 vs. 49%). Minimal hyperintensities were seen most commonly. Cohen's kappa coefficient for sagittal images was 0.964 (almost perfect agreement); for axial images 0.764 (substantial agreement). The anatomical studies demonstrated that the Achilles tendon is made up of different components that are partially separated and twist around each other explaining the pseudo-tear appearance. CONCLUSION: The Achilles tendon is frequently not homogenously dark in normal volunteers as would be expected. Hyperintense signal is common in the long and short axis and related to the underlying anatomical features.

PURPOSE In triggered acquisition noncontrast enhancement magnetic resonance angiography using ECG-gated with short-term inversion recovery (STIR-TRANCE), signal intensity and contrast fluctuate according to the value of refocus flip angle (RFA). We believe that we can visualize the pulmonary vascular excellently by optimized RFA which improves the signal intensity of pulmonary vascular and the contrast between pulmonary vascular and lung parenchyma. The purpose of this study is to optimize RFA in pulmonary vascular magnetic resonance angiography (MRA) imaging using STIR-TRANCE. METHOD Pulmonary vascular MRA was performed in five normal volunteers. The department's ethics committee approved the study, and informed consent was obtained from all subjects. Before the STIR-TRANCE study, an ECG-gated single shot TSE (SS TSE) scan was performed to determine the timing of diastole. Later, the diastolic STIR-TRANCE imaging using both ECG and respiratory gating was performed with three different RFA (140 degree, 160 degree, and 180 degree). For physical evaluation, we used the signal to noise ratio (SNR) and contrast and for visual evaluation, so we used the Scheffe's method. RESULTS SNR increases with increasing RFA. The contrast of 160 degree was significantly higher than the contrast of 180 degree. There was no significant difference in visual evaluation. CONCLUSION From the perspective of specific absorption rate (SAR) reduction, we concluded that the optimal RFA for pulmonary vascular MRA in this study was 160 degree.

Background. Only few direct comparative studies evaluated the effectiveness of telemedicine-guided home blood pressure (tele-HBPM) compared to 24 h ambulatory blood pressure monitoring (ABPM) in assessing blood pressure (BP) and BP control. Material and methods. This prospective clinical trial included patients with arterial hypertension, with (n = 23) and without (n = 18) chronic kidney disease and normal volunteers (n = 16). All subjects underwent with a 1-month interval twice one-week of BP monitoring with office BP (3 measurements at 2 visits), 24 h-ABPM and tele-HBPM during 7 consecutive days. Results. Mean (SD) BP levels were 128/77 [19/11] mm Hg and 126/75 [14/9] mm Hg for tele-HBPM, 129/78 [17/11] mm Hg and 127/75 [14/9] mm Hg for daytime-ABPM, and 133/77 [23/12] mm Hg and 130/74 [17/11] mm Hg for office BP, all respectively at the first and the second measurement periods. Blood pressure and BP control were comparable between the two out-of-office techniques. Conclusion. Both out-of-office techniques (tele-HBPM and 24h-ABPM) show good agreement for systolic as well as diastolic BP, and are equally effective in assessing BP and BP control, explicitly during daytime.

Purpose. To evaluate differences of Achilles tendon (AT) hardness and morphology between asymptomatic tendons in patients with acute AT ruptures on the contralateral side and asymptomatic tendons in healthy people by using computer-assisted quantification on axial-strain sonoelastography (ASE). Methods. The study consisted of 33 asymptomatic tendons in 33 patients (study group) and 34 tendons in 19 healthy volunteers (control group). All the tendons were examined by both ASE and conventional ultrasound. Computer-assisted quantification on ASE was applied to extract hardness variables, including the mean (Hmean), 20th percentile (H20), median (H50) and skewness (Hsk) of the hardness within tendon, and the ratio of the mean hardness within tendon to that outside tendon (Hratio) and three morphological variables: the thickness (THK), cross-sectional area, and eccentricity (ECC) of tendons. Results. The Hmean, Hsk, H20, H50, and Hratio in the proximal third of the tendon body in study group were significantly smaller than those in control group (Hmean: 0.43±0.09 vs 0.50±0.07, p=0.001; Hsk: -0.53±0.51 vs -1.09±0.51, p Conclusions. As a quantitative objective method, the computer-assisted ASE reveals that the asymptomatic ATs contralateral to acute rupture are softer than those of healthy control group at the proximal third and the asymptomatic tendons in people with rupture history are thicker, larger, and rounder than those of normal volunteers especially at the middle and distal thirds of AT body.

Background. The purpose of this observational case series study was to investigate the role of 25 MHz ultrasound biomicroscopy (UBM) in detecting subluxated lenses and compare it with 50 MHz UBM. Methods. 45 patients (49 eyes) with suspected subluxation of the lens and 20 normal volunteers (40 eyes) were included. Different cross-sectional images of the lens position were captured in axial and longitudinal scanning modes using 25 and 50 MHz UBM. The main outcome measurements included the linear distance between the lens equator and ciliary process, the difference value (D-value) between the same cross section of the above bilateral linear distance in the normal and the subluxated subjects, the diagnostic accuracy, and the testing times obtained with 25 and 50 MHz UBM. Results. The position of the lens on axial sections could be clearly shown by using 25 MHz UBM. The D-value of the subluxated eyes was 1-2 mm longer than that of the normal ones. There was a statistically significant difference between 25 and 50 MHz UBM in showing subluxation of the lens, the testing time was significantly faster (2.0 min versus 7.5 min), and the diagnostic accuracy was much higher (98.0% versus 71.4%) with 25 versus 50 MHz UBM. Fifteen eyes with slightly subluxated lens were detected by 25 MHz UBM, and only one eye with slight lens subluxation was detected by 50 MHz UBM. Conclusions. The results indicated that 25 MHz UBM has a greater diagnostic value than 50 MHz UBM in verifying the status of the lens subluxation and can provide reliable and quantitative imaging evidence for clinical use. This trial is registered with ChiCTR–DOD –15007603.

The aim of this study was to characterize the standard morphology of the oral commissure and to describe the changes after reconstruction in patients with through-and-through cheek defects involving the oral commissure. Indices for the morphological analyses of the commissure were derived from examinations of 50 normal Japanese volunteers. Ten patients with full-thickness cheek defects involving the commissure were then evaluated. All of these patients underwent free flap reconstruction with vermilion advancement flaps from the remaining vermilion. The morphology of the commissure with the mouth closed was classified based on the point of entrance of the vermilion into the oral cavity. In normal volunteers, the commissure pattern consisting of the entrance of the upper vermilion into the oral cavity before the lower vermilion and just prior to forming the oral commissure was considered to be the standard. However, in the reconstructed cases, there was an increase in the pattern in which the lower vermilion enters the oral cavity before the upper vermilion for the remaining commissure postoperatively, especially when the lower lip defects were greater than those of the upper lip. It is important to refer not only to the standard morphology of the commissure, but also to the changes according to the extent of resection and the method of reconstruction.

Background Measurements of transepidermal water loss (TEWL) and stratum corneum (SC) hydration are important for assessing epidermal functions. However, the availability of reliable and user-friendly devices, which can simultaneously measure both TEWL and SC hydration and can allow health providers to remotely access data in time, is limited. Materials and methods GPSkin Barrier® was compared with MPA5 system in the measurements of TEWL and SC hydration on the cheek, the dorsal hand, and the forearm in 200 normal volunteers, including 126 females and 74 males, aged 1-78 years with an average age of 45.24 ± 1.04 years. Correlation of data measured with MPA5 system and GPSkin Barrier® was determined. Results Levels of both TEWL and SC hydration measured with the Barrie GPSkin Barrier® were lower than that with MPA5 system on all 3 body sites except for hydration on the cheek. The levels of both TEWL and SC hydration measured with GpSkin Barrier® were correlated well with that measured with MPA5 system on all 3 body sites CONCLUSIONS: GPSkin Barrier® is a reliable, affordable, and versatile device for assessing epidermal permeability barrier function and SC hydration.

Purpose To investigate the effect of multiple enface image averaging on image quality of the optical coherence tomography angiography (OCTA). Methods Twenty-one normal volunteers were enrolled in this study. For each subject, one eye was imaged with 3 × 3 mm scan protocol, and another eye was imaged with the 6 × 6 mm scan protocol centred on the fovea using the ZEISS Angioplex™ spectral-domain OCTA device. Eyes were repeatedly imaged to obtain nine OCTA cube scan sets, and nine superficial capillary plexus (SCP) and deep capillary plexus (DCP) were individually averaged after registration. Results Eighteen eyes with a 3 × 3 mm scan field and 14 eyes with a 6 × 6 mm scan field were studied. Averaged images showed more continuous vessels and less background noise in both the SCP and the DCP as the number of frames used for averaging increased, with both 3 × 3 and 6 × 6 mm scan protocols. The intensity histogram of the vessels dramatically changed after averaging. Contrast-to-noise ratio (CNR) and subjectively assessed image quality scores also increased as the number of frames used for averaging increased in all image types. However, the additional benefit in quality diminished when averaging more than five frames. Averaging only three frames achieved significant improvement in CNR and the score assigned by certified grades. Conclusion Use of multiple image averaging in OCTA enface images was found to be both objectively and subjectively effective for enhancing image quality. These findings may of value for developing optimal OCTA imaging protocols for future studies.

OBJECTIVE To determine the effect of botulinum toxin A (BTX-A) on the eyelid pressure in patients with benign essential blepharospasm (BEB). METHODS Twenty normal volunteers (10 men, 10 women; average age 59.7 ± 11.3 years) and 33 patients (12 men, 21 women; average age 61.1 ± 14.7 years) with BEB were studied. The upper and lower eyelid pressures were measured with a blepharo-tensiometer in the normal subjects (N group). The eyelid pressures and intraocular pressures (IOP) were measured before and after the BTX-A injections in the BEB patients (B group). RESULTS The mean eyelid pressure in the N group was 31.0 ± 6.8 mmHg for the upper eyelid and 29.9 ± 6.5 mmHg for the lower eyelid (P > 0.05). The mean eyelid pressure in the B group before treatment was 35.3 ± 7.0 mmHg for the upper eyelid and 37.8 ± 6.6 mmHg for the lower eyelid. The eyelid pressure in the B group was significantly higher than in the N group for the upper and lower eyelids (both P