Clinical Outcome vs. Structural Integrity: What Really Matters?

BACKGROUND Corneal blindness has been a significant visual disability in developing countries like India. Corneal ulcer contributes mainly as the leading cause for monocular blindness. Considering the common condition, the studies and literature have been surprisingly less when it comes to corneal ulcer and their management. But with the advent of therapeutic penetrating keratoplasty (TPK), the scenario and prevalence of corneal blindness can be reduced. Hence this study was done to know the importance of therapeutic penetrating keratoplasty in case of non-healing infective and perforated corneal ulcers. The objectives were to assess the clinical outcome in a non-healing and perforated corneal ulcer, reduction in symptoms and signs of infection, anatomical or structural integrity of the globe and also evaluate the visual outcome following therapeutic penetrating keratoplasty. METHODS Data were obtained from 30 patients operated at our institute for therapeutic penetrating keratoplasty. Patients with less than one year of follow up, paediatric cases, PL negative cases were excluded. The outcome was assessed based on maintenance of structural integrity, reduction in infective load, improvement in visual acuity and graft survival and its correlation with corneal vascularisation, previously failed grafts, donor tissue quality, graft size and type of surgery. RESULTS Structural integrity was maintained in 93.3 % of the cases, reduction of infective load in 90 % of cases and optically clear grafts in 46.7 % of cases and vision was better than 6/60 in 30 % of cases. CONCLUSIONS The study proved that in the case of non-healing and perforated corneal ulcers, therapeutic penetrating keratoplasty had a good prognosis in reducing infective load, maintaining structural integrity without which eye could have been lost. KEYWORDS Therapeutic Penetrating keratoplasty, Perforated corneal ulcer, non-healing corneal ulcer, corneal blindness, TPK

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Lesion-symptom mapping with NIHSS sub-scores in ischemic stroke patients

Stroke and Vascular Neurology ◽

10.1136/svn-2021-001091 ◽

2021 ◽

pp. svn-2021-001091

Author(s):

Deepthi Rajashekar ◽

Matthias Wilms ◽

M Ethan MacDonald ◽

Serena Schimert ◽

Michael D Hill ◽

...

Keyword(s):

Clinical Outcome ◽

Structure Function ◽

Structural Integrity ◽

Brain Regions ◽

Specific Structure ◽

Neurological Deficits ◽

Escape Trial ◽

Nihss Score ◽

Post Stroke ◽

Lesion Symptom Mapping

BackgroundLesion-symptom mapping (LSM) is a statistical technique to investigate the population-specific relationship between structural integrity and post-stroke clinical outcome. In clinical practice, patients are commonly evaluated using the National Institutes of Health Stroke Scale (NIHSS), an 11-domain clinical score to quantitate neurological deficits due to stroke. So far, LSM studies have mostly used the total NIHSS score for analysis, which might not uncover subtle structure–function relationships associated with the specific sub-domains of the NIHSS evaluation. Thus, the aim of this work was to investigate the feasibility to perform LSM analyses with sub-score information to reveal category-specific structure–function relationships that a total score may not reveal.MethodsEmploying a multivariate technique, LSM analyses were conducted using a sample of 180 patients with NIHSS assessment at 48-hour post-stroke from the ESCAPE trial. The NIHSS domains were grouped into six categories using two schemes. LSM was conducted for each category of the two groupings and the total NIHSS score.ResultsSub-score LSMs not only identify most of the brain regions that are identified as critical by the total NIHSS score but also reveal additional brain regions critical to each function category of the NIHSS assessment without requiring extensive, specialised assessments.ConclusionThese findings show that widely available sub-scores of clinical outcome assessments can be used to investigate more specific structure–function relationships, which may improve predictive modelling of stroke outcomes in the context of modern clinical stroke assessments and neuroimaging.Trial registration numberNCT01778335.

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Clinical outcome and structural integrity of all-arthroscopic repair of degenerative subscapularis tendon tears

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-012-2147-7 ◽

2012 ◽

Vol 21 (7) ◽

pp. 1620-1625 ◽

Cited By ~ 6

Author(s):

Peer van der Zwaal ◽

Lisanne Schuller ◽

Thijs A. J. Urlings ◽

Emile G. Coerkamp ◽

Ewoud R. A. van Arkel ◽

...

Keyword(s):

Clinical Outcome ◽

Structural Integrity ◽

Arthroscopic Repair ◽

Subscapularis Tendon ◽

Tendon Tears

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Combined tears of the subscapularis and supraspinatus tendon: clinical outcome, rotator cuff strength and structural integrity following open repair

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-011-1400-8 ◽

2011 ◽

Vol 132 (1) ◽

pp. 41-50 ◽

Cited By ~ 22

Author(s):

Christoph Bartl ◽

Monika Senftl ◽

Stefan Eichhorn ◽

Konstantin Holzapfel ◽

Andreas Imhoff ◽

...

Keyword(s):

Rotator Cuff ◽

Clinical Outcome ◽

Structural Integrity ◽

Open Repair ◽

Supraspinatus Tendon

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Electron Beam Damage of Biomolecules Assessed by Energy Loss Spectroscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100069855 ◽

1978 ◽

Vol 36 (3) ◽

pp. 61-69

Author(s):

M. Isaacson ◽

M.L. Collins ◽

M. Listvan

Keyword(s):

Electron Microscopy ◽

Radiation Damage ◽

Structural Integrity ◽

Analytical Electron Microscopy ◽

High Dose ◽

Dose Rates ◽

Special Cases ◽

Analytical Electron ◽

Atom Migration ◽

Beam Damage

Over the past five years it has become evident that radiation damage provides the fundamental limit to the study of blomolecular structure by electron microscopy. In some special cases structural determinations at very low doses can be achieved through superposition techniques to study periodic (Unwin & Henderson, 1975) and nonperiodic (Saxton & Frank, 1977) specimens. In addition, protection methods such as glucose embedding (Unwin & Henderson, 1975) and maintenance of specimen hydration at low temperatures (Taylor & Glaeser, 1976) have also shown promise. Despite these successes, the basic nature of radiation damage in the electron microscope is far from clear. In general we cannot predict exactly how different structures will behave during electron Irradiation at high dose rates. Moreover, with the rapid rise of analytical electron microscopy over the last few years, nvicroscopists are becoming concerned with questions of compositional as well as structural integrity. It is important to measure changes in elemental composition arising from atom migration in or loss from the specimen as a result of electron bombardment.

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Structural integrity after cold storage of human epidermal model in hypothermosol: A correlative ultrastructural and fluorescent assay

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100169080 ◽

1994 ◽

Vol 52 ◽

pp. 270-271

Author(s):

Henry H. Eichelberger ◽

John G. Baust ◽

Robert G. Van Buskirk

Keyword(s):

Cold Storage ◽

Structural Integrity ◽

Culture Media ◽

Cell Structure ◽

Natural State ◽

Sodium Cacodylate ◽

Ruthenium Tetroxide ◽

Cacodylate Buffer ◽

Before And After

For research in cell differentiation and in vitro toxicology it is essential to provide a natural state of cell structure as a benchmark for interpreting results. Hypothermosol (Cryomedical Sciences, Rockville, MD) has proven useful in insuring the viability of synthetic human epidermis during cold-storage and in maintaining the epidermis’ ability to continue to differentiate following warming.Human epidermal equivalent, EpiDerm (MatTek Corporation, Ashland, MA) consisting of fully differentiated stratified human epidermal cells were grown on a microporous membrane. EpiDerm samples were fixed before and after cold-storage (4°C) for 5 days in Hypothermosol or skin culture media (MatTek Corporation) and allowed to recover for 7 days at 37°C. EpiDerm samples were fixed 1 hour in 2.5% glutaraldehyde in sodium cacodylate buffer (pH 7.2). A secondary fixation with 0.2% ruthenium tetroxide (Polysciences, Inc., Warrington, PA) in sodium cacodylate was carried out for 3 hours at 4°C. Other samples were similarly fixed, but with 1% Osmium tetroxide in place of ruthenium tetroxide. Samples were dehydrated through a graded acetone series, infiltrated with Spurrs resin (Polysciences Inc.) and polymerized at 70°C.

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High-Resolution electron crystallography of the light-harvesting chlorophyll-a/b protein complex from chloroplast membranes

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100181816 ◽

1990 ◽

Vol 48 (1) ◽

pp. 610-610

Author(s):

Werner Kühlbrandt ◽

Da Neng Wang ◽

K.H. Downing

Keyword(s):

High Resolution ◽

Electron Diffraction ◽

Chlorophyll A ◽

Protein Complex ◽

Structural Integrity ◽

Light Harvesting ◽

Lhc Ii ◽

Diffraction Patterns ◽

Difference Fourier ◽

2D Crystals

The light-harvesting chlorophyll-a/b protein complex (LHC-II) is the most abundant membrane protein in the chloroplasts of green plants where it functions as a molecular antenna of solar energy for photosynthesis. We have grown two-dimensional (2d) crystals of the purified, detergent-solubilized LHC-II . The crystals which measured 5 to 10 μm in diameter were stabilized for electron microscopy by washing with a 0.5% solution of tannin. Electron diffraction patterns of untilted 2d crystals cooled to 130 K showed sharp spots to 3.1 Å resolution. Spot-scan images of 2d crystals were recorded at 160 K with the Berkeley microscope . Images of untilted crystals were processed, using the unbending procedure by Henderson et al . A projection map of the complex at 3.7Å resolution was generated from electron diffraction amplitudes and high-resolution phases obtained by image processing .A difference Fourier analysis with the same image phases and electron diffraction amplitudes recorded of frozen, hydrated specimens showed no significant differences in the 3.7Å projection map. Our tannin treatment therefore does not affect the structural integrity of the complex.

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