Objectives: To (a) compare ultrasound (US; including grey scale and colour and power Doppler) and magnetic resonance imaging (MRI; with high resolution and fat saturation sequences) with a clinical yardstick in the evaluation of chronic Achilles tendinopathy, and (b) examine whether either imaging method predicted 12 and 24 month clinical outcome. Methods: Forty five patients with symptoms in 57 Achilles tendons were diagnosed with tendinopathy by an experienced sports medicine doctor. All patients underwent US examination (12 MHz probe) with colour and power Doppler, and 25 consecutive patients also underwent MRI with high resolution T1 weighted and STIR sequences. Results: US identified abnormal morphology in 37 of the 57 symptomatic tendons (65%) and normal morphology in 19 of 28 asymptomatic tendons (68%). Baseline US findings did not predict 12 month clinical outcome. The addition of colour and power Doppler did not improve the diagnostic performance of US. MRI identified abnormal morphology in 19 of 34 symptomatic tendons (56%) and normal morphology in 15 of 16 asymptomatic tendons (94%). Lesser grades of MR signal abnormality at baseline were associated with better clinical status at 12 month follow up. Conclusions: US and MRI show only moderate correlation with clinical assessment of chronic Achilles tendinopathy. Graded MRI appearance was associated with clinical outcome but US was not. B oth ultrasound (US) and magnetic resonance imaging (MRI) can provide excellent morphological information in patients with overuse injury of the Achilles tendon.
High success rates in clinical trials on keratoconic corneas suggest the possibility of efficient treatment against myopic progression. This study quantitatively investigated the in vitro ultrastructural effects of a photooxidative collagen cross-linking treatment with photosensitizer riboflavin and UVA light in human corneo-scleral collagen fibrils. A total of 30.8 × 2 mm corneo-scleral strips from donor tissue were sagittally dissected using a scalpel. The five analytic parameters namely fibril density, fibril area, corneo-scleral thickness, fibril diameter, and fibril arrangement were investigated before and after riboflavin-UVA-catalyzed collagen cross-linking treatment. Collagen cross-linking effects were measured at the corneo-scleral stroma and were based on clinical corneal cross-linking procedures. The structural response levels were assessed by histology, digital mechanical caliper measurement, scanning electron microscopy, and atomic force microscopy. Riboflavin-UVA-catalyzed collagen cross-linking treatment led to an increase in the area, density, and diameters of both corneal (110, 112, and 103 %) and scleral (133, 133, and 127 %) stromal collagens. It also led to increases in corneal (107 %) and scleral (105 %) thickness. Collagen cross-linking treatment through riboflavin-sensitized photoreaction may cause structural property changes in the collagen fibril network of the cornea and sclera due to stromal edema and interfibrillar spacing narrowing. These changes were particularly prominent in the sclera. This technique can be used to treat progressive keratoconus in the cornea as well as progressive myopia in the sclera. Long-term collagen cross-linking treatment of keratoconic and myopic progression dramatically improves weakened corneo-scleral tissues.
This study examined the effects of an orthodontic treatment using a bicuspid extraction on the surface roughness and mechanical properties of stainless steel (SS) brackets adjacent to the extraction space. Four experimental groups were employed; groups 1 and 2 used the Archist(®) SS brackets before and after the extraction treatment, respectively, and groups 3 and 4 used the Victory(®) SS brackets before and after the extraction treatment, respectively. The slot surfaces of the bracket were scanned in air at a resolution of 512 × 512 pixels with a scan speed of 0.8 line/s. The visco-elasticity of the bracket slot was determined from the force-distance curves of atomic force microscopy. The orthodontic treatment with bicuspid extraction led to a significant increase (p<0.0001) in surface roughness in both groups. In particular, the Archist(®) SS brackets showed more changes than the Victory(®) SS brackets (p<0.0005). However, there was no significant difference in properties of the Victory(®) and Archist(®) brackets between before and after treatment. This suggests that the orthodontic treatment with bicuspid extraction is more responsible for the changes in surface roughness than the properties of the brackets.
PRF-induced pain relief may be due to temporary blockage of nerve signals through the nerve pathway responsible for reversible neuronal depression. However, CRF-induced pain relief may be due to permanent blockage of nerve signals through other nerve pathways. Therefore, CRF could be applied to chronic inflammatory models used to study the mechanism of neuropathic pain.
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