AIMS: The aim of the study was to analyse the values of the anteroposterior corneal optical power ratio (AP ratio), to compare the resulting values with those of theoretical models of the eye, and to define the effect of using an individual ratio value on the approximation of the total corneal power. MATERIAL AND METHODS: A total of 406 eyes were included. Each patient underwent an OCT (RTVue XR) examination, according to which the AP ratio of the cornea was determined, as well as the biometric parameters of the eye (Lenstar LS900). The correlation between the biometric parameters of the eye and the individual AP ratio values was evaluated using Pearsons correlation coefficient. In the analysis, the AP ratio results were compared with selected schematic models of the eye. Using Gaussian equations, a theoretical calculation of the total corneal optical power (KG) was performed, by fitting the AP ratio value and comparing it with the actually measured total corneal power (TCP). RESULTS: The mean value of the individually determined AP ratio was 1.17 ±0.02. The most frequently represented interval (33.74 %) was 1.17 to 1.18 AP ratio values, with the vast majority of eyes (79.56 %) in the range of 1.15 to 1.20. Individual values of total corneal optical power were statistically significantly different (p < 0.05) from the theoretical values of TCP (except in the Liu-Brennan eye model, where p = 0.06). The lowest mean difference of values was found for the Navarro schematic model. The dependence of the measured AP ratio values and biometric parameters reached a moderate negative correlation (r = -0.50 for p < 0.05) with the parameter corneal posterior surface curvature (Rp), as well as a weak negative correlation with limbal diameter WtW (r = -0.26 for p < 0.05) and a weak positive correlation with central corneal thickness CCT (r = 0.17 for p < 0.05). CONCLUSION: The assumption of a constant value of the AP ratio according to the selected schematic models of the eye is statistically significantly different from the actual measured values and was defined to have only a negative weak correlation with the size of the limbus diameter. Using the resulting average value of the determined AP ratio (1.17 ±0.02), a lower difference between real and calculated total corneal optical power was achieved.

• Klíčová slova
• corneal AP ratio, optical coherence tomography, optical cohoerence tomography, posterior corneal radius, total corneal power,
• MeSH
• biometrie MeSH
• lidé MeSH
• optická koherentní tomografie * metody   MeSH
• reprodukovatelnost výsledků MeSH
• rohovka * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE OF THE STUDY This study aims to ascertain whether a high anteversion of the femoral neck can influence the measurement of the caputcollum-diaphyseal (CCD) angle on a plain anteroposterior (AP) radiograph of the proximal femur. MATERIAL AND METHODS We developed a new method of measuring the CCD angle and femoral neck version of the femur. This was done with the use of a computer program that utilised the measurement of the entire visualised area of femoral neck and shaft to calculate their long axis. Using this method, we measured the CCD angle and femoral neck version (FNV) of 100 photographed cadaveric femurs in two projections: The condylar line (CL) projection and the femoral neck (FN) projection. The same method was applied to 50 radiographs of the same femurs. The femurs were divided into three groups depending on the femoral neck version: Retro (FNV of <0°), Normal (FNV of 0-15°) and Ante (FNV of >15°) RESULTS We found a statistically significant difference in the CCD angle measured in the FN and CL projections in the Normal and Ante groups but not in the Retro group. There is a significant correlation between the increase in FNV and the difference between the measured CCD values in the FL and CL projections. The femoral neck version of our cadaveric femurs varied from -14. 4° to 31. 5° which is a range of more than 35°. CONCLUSIONS From the results, it is clear that with an increase in femoral neck anteversion, there is a statistically significant difference in the CCD angle measured between the two projections. This difference can be up to almost 10°. Surgeons should be aware of the limitation of the AP projection when planning for surgery on the hip. Key words: femoral neck anteversion, CCD angle, templating, preoperative planning.

• MeSH
• diafýzy MeSH
• femur * diagnostické zobrazování   MeSH
• krček femuru diagnostické zobrazování   MeSH
• lidé MeSH
• počítačová rentgenová tomografie * MeSH
• radiografie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Peak amplitudes of the QRS complex were evaluated in 28 adult macaques (Macaca mulatta) and 28 adult baboons (Papio hamadryas), using two anatomically orthogonal lead systems. The anteroposterior (z) and the transversal (x) component of the cardiac electric field was smaller in females than in males. Comparison of QRS amplitudes in baboons and macaques indicates that the loop of the spatial vectorcardiogram is situated further ventrally and to the right in the former. The relationship between ventrally and dorsally oriented cardiac vectors, in both baboons and macaques, displays a prevalence of ventrally oriented vectors compared with man, in whom this type of relationship is normally not found after the second year of life.

• MeSH
• druhová specificita MeSH
• elektrokardiografie * MeSH
• Haplorrhini MeSH
• Macaca mulatta fyziologie   MeSH
• Macaca fyziologie   MeSH
• Papio fyziologie   MeSH
• sexuální faktory MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE Gamma Knife radiosurgery (GKRS) is frequently used to treat residual or recurrent nonfunctioning pituitary macroadenomas. There is no consensus as to whether GKRS should be used early after surgery or if radiosurgery should be withheld until there is evidence of imaging-defined progression of tumor. Given the high incidence of adenoma progression after subtotal resection over time, the present study intended to evaluate the effect of timing of radiosurgery on outcome. METHODS This is a multicenter retrospective review of patients with nonfunctioning pituitary macroadenomas who underwent transsphenoidal surgery followed by GKRS from 1987 to 2015 at 9 institutions affiliated with the International Gamma Knife Research Foundation. Patients were matched by adenoma and radiosurgical parameters and stratified based on the interval between last resection and radiosurgery. Operative results, imaging data, and clinical outcomes were compared across groups following early (≤ 6 months after resection) or late (> 6 months after resection) radiosurgery. RESULTS After matching, 222 patients met the authors' study criteria (from an initial collection of 496 patients) and were grouped based on early (n = 111) or late (n = 111) GKRS following transsphenoidal surgery. There was a greater risk of tumor progression after GKRS (p = 0.013) and residual tumor (p = 0.038) in the late radiosurgical group over a median imaging follow-up period of 68.5 months. No significant difference in the occurrence of post-GKRS endocrinopathy was observed (p = 0.68). Thirty percent of patients without endocrinopathy in the early cohort developed new endocrinopathies during the follow-up period versus 27% in the late cohort (p = 0.84). Fourteen percent of the patients in the early group and 25% of the patients in the late group experienced the resolution of endocrine dysfunction after original presentation (p = 0.32). CONCLUSIONS In this study, early GKRS was associated with a lower risk of radiological progression of subtotally resected nonfunctioning pituitary macroadenomas compared with expectant management followed by late radiosurgery. Delaying radiosurgery may increase patient risk for long-term adenoma progression. The timing of radiosurgery does not appear to significantly affect the rate of delayed endocrinopathy.

• Klíčová slova
• ACTH = adrenocorticotrophic hormone, AP = anteroposterior, CC = craniocaudal, GKRS = Gamma Knife radiosurgery, Gamma Knife, NFPA = nonfunctioning pituitary adenoma, SRS = stereotactic radiosurgery, TR = transverse, macroadenoma, nonfunctioning pituitary adenoma, pituitary surgery, stereotactic radiosurgery, transsphenoidal surgery,
• MeSH
• čas zasáhnout při rozvinutí nemoci * MeSH
• časná lékařská intervence * MeSH
• dospělí MeSH
• endoskopie MeSH
• kohortové studie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru diagnóza   chirurgie   MeSH
• nádory hypofýzy diagnóza   chirurgie   MeSH
• radiochirurgie normy   MeSH
• reoperace MeSH
• retrospektivní studie MeSH
• reziduální nádor diagnóza   chirurgie   MeSH
• senioři MeSH
• sinus sphenoidalis chirurgie   MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• srovnávací studie MeSH

PURPOSE: The objective of this study was to provide a morphologic description of the distal femur and to determine whether there are any gender differences in the shape that might have an important consequence for the design of a femoral component of a total knee prosthesis. METHODS: Anthropometric data on the distal femur of 200 normal knees were obtained using two-dimensional MRI measurements. In all 18 parameters of the distal femur were measured including the anteroposterior (AP) dimension of femoral condyles, the mediolateral (ML) width of the distal femur at four levels, and the AP dimension and ML width of the trochlea. The aspect ratios between the AP and ML dimensions were calculated to determine whether there is a shape difference between genders. RESULTS: The female distal femur is significantly smaller in all measured parameters. The mean AP/ML aspect ratio of the female distal femur is significantly larger (p<0.05) at all measured ML levels except that of the anterior edge of the anterior chamfer. The AP dimensions of both the medial and lateral trochlea were significantly greater in men (p<0.001), but AP/ML aspect ratio did not differ between genders. CONCLUSIONS: We have found that although the female distal femur is relatively narrower (larger AP/ML aspect ratio) than the male in three of the four measured levels, there is no significant difference between genders at the level of the anterior edge of the anterior chamfer. It is at this level that it has been suggested that impingement between soft tissues and an overhanging prosthesis is most likely to be painful. Equally, there were no gender-related differences in the shape of the trochlea. These data therefore do not support the provision of narrow femoral components for TKA for women.

• MeSH
• antropometrie MeSH
• artróza kolenních kloubů chirurgie   MeSH
• bolest chirurgie   MeSH
• dospělí MeSH
• femur anatomie a histologie   chirurgie   MeSH
• kolenní kloub chirurgie   MeSH
• koleno chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• magnetická rezonanční tomografie metody   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• pohlavní dimorfismus * MeSH
• protézy kolene MeSH
• totální endoprotéza kolene metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

PURPOSE: To investigate the setup margins in prostate cancer treatment without using daily online repositioning methods. METHODS: We analysed the data from patients treated with curative-intend radiotherapy. Each patient underwent a series of pretreatment online localizations during daily setup using conebeam CT. The skin-prostate shifts and bone-prostate shifts were recorded in anteroposterior (AP), craniocaudal (CC), and laterolateral (LL)direction. The safety margins based on van Herk equation (2.5Σ+0.7σ) were calculated and the correlations between margins and various patient characteristics and prostate locations were investigated. RESULTS: A total of 307 patients were included, representing 11,726 localisations resulting in 70,356 shifts. The man skin-prostate setup inaccuracy was 0.8 ± 5.4mm in AP, 1.3 ± 4.8mm for CC, and 0.1 ± 5.6mm in LL direction. The man bone-prostate setup inaccuracy was 0.4 ± 3.3mm in AP, 0.1 ± 2.5mm for CC, and 0.1 ± 1.4mm in LL direction. According to van Herk equation, clinical target volume (CTV)-planning target volume (PTV) margins of 11.4, 10.6, and 11.8 mm (AP, CC, and LL, respectively) would be required for setup using skin markers and margins of 7.0, 4.7, and 2.1mm would be necessary for setup using bone structures. The average rectal area < 11cm(2) and volume of bladder > 300 cm(3) were associated with smaller CTV-PTV margins for setup using bone structures. The largest margins (15.8 mm in LL direction) were needed in patients with body mass index (BMI) > 35 using skin markers. CONCLUSIONS: Our results confirm that the commonly used CTV-PTV margins are inadequate.

• MeSH
• lidé MeSH
• nádory prostaty diagnostické zobrazování   radioterapie   MeSH
• počítačová tomografie s kuželovým svazkem * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The biomechanical function of the anteromedial (AM) and posterolateral (PL) bundles of the anterior cruciate ligament (ACL) remains controversial. Some studies report that the AM bundle stabilises the knee joint in anteroposterior (AP) translation and rotational movement (both internal and external) to the same extent as the PL bundle. Others conclude that the PL bundle is more important than the AM in controlling rotational movement. The objective of this randomised cohort study involving 60 patients (39 men and 21 women) with a mean age of 32.9 years (18 to 53) was to evaluate the function of the AM and the PL bundles of the ACL in both AP and rotational movements of the knee joint after single-bundle and double-bundle ACL reconstruction using a computer navigation system. In the double-bundle group the patients were also randomised to have the AM or the PL bundle tensioned first, with knee laxity measured after each stage of reconstruction. All patients had isolated complete ACL tears, and the presence of a meniscal injury was the only supplementary pathology permitted for inclusion in the trial. The KT-1000 arthrometer was used to apply a constant load to evaluate the AP translation and the rolimeter was used to apply a constant rotational force. For the single-bundle group deviation was measured before and after ACL reconstruction. In the double-bundle group deviation was measured for the ACL-deficient, AM- or PL-reconstructed first conditions and for the total reconstruction. We found that the AM bundle in the double-bundle group controlled rotation as much as the single-bundle technique, and to a greater extent than the PL bundle in the double-bundle technique. The double-bundle technique increases AP translation and rotational stability in internal rotation more than the single-bundle technique.

• MeSH
• dospělí MeSH
• kolenní kloub patofyziologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• ligamentum cruciatum anterius patofyziologie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• poranění kolena patofyziologie   chirurgie   MeSH
• rekonstrukce předního zkříženého vazu * MeSH
• rotace MeSH
• stereotaktické techniky MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Stair descent is one of the most common forms of daily locomotion and concurrently one of the most challenging and hazardous daily activities performed by older adults. Thus, sufficient attention should be devoted to this locomotion and to the factors that affect it. This study investigates gender and age-related differences in balance control during and after stair descent on a foam mat. Forty-seven older adults (70% women) and 38 young adults (58% women) performed a descent from one step onto a foam mat. Anteroposterior (AP) and mediolateral (ML) centre of pressure velocity (CoP) and standard deviation of the CoP sway were investigated during stair descent and restabilization. A two-way analysis of variance (ANOVA) revealed the main effects of age for the first 5 s of restabilization. Older women exhibited significantly higher values of CoP sway and velocity in both directions compared to the younger individuals (CoP SDAP5, 55%; CoP SDML5, 30%; CoP VAP5, 106%; CoP VML5, 75%). Men achieved significantly higher values of CoP sway and velocity only in the AP direction compared to their younger counterparts (CoP SDAP5, 50% and CoP VAP5, 79%). These findings suggest that with advancing age, men are at higher risk of forward falls, whereas women are at higher risk of forward and sideways falls.

• MeSH
• chůze (způsob) fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokomoce fyziologie   MeSH
• mladý dospělý MeSH
• posturální rovnováha fyziologie   MeSH
• senioři MeSH
• sexuální faktory MeSH
• úrazy pádem * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

We studied the effect of sinusoidal stimulation of the labyrinths on postural reflexes in man, using a 0.3 Hz current of alternating polarity and +/- 1 mA intensity for stimulation. The test subjects were tested binaurally by the bipolar method (BB), with two electrodes on the mastoid processes, and binaurally by the monopolar method (BM), with electrodes localized bilaterally on the mastoid process and the hand. Stabilographic postural parameters were measured in 22 subjects in five experimental situations. Each situation lasted 60 s. Body sway, detected by astabilometer, was recorded on a Philips FM tape-recorder and then analysed off-line on a PDP-11/34 computer. On BB stimulation of the labyrinths, the variance of body sway in the left-right (LR) direction increased more than in the anteroposterior (AP) direction. In BM stimulation, only the variance of LR sway increased. Other posturographic parameters displayed a similar effect. From the aspect of body sway frequency, BB stimulation produced a peak in the course of the power spectral density of the lateral stabilogram at 0.3 Hz. In this experimental situation, a habituation effect was manifested, depending on the subject. It can be stated that binaural bipolar (BB) stimulation of the labyrinths selectively influences lateral body sway, while the increase in AP body sway in this situation is merely a concomitant phenomenon.

• MeSH
• dospělí MeSH
• elektrická stimulace MeSH
• funkční lateralita MeSH
• lidé středního věku MeSH
• lidé MeSH
• pohyb MeSH
• postura těla * MeSH
• vestibulární aparát fyziologie   MeSH
• vnitřní ucho fyziologie   MeSH
• zrak MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE Recent studies have described encouraging outcomes after cervical total disc replacement (cTDR), but there are also critical debates regarding the long-term effects of heterotopic ossification (HO) and the prevalence of adjacent-level degeneration. The aim in this paper was to provide 4-year clinical and radiographic outcome results on the activ C disc prosthesis. METHODS A total of 200 subjects underwent single-level activ C (Aesculap AG) implantation between C-3 and C-7 for the treatment of symptomatic degenerative disc disease. Clinical and radiographic assessments were performed preoperatively, intraoperatively, at discharge, and again at 6 weeks, 6 months, 1 year, 2 years, and 4 years. Radiographic evaluations were done by an independent core laboratory using a specific software for quantitative motion analysis. RESULTS Neck Disability Index (NDI) and visual analog scale (VAS) score for neck and arm pain decreased significantly from baseline to the 4-year follow-up. The mean improvement for NDI was 20, for VAS severity and frequency of neck pain 26.4 and 28, and for VAS severity and frequency of arm pain 30.7 and 35.1, respectively. The neurological situation improved for the majority of patients (86.4%); 76.1% of cases were asymptomatic. Subsequent surgical interventions were reported in 7% of the cases, including device removals in 3%. In 2.5% a subsidence greater than 3 mm was recorded; 1 of these cases also had a migration greater than 3 mm. No device displacement, expulsion, disassembly, loose or fractured device, osteolysis, or facet joint degeneration at the index level was observed. Segmental lordotic alignment changed from -2.4° preoperatively to -6.2° at 4 years, and postoperative height was maintained during the follow-up. Advanced HO (Grade III and IV) was present in 27.1% of the cases; 82.4% showed segmental mobility. A progression of radiographic adjacent-segment degeneration occurred in 28.2%, but only 4.5% required surgical treatment. CONCLUSIONS The activ C is a safe and effective device for cervical disc replacement confirming the encouraging results after cTDR. Clinical trial registration no.: NCT02492724 ( clinicaltrials.gov ).

• Klíčová slova
• ACDF = anterior cervical discectomy and fusion, AE = adverse event, AP = anteroposterior, ASD = adjacent-segment disease, BMI = body mass index, COI = conflict of interest, COR = center of rotation, FJD = facet joint degeneration, HO = heterotopic ossification, NDI = Neck Disability Index, Neck Disability Index, RCT = randomized controlled trial, ROM = range of motion, VAS = visual analog scale, activ C, adjacent-segment degeneration, cTDR = cervical total disc replacement, cervical spine, clinical outcome, degenerative disc disease, heterotopic ossification, long-term results, range of motion, total disc replacement, visual analog scale,
• MeSH
• artroplastika meziobratlové ploténky * přístrojové vybavení   metody   MeSH
• bolest krku diagnostické zobrazování   etiologie   chirurgie   MeSH
• časové faktory MeSH
• chirurgická dekomprese metody   MeSH
• degenerace meziobratlové ploténky komplikace   diagnostické zobrazování   chirurgie   MeSH
• diskektomie metody   MeSH
• dospělí MeSH
• krční obratle * MeSH
• lidé MeSH
• lordóza diagnostické zobrazování   etiologie   chirurgie   MeSH
• měření bolesti MeSH
• následné studie MeSH
• posuzování pracovní neschopnosti MeSH
• prospektivní studie MeSH
• protézy kloubů * MeSH
• software MeSH
• stupeň závažnosti nemoci MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa MeSH