Finding cases of angle-closure glaucoma in clinic setting using a newly developed instrument.

PURPOSE: To validate the applicability of a newly developed, noncontact scanning peripheral anterior chamber depth analyzer (SPAC) for screening eyes at the risk of angle-closure glaucoma (ACG). SUBJECTS AND METHODS: All glaucoma patients who visited the University of Yamanashi Hospital from February through May 2003 were enrolled, except those with aphakic eye or pseudophakic eye. Of the 552 enrolled patients, 48 with ACG or narrow angles requiring laser iridotomy (LI) were categorized as patients with high-risk ACG eyes, and those with open angle were categorized as patients with control eyes. In all, 20 patients with ACG or narrow angles requiring prophylactic LI, who were followed up by an independent private ophthalmic clinic, were enrolled for threshold analysis. Nonophthalmologists measured anterior chamber depth and the averaged values of three measurements were employed for analysis. Threshold analysis and discriminant analysis were employed for determining the sensitivity and specificity of SPAC for diagnosing eyes with high-risk ACG. RESULTS: SPAC distinguished well the high-risk ACG eyes from the control eyes, and one of the most useful criteria for screening is as follows: any of the four measured points should exceed 95% confidence interval, and sensitivity and specificity should be 97.6 and 83.5%, respectively. CONCLUSION: SPAC is thought to be useful for detecting eyes at the risk of ACG by nonophthalmologists.

Focal area of ground-glass opacity and ground-glass opacity predominance on thin-section CT: discrimination between neoplastic and non-neoplastic lesions.

AIM: To reveal differences in thin-section computed tomography (CT) findings between lung neoplastic lesions and non-neoplastic lesions, which showed a focal area of ground-glass opacity or ground-glass opacity predominance. MATERIALS AND METHODS: A total of 82 focal areas of ground-glass opacity and ground-glass opacity predominance, consisting of 38 neoplastic and 44 non-neoplastic lesions, were assessed retrospectively regarding their thin-section CT findings. RESULTS: The frequency of wholly well-defined margin (p=0.001), spiculation (p=0.019), pleural indentation (p=0.016), air bronchograms (p=0.027), air-containing space (p=0.004) was significantly higher in neoplastic lesions than in non-neoplastic lesions. Thirty-four of 38 (89%) neoplastic lesions were well-defined in more than 50% of the circumference, of which nine had an air-containing space other than air bronchogram, whereas only one non-neoplastic lesion had these features. CONCLUSION: A focal area of ground-glass opacity or ground-glass opacity predominance with a well-defined margin and air-containing space is more likely to be a neoplasm.

Mantel-Haenszel-type tests for testing equivalence or more than equivalence in comparative clinical trials.

This paper proposes Mantel-Haenszel-type statistics for testing whether a new treatment is at least as effective as the standard treatment in comparative binomial trials. The null hypotheses considered are of a specified nonzero difference and of a ratio not equal to unity. It is shown that we may also use these tests for testing the equivalence of two treatments.