Objective lt;brgt;To evaluated the effect of transpupillary thermotherapy (TTT) on age-related macular degeneration (AMD). lt;brgt; lt;brgt;Methods lt;brgt;Sixty-two cases (62 eyes) of exudative AMD were managed with TTT. Before treatment, 58 cases underwent fundus fluorescein angiography(FFA),42 cases underwent simultaneous indocyanine green angiography (ICGA), and 56 cases underwent optic coherence tomography (OCT).TTT was delivered using a 810 nm diode laser with variable spot sizes 0.5-3.0 mm and power range 60-40 mW,60 seconds duration. Sixty-two cases were followed up for 1-10 months with 4.8 months average. lt;brgt; lt;brgt;Results lt;brgt;The visual acuities of last visit were compared with those before the treatment. The visual acuity was unchanged in 43 cases (69.3%), improved in 15 cases (24.2%), and declined in 4 cases (6.5%). OCT was re-done in 51 cases and compared with OCT images before TTT treatment. The height of macular edema was unchanged in 29 cases (56.9%), decreased in 18 cases (35.3%), and increased in 4 cases (7.8%). The amelioration of visual acuity was compatible with that of macular configuration in the majority of cases (74.5%). Only in 13 cases (25.5%) the amelioration of visual acuity lagged behind that of macular configuration. The re-treatment was performed in 18 cases (29.1%), probably due to insufficiency of laser power. No side-effect was found. lt;brgt; lt;brgt;Conclusion lt;brgt;TTT makes most of the cases of exudative AMD retaining or improving their visual acuity. The employment is secured. Further exploration is needed in order to obtain the parameters of the laser treatment. (Chin J Ocul Fundus Dis, 2002, 18: 180-183)
Ten cases of basicranial repair and reconstruction after resection of malignant tumors in nasal sinuses invading base of skull were reported. Dural repair was performed when the resected basicranial osseous lamella was less than 3 cm in diameter; when the lamella ranged from 4 to 7 cm, bone graft was not required either, the defect was repaired with either fascia lata and pericranium of pedunculated galea aponeurotica or frontal myocutaneous. No leakage of cerebrospinal fluid, cerebral hernia and intracranial infection happened postoperatively.
Semitendinosus muscle composite flap was used to repair the neighbouring tissue defects. This is a admissible operation method. Accordingly, this article introduced our studies on semitendinosus muscle: 1. The length of the muscle renter was evaluated by regression equation. 2. Morphological characteristics the muscle, the source and distribution of the vessels were observed. The length of the pedicle of the vessel and external caliber were measured. 3. According to the clinic requrement, the muscle was divided at certain position and was turned upwards or downwards with the vascular pedicle to carry out the repair the defects of the gluteal, sacral, perineal or leg region, and so forth. This study provided the morphoiogical data of semitendinosus muscle composite flap for surgical application.
Objective To discuss the technical keypoints of the second-phase diaplasis treatment after Hartmann operation. Methods Twenty-one cases of the second-phase diaplasis operation of Hartmann operation in this hospital from January 2003 to December 2007 were analysed retrospectively. Results In this group, stapler technique was used in 15 cases, anastomotic ring was used in 3 cases, and one-layer suture was used in 3 cases. The time of these operations was between 118 min and 240 min (mean 164 min). Neither stomal leak nor stomal stenosis occurred, acute ileus occurred in 2 cases, and both recovered after the treatments of gastrointestinal decompression, inhibition of secretion digestive juice and reoperation. Acute retension of urine occurred in 1 case after urine catheter removed. The symptoms disappeared after excises of bladder function. These cases were followed up for 3-36 months (mean 20 months). All the patients recovered to normal function of defecation. Conclusion The technical keypoints of the second-phase diaplasis treatment after Hartmann operation are how to find and liberate the end of the distal colon. It will affect the prognosis and the occurrence of complications after this operation.
Twelve patients with multiple vavices were found adjacent to the common bile duct during cholecystectomy and exploration of the common blie duct in the presence of stones. Eleven of them were with cirrhosis. The authors recommend that retrograde cholecystecotomy, or partial cholecystestomy with electrical cauterization of the remaining gallbladder mucosa ,or even cholecystostomy be the optimal selection in the presence of a large venous channel in calot’s triangle. Multiple fine-needle puncture of the bile duct can be performed over the vascullar area until bile is aspirated; extracting the choledocholith from a transduodenal sphincterotomy is another selective maneuver; and if bleeding occurs, suturing for hemostasis can be placed on the connective tissue over both sides of the lacerated vessel instead of the wall of varices.
Schwanns cell (SC) was isolated from sciatic nerve of adult rat with Wallerine degeneration. After culture, SC-serum free culture media (SCSFCM) was obtained. By ultrafiltration with PM-10 Amicon Membrane, electrophoresis with DiscPAGE,and electrical wash-out with Biotrap apparatus, D-band protein was isolated from the SC-SFCM. The D-band protein in the concentration of 25ng/ml could affect the survival of the spinal anterior horn neuron in vitro, prominently and itsactivity was not changed after being frozen. The molecular weight of the protein ranged from 43 to 67 Kd. The D-band protein might be a neurotrophic substancedifferent from the known SCderived neurotrophic factors (NTF). Its concentration with biological activity was high enough to be detected. The advantages of MTT in assessment of NTF activity were also discussed.
In recent years, the diagnosis and treatment of hepatocellular carcinoma (HCC) has entered a brand-new era due to the advancement of diagnosis methods and the emergence of targeted drugs and immunotherapy drugs. The author described and summarized in detail the screening program, diagnostic thought and procedure, clinical staging, mechanism of targeted and immune therapy and application range of HCC.
Objective To investigate the operative technique and clinical effect of perforator-based flap for repair of glutealsacral skin defects. Methods A new perforator-based flap derived from the gluteal, parasacral and the lumbar arteries was used to repair skin defects ofglutealsacral region caused by trauma or pressure sore. The flap areas ranged from 6 cm×5 cm to 19 cm×11 cm, the diametre of perforating vessel ranged from 1.3 to 2.1 mm,the length of free perforating vessel pedicle ranged from 2.5 to 4.5 cm.Results All the flaps survived andthe wound gained primary healing. All the patients were followed up for 6 to 24months. The colour and texture of the flaps were excellent, the configuration was satifactory and there was no ulcer recurrence. Conclusion This new type of flap is characterized by delicate design, easy dissection, reliable blood supply, nosacrifice of the underlying muscle and no requirement skin graft for donor site closure. It is an optimalmethod in repairing soft tissue defects of the gluteal-sacral region.
Objective To evaluate the application of tendency-oriented perimetry (TOP) in detecting the visual function of glaucoma. Methods The traditional threshold perimetry (Normal/Normal strategy) and TOP (TOP/Normal strategy) carried out by Octopus 101 perimetry were used to examine the visual field of 20 normal subjects (20 eyes), 32 cases (32 eyes) of primary open-angle glaucoma (POAG), and 14 cases (14 eyes) of suspected POAG, respectively. The visual field outcomes, indices, point by point threshold variability and defective points of the two perimetries were compared and analysed. Results The negative rate of TOP was 90% in normal subjects. The positive rate of TOP was 75% in POAG , and 100% in middle and late stage of POAG. The visual field indices of two perimetries were positively correlated, with mean sensitivity (MS) of r=0.9335, mean defect (MD) of r=0.9189, and loss variance (LV) of r=0.9621. The point by point threshold variability and defective points of TOP were higher than those of traditional threshold perimetry, but the difference between the two perimetries was not significant (P=0.2019, P=0.4448). Conclusion The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sensitivity and reproducibility of TOP are high in detecting the visual function of middle and late stage of POAG. (Chin J Ocul Fundus,Dis, 2002, 18: 269-272)