Differences in energy and corneal endothelium between femtosecond laser-assisted and conventional cataract surgeries：prospective,intraindividual,randomized controlled trial

AIM: To compare intraoperative phacoemulsification parameters and its effect on the corneal endothelium of eyes undergoing femtosecond laser-assisted cataract surgery(FLACS) versus conventional phacoemulsification(CP) cataract surgery.METHODS: Two hundred eyes from one hundred patients were included in a prospective, non-blinded, randomized, controlled, intraindividual clinical study. One hundred eyes underwent FLACS while their one hundred fellow eyes underwent CP. All surgeries were performed using the Victus? femtosecond laser platform and Infinity? Vision System phacoemulsification machine. Primary outcome measure was endothelial cell density 6 mo after surgery. Secondary outcome measures included central corneal thickness(CCT), average cell area, standard deviation, coefficient of variation and hexagonality before surgery and 6 mo after surgery and endothelial cell density loss during this period were also evaluated. Intraoperative efficiency parameters [cumulative dissipated energy(CDE), total intraocular surgery time, total ultrasound time, total phacoemulsification time, total torsional energy time, total aspiration time, ultrasound energy, torsional amplitude and fluid required during surgery] were also collated. RESULTS: Data from these patients was not considered for analysis. Data from 92 patients were analysed. Postoperative endothelial cell density(cells/mm2) between groups(2211.88±392.49 CP; 2246.31±403.48 FLACS) was not statistically significant(P=0.869). Total ultrasound time, torsional energy time, CDE and fluid requirements were significantly lower the FLACS group(P<0.05). Other parameters did not show statistically significant difference between FLACS and CP.CONCLUSION: FLACS displays significant improvements in phacoemulsification parameters in comparison to CP. There are no significant differences in corneal endothelium measures between FLACS and CP.

Prognosis and follow-up of 135 patients with ischemic colitis over a five-year period

AIM:To study the prognosis(recurrence and mortality)of patients with ischemic colitis(IC).METHODS:This study was conducted in four Spanish hospitals,participants in the Ischemic Colitis in Spain study We analyzed prospectively 135 consecutive patients who met criteria for definitive or probable IC according to Brandt criteria,and follow up these patients during the next five years,retrospectively.Long-term results(recurrence and mortality)were evaluated retrospectively after a median interval of 62 mo(range54-75 mo).RESULTS:Estimated IC recurrence rates were 2.9%,5.1%,8.1%and 9.7%at years 1,2,3 and 5 years,respectively.Five-year survival was 69%(93 of 135)and 24%(10 of 42 patients)died for causes related to the IC.Among these 10 patients,8 died in their first episode at hospital(4 had gangrenous colitis and 4 fulminant colitis)and 2 due to recurrence.CONCLUSION:The five-year recurrence rate of IC was low.On the other hand,mortality during follow-up was high and was not associated with ischemic colitis.

Biochemical determination of lipid content in hepatic steatosis by the Soxtec method

AIM:To establish a quantitative method to measure the amount of lipids.METHODS:The livers of 53 male Wistar rats(225 g) with different degrees of hepatic steatosis were studied.This model of hepatic steatosis was based on a high carbohydrate,fat-free modified diet.Biopsies were classified into four grades depending on fat accumulation,using the Kleiner and Brunt classification.Total fat was studied by the Soxtec method(SoxtecTM 2050 Auto Fat Extraction System),and agreement between both assays was assessed by calculating theκ coefficient.RESULTS:According to the histological classification,38% of rats presented grade 0,21% grade 1,22% grade 2 and 20% grade 3.The amount of fat per 100 g tissue was 2.60±0.64 g for grade 0,3.87±1.59 g for grade 1,5.82±1.37 g for grade 2 and 8.68± 2.30 g for grade 3.Statistically significant differences were found between the mean values for each of the histological grades(P<0.05).The correlation for the quantification of fat in the liver between both assays was moderate(κ=0.60).CONCLUSION:The biochemical quantification of fat in liver tissue by the Soxtec method was correlated with the histological classification,although the agreement between the two tests was only moderate.

Colorectal cancer prognosis twenty years later

AIM:To evaluate changes in colorectal cancer(CRC) survival over the last 20 years.METHODS:We compared two groups of consecutive CRC patients that were prospectively recruited:Group Ⅰincluded 1990 patients diagnosed between 1980 and 1994.GroupⅡincluded 871 patients diagnosed in 2001.RESULTS:The average follow up time was 21 mo(1-229)for GroupⅠand 50 mo(1-73.4)for GroupⅡ.Overall median survival was significantly longer in Group Ⅱthan in GroupⅠ(73 mo vs 25 mo,P<0.001)and the difference was significant for all tumor stages.Post surgical mortality was 8% for GroupⅠand 2% for Group Ⅱ(P<0.001).Only 17% of GroupⅠpatients received chemotherapy compared with 50% of GroupⅡpatients(P<0.001).CONCLUSION:Survival in colorectal cancer patients has doubled over the past 20 years.This increase seems to be partly due to the generalization in the administration of chemotherapy and to the decrease of post surgical mortality.