Objectives: In this study, we aimed to compare early results of the modified eversion carotid endarterectomy technique with the conventional carotid endarterectomy technique. The modified eversion carotid endarterecto...Objectives: In this study, we aimed to compare early results of the modified eversion carotid endarterectomy technique with the conventional carotid endarterectomy technique. The modified eversion carotid endarterectomy technique consisted of a longitudinal arteriotomy that was begun from the common carotid artery proximally to the origin of external carotid artery. We also avoided applying a carotid shunt during surgery in both techniques. Methods: Each patient was evaluated for coronary artery stenosis and valve replacement indications. Diagnosis of significant coronary artery stenosis or valve disease directed us to a combination of CEA and cardiac surgery (CABG/Valvular). We generally had a tendency to perform these two surgical procedures separately. Patients which had surgery for both at the same session were excluded in this study. As a result, our study included 120 patients and 137 carotid interventions. We performed the modified eversion carotid endarterectomy technique in 61 patients (68 carotid interventions) (Group A) and the conventional CEA technique in 59 patients (69 carotid interventions) (Group B). At follow-up, the patients were evaluated by physical examination and color Doppler USG. Results: There was no significant difference between the groups in terms of demographic data. Statistically significant difference was observed in one operative parameter between Group A and Group B;patchplasty requirements during surgery (12 carotid interventions in group B and 4 carotid interventions in group A, p = 0.036). We recorded temporary tongue deviation in five cases, facial asymmetry in eight cases, hoarseness in four cases, neurocognitive impairment in three cases and transient neurologic in two cases with no significant difference between the groups. There was in one case of permanent neurologic deficit (1 in group B). There were two postoperative deaths (1 in group A and 1 in group B). The death in group A occurred because of subarachnoid haemorrhage and the death in group B occurred because of myocardial infarction. After 6 month follow-up, no restenosis occurred in group A. Restenosis occurred in three patients of group B. Conclusion: The modified eversion technique for carotid endarterectomy decrease the incidence of patchplasty applications and postoperative restenosis by avoiding internal carotid artery manipulation and sewing. Besides, it is easy and possible to remove plaques completely from internal carotid artery via the modified arteriotomy line.展开更多
Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly,...Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of non syndromic congenital bilateral severe upper eyelid eversion in otherwise normal 3 days old neonate of African descent (Tanzanian), born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. We report this case because from the best of our knowledge it has never been documented here at our hospital and Tanzania before.展开更多
Total knee replacement(TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical proced...Total knee replacement(TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, aresome of the parameters that might contribute more to achieving the optimal results for the patients.展开更多
In this study, a novel duoprism mechanism that demonstrates a fascinating eversion motion is developed. The mechanism comprises three scalable platforms and nine retractable limbs and is constructed by inserting prism...In this study, a novel duoprism mechanism that demonstrates a fascinating eversion motion is developed. The mechanism comprises three scalable platforms and nine retractable limbs and is constructed by inserting prismatic and revolute joints into the： edges and vertices of the duoprism, respectively. According to mobility and kinematic analyses, the mechanism has five degrees of freedom. Six inputs, including a redundant one, are required to overcome singularity and achieve an eversion motion. In the eversion motion, three platforms expand/ contract synchronously, and the mechanism continuously turns inside out. The detailed gait：~ of eversion motion along an ellipse and a circle after a cycle are illustrated with two examples. A kinematic simulation is conducted, and a manual prototype is fabricated to verify the feasibility of the eversible duoprism mechanism.展开更多
文摘Objectives: In this study, we aimed to compare early results of the modified eversion carotid endarterectomy technique with the conventional carotid endarterectomy technique. The modified eversion carotid endarterectomy technique consisted of a longitudinal arteriotomy that was begun from the common carotid artery proximally to the origin of external carotid artery. We also avoided applying a carotid shunt during surgery in both techniques. Methods: Each patient was evaluated for coronary artery stenosis and valve replacement indications. Diagnosis of significant coronary artery stenosis or valve disease directed us to a combination of CEA and cardiac surgery (CABG/Valvular). We generally had a tendency to perform these two surgical procedures separately. Patients which had surgery for both at the same session were excluded in this study. As a result, our study included 120 patients and 137 carotid interventions. We performed the modified eversion carotid endarterectomy technique in 61 patients (68 carotid interventions) (Group A) and the conventional CEA technique in 59 patients (69 carotid interventions) (Group B). At follow-up, the patients were evaluated by physical examination and color Doppler USG. Results: There was no significant difference between the groups in terms of demographic data. Statistically significant difference was observed in one operative parameter between Group A and Group B;patchplasty requirements during surgery (12 carotid interventions in group B and 4 carotid interventions in group A, p = 0.036). We recorded temporary tongue deviation in five cases, facial asymmetry in eight cases, hoarseness in four cases, neurocognitive impairment in three cases and transient neurologic in two cases with no significant difference between the groups. There was in one case of permanent neurologic deficit (1 in group B). There were two postoperative deaths (1 in group A and 1 in group B). The death in group A occurred because of subarachnoid haemorrhage and the death in group B occurred because of myocardial infarction. After 6 month follow-up, no restenosis occurred in group A. Restenosis occurred in three patients of group B. Conclusion: The modified eversion technique for carotid endarterectomy decrease the incidence of patchplasty applications and postoperative restenosis by avoiding internal carotid artery manipulation and sewing. Besides, it is easy and possible to remove plaques completely from internal carotid artery via the modified arteriotomy line.
文摘Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down’s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of non syndromic congenital bilateral severe upper eyelid eversion in otherwise normal 3 days old neonate of African descent (Tanzanian), born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching. We report this case because from the best of our knowledge it has never been documented here at our hospital and Tanzania before.
文摘Total knee replacement(TKR) is a widely used operation that has radically improved the quality of life of millions of people during the last few decades. However, some technical details, concerning the surgical procedure and the rehabilitation following total knee arthroplasty, are still a matter of a strong debate. In this review of the literature, we have included the best evidence available of the last decade, in an effort to shed light on some of the most controversial subjects related to TKR surgery. Posterior-stabilized or cruciate-retaining prosthesis? To use a tourniquet during operation or not? Do patients need continuous passive motion for their post-surgery rehabilitation? To resurface patella or not? These are some of the most controversial topics that until now have been persistent dilemmas for the orthopedic surgeon. Results of this systematic review of the literature are highly controversial. These conflicting results are an indication that larger and more well conducted high quality trials are needed in order to gain more secure answers. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, aresome of the parameters that might contribute more to achieving the optimal results for the patients.
文摘In this study, a novel duoprism mechanism that demonstrates a fascinating eversion motion is developed. The mechanism comprises three scalable platforms and nine retractable limbs and is constructed by inserting prismatic and revolute joints into the： edges and vertices of the duoprism, respectively. According to mobility and kinematic analyses, the mechanism has five degrees of freedom. Six inputs, including a redundant one, are required to overcome singularity and achieve an eversion motion. In the eversion motion, three platforms expand/ contract synchronously, and the mechanism continuously turns inside out. The detailed gait：~ of eversion motion along an ellipse and a circle after a cycle are illustrated with two examples. A kinematic simulation is conducted, and a manual prototype is fabricated to verify the feasibility of the eversible duoprism mechanism.
