Detachable string magnetically controlled capsule endoscopy for the noninvasive diagnosis of esophageal diseases:A prospective,blind clinical study

BACKGROUND Traditional esophagogastroduodenoscopy(EGD),an invasive examination method,can cause discomfort and pain in patients.In contrast,magnetically controlled capsule endoscopy(MCE),a noninvasive method,is being applied for the detection of stomach and small intestinal diseases,but its application in treating esophageal diseases is not widespread.AIM To evaluate the safety and efficacy of detachable string MCE(ds-MCE)for the diagnosis of esophageal diseases.METHODS Fifty patients who had been diagnosed with esophageal diseases were pros-pectively recruited for this clinical study and underwent ds-MCE and conven-tional EGD.The primary endpoints included the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for patients with esophageal diseases.The secondary endpoints consisted of visualizing the esophageal and dentate lines,as well as the subjects'tolerance of the procedure.RESULTS Using EGD as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic accuracy of ds-MCE for esophageal disease detection were 85.71%,86.21%,81.82%,89.29%,and 86%,respectively.ds-MCE was more comfortable and convenient than EGD was,with 80%of patients feeling that ds-MCE examination was very comfortable or comfortable and 50%of patients believing that detachable string v examination was very convenient.CONCLUSION This study revealed that ds-MCE has the same diagnostic effects as traditional EGD for esophageal diseases and is more comfortable and convenient than EGD,providing a novel noninvasive method for treating esophageal diseases.

Pseudoaneurysm formation following transarterial embolization of traumatic carotid-cavernous fistula with detachable balloon:An institutional cohort long-term study

BACKGROUND The goal of therapy for traumatic carotid-cavernous fistula(TCCF)is the elimination of fistula while maintaining patency of the parent artery.The treatment for TCCF has evolved from surgery to endovascular management using detachable balloons,coils,liquid embolic agents,covered stents,or flow-diverter stent through arterial or venous approaches.Despite the withdrawal of detachable balloons from the market in the United States since 2004,transarterial embolization with detachable balloons has currently remained the best initial treatment for TCCF in several countries.However,the pseudoaneurysm formation following transarterial detachable balloon embolization has rarely been observed in long-term follow-up.AIM To determine the occurrence and long-term follow-up of pseudoaneurysm after transarterial detachable balloon for TCCF.METHODS Between January 2009 and December 2019,79 patients diagnosed with TCCF were treated using detachable latex balloons(GOLDBAL)of four sizes.Pseudoaneurysm sizes were stratified into five grades for analysis.Initial and follow-up assessments involved computed tomography angiography at 1 month,6 month,1 year,and longer intervals for significant cases.Clinical follow-ups occurred semi-annually for 2 years,then annually.Factors analyzed included sex,age,fistula size and location,and balloon size.RESULTS In our cohort of 79 patients treated for TCCF,pseudoaneurysms formed in 67.1%,with classifications ranging from grade 0 to grade 3;no grade 4 or giant pseudoaneurysms were observed.The majority of pseudoaneurysms did not progress in size,and some regressed spontaneously.Calcifications developed in most large pseudoaneurysms over 5-10 years.Parent artery occlusion occurred in 7.6%and recurrent fistulas in 16.5%.The primary risk factors for pseudoaneurysm formation were identified as the use of specific balloon sizes,with balloon SP and No.6 significantly associated with its occurrence(P=0.005 and P=0.002,respectively),whereas sex,age,fistula size,location,and the number of balloons used were not significant predictors.CONCLUSION Pseudoaneurysm formation following detachable balloon embolization for TCCF is common,primarily influenced by the size of the balloon used.Despite this,all patients with pseudoaneurysms remained asymptomatic during long-term follow-up.

Calculation and prediction of divertor detachment via impurity seeding by using one-dimensional model

Achieving the detachment of divertor can help to alleviate excessive heat load and sputtering problems on the target plates,thereby extending the lifetime of divertor components for fusion devices.In order to provide a fast but relatively reliable prediction of plasma parameters along the flux tube for future device design,a one-dimensional(1D)modeling code for the operating point of impurity seeded detached divertor is developed based on Python language,which is a fluid model based on previous work(Plasma Phys.Control.Fusion 58045013(2016)).The experimental observation of the onset of divertor detachment by neon(Ne)and argon(Ar)seeding in EAST is well reproduced by using the 1D modeling code.The comparison between the 1D modeling and two-dimensional(2D)simulation by the SOLPS-ITER code for CFETR detachment operation with Ne and Ar seeding also shows that they are in good agreement.We also predict the radiative power loss and corresponding impurity concentration requirement for achieving divertor detachment via different impurity seeding under high heating power conditions in EAST and CFETR phase II by using the 1D model.Based on the predictions,the optimized parameter space for divertor detachment operation on EAST and CFETR is also determined.Such a simple but reliable 1D model can provide a reasonable parameter input for a detailed and accurate analysis by 2D or three-dimensional(3D)modeling tools through rapid parameter scanning.

The Early Mesozoic NE-SW Extensional Model and Exhumation Processes at the Southeastern Margin of the Central Asian Orogenic Belt:Insights from the Strain and Kinematic Vorticity Analysis of the Sonid Zuoqi Ductile Detachment Zone

The Sonid Zuoqi ductile detachment zone is located at the southeastern margin of the Central Asian orogenic belt(CAOB),striking EW and dipping to the S.The major rock type of the Sonid Zuoqi ductile detachment zone is mylonite derived from granite.The sequence of mylonite features is:(1)S and C foliations of mylonite,and(2)extensional crenulation cleavage(ecc)or C′and the kinematic vorticity(Wk)value changed from 0.70 to 0.95 and from 0.37 to 0.69,respectively;the strain type of the mylonites within the Sonid Zuoqi ductile detachment zone is compressional to planar strain.The strong deformation mylonite and Halatu plutons yielded a zircon U-Pb age of 244 Ma and a zircon(U-Th)/He age of 214 Ma,respectively.Based on the strain and kinematic vorticity analysis,together with the zircon U-Pb and zircon(U-Th)/He ages and the regional tectonic background,the study area experienced three stage evolution:tangential simpleshear(244 Ma),simple-shear-dominated general shear represented by upper crustal extension(224 Ma)and pure-shear-dominated general shear represented by the Halatu pluton doming(214 Ma),which constrained the early Mesozoic NE-SW crustal extension at the southeastern margin of the CAOB.This NE-SW extension probably originated from the postorogenic extensional collapse of the CAOB,subsequent exhumation being controlled by the far afield effects of the closure of the Mongol-Okhotsk belt.

Pars plana vitrectomy for retinal detachment using perfluoro-n-octane as intraoperative tamponade:a multicenter,randomized,non-inferiority trial

AIM:To evaluate the efficacy and safety of perfluoro-n-octane(PFO)for ophthalmic surgery versus F-Octane as an intraoperative tamponade in pars plana vitrectomy(PPV)in management of retinal detachment.METHODS:This multicenter,prospective,randomized,double-masked,parallel-controlled,non-inferiority trial was conducted in three ophthalmology clinical centers in China.Patients with retinal detachment,who were eligible for PPV were consecutively enrolled.Participants were assigned to PFO for ophthalmic surgery or F-Octane for intraocular tamponade in a 1:1 ratio.Best-corrected visual acuity(BCVA),intraocular pressure(IOP)measurement,and dilated fundus examination were performed preoperatively and at 1,7±1,28±3d postoperatively.The primary outcome was complete retinal reattachment rate at postoperative day one.The non-inferiority margin was set at 9.8%.The secondary outcomes included intraoperative retinal reattachment rate,and mean changes in IOP and BCVA from baseline to 1,7±1,28±3d postoperatively,respectively.Safety analyses were presented for all randomly assigned participates in this study.RESULTS:Totally 124 eligible patients completed the study between Mar.14,2016 and Jun.7,2017.Sixty of them were randomly assigned to the PFO for ophthalmic surgery group,and 64 were assigned to the F-Octane group.Baseline characteristics were comparable between the two groups.Both groups achieved 100%retinal reattachment at postoperative day one(difference 0,95%CI:-6.21%to 5.75%,P=1).The pre-defined noninferiority criterion was met.No significant difference was observed in intraoperative retinal reattachment rate(difference 1.77%,P=0.61),mean changes in IOP(difference 0.36,-0.09,2.22 mm Hg at 1,7±1,28±3d postoperatively,with all P>0.05)and BCVA(difference 0.04,-0.02,0.06 logMAR at 1,7±1,28±3d postoperatively,all P>0.05)between the two groups.No apparent adverse events related to the utilization of PFO were reported.CONCLUSION:In patients with retinal detachment undergoing PPV,PFO for ophthalmic surgery is non-inferior to F-Octane as an intraocular tamponade,and both are safe and well-tolerated.

Non-contact wide-field viewing system-assisted scleral buckling surgery for retinal detachment in silicone oilfilled eyes

AIM:To evaluate scleral buckling(SB)surgery using a noncontact wide-field viewing system and 23-gauge intraocular illumination for the treatment of rhegmatogenous retinal detachment in silicone oil(SO)-filled eyes.METHODS:Totally 9 patients(9 eyes)with retinal detachment in SO-filled eyes were retrospectively analyzed.All patients underwent non-contact wide-field viewing system-assisted buckling surgery with 23-gauge intraocular illumination.SO was removed at an appropriate time based on recovery.The patients were followed up for at least 3mo after SO removal.Retinal reattachment,complications,visual acuity and intraocular pressure(IOP)before and after surgery were observed.RESULTS:Patients were followed up for a mean of 8.22mo(3-22mo)after SO removal.All patients had retinal reattachment.At the final follow-up,visual acuity showed improvement for 8 patients,and no change for 1 patient.The IOP was high in 3 patients before surgery,but it stabilized after treatment;it was not affected in the other patients.None of the patients had infections,hemorrhage,anterior ischemia,or any other complication.CONCLUSION:This new non-contact wide-field viewing system-assisted SB surgery with 23-gauge intraocular illumination is effective and safe for retinal detachment in SO-filled eyes.

Efficacy of scleral buckling for the treatment of rhegmatogenous retinal detachment using a novel foldable capsular buckle

●AIM:To evaluate the effectiveness and safety of scleral buckling for the treatment of rhegmatogenous retinal detachment(RRD)using a novel foldable capsular buckle(FCB).●METHODS:This was a series of case observation studies.Eighteen patients(18 eyes)who visited our ophthalmology department between August 2020 and August 2022 and were treated for RRD with scleral buckling using FCB were included.The procedure was similar to conventional scleral buckling,while a balloon-like FCB was placed onto the retinal break with balanced salt solution filling for a broad,external indentation instead of the silicone buckle.The retinal reattachment rate,best corrected visual acuity(BCVA),intraocular pressure(IOP),refractive dioptre and astigmatism degree,and complications were evaluated and recorded.●RESULTS:There were 7 males and 11 females aged 19-58y.The average time course of RRD was 12d,ranging from 7-20d.The retinal break was located in the superior quadrants in 8 eyes and in the inferior quadrants in 10 eyes,with macula-off detachments in 12 eyes.The patients were followed-up for at least 6mo.The final retinal reattachment rate was 100%.The BCVA was significantly improved compared with the baseline(P<0.05).There was no significant change in refractive dioptre or astigmatism degree at each follow-up(all P>0.05).Three patients had transiently high IOPs within one week after surgery.Mild diplopia occurred in 5 patients after surgery and then disappeared after the balloon fluid was removed.●CONCLUSION:The success rate of FCB scleral buckling for RRD is satisfactory.This procedure can be expected to be applied in new,uncomplicated cases of RRD.

Rhegmatogenous retinal detachment in highly myopic eyes with implantable collamer lens

AIM:To investigate the clinical characteristics,treatment methods and outcomes of rhegmatogenous retinal detachment(RRD)in highly myopic eyes with implantable collamer lens(ICL).METHODS:High myopia patients who received treatment for nontraumatic RRD after ICL implantation surgery at the Retinal Department of Zhongshan Ophthalmic Center from Jan 2018 to Dec 2022 were reviewed.Comprehensive ophthalmologic examinations including visual acuity measurement and digital fundus photography were performed in each patient.RESULTS:A total of nine RRD eyes from nine patients who received V4c-ICL implantation were included.The mean time from ICL implantation surgery to the diagnosis of RRD was 32.44±22.56mo(range,1-60mo).At the initial visit for RRD,giant retinal tear(GRT),horseshoe tear,simple round hole,and horseshoe tear combined with round hole were detected in 3,3,2,and 1 eye(s),respectively,with maculaoff in eyes.Eight patients received surgical treatment,and one patient was treated by retinal laser photocoagulation alone.The ICL was preserved in 7 eyes.At the last followup,the mean best corrected visual acuity(BCVA)improved significantly from 1.76±1.06 logMAR at presentation to 0.81±1.01 logMAR(P=0.035),and no case of recurrent retinal detachment was found.CONCLUSION:The morphological presentation of retinal breaks is diverse in this study.The ICL can be preserved in most cases during the course of retinal detachment repair surgery in our data,companied with acceptable visual and anatomical outcomes.

Left atrial appendage occluder detachment treated with transthoracic ultrasound combined with digital subtraction angiography guided catcher:A case report

BACKGROUND There are very few cases of cardiac occluder detachment,and it is rare to completely remove the occluder using interventional methods without undergoing thoracotomy surgery after detachment.This case innovatively used ultrasound guidance combined with digital subtraction angiography(DSA)to completely remove the occluder,accumulating some experience.CASE SUMMARY The patient underwent left atrial appendage occlusion surgery in our hospital due to atrial fibrillation.After the surgery,the occluder fell off and became free in the left ventricle,which is very dangerous.We innovatively used ultrasound guidance,combined with DSA,and interventional surgery to successfully capture the free occluder using a catcher,completely remove it,and then re implant a new left atrial appendage occluder.After the surgery,the patient recovered very well.CONCLUSION The size selection of the occluder is slightly conservative,and the shape of the left atrial appendage opening is irregular.

Transcatheter closure of coronary artery fistula using Guglielmi detachable coil

Background Coronary artery fistula （CAF） is a rare anomaly.Transcatheter CAF closure has been introduced using various materials,but only few data are available on the Guglielmi detachable coil （GDC）.The advantage of using GDC for transcatheter CAF closure is more controllable,therefore much safer when compared to other coils.This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods ＆ Results From 2002 to 2007,there were 10 patients with CAFs （age range：28 to 56 year-old,7 males） who underwent transcatheter CAF closure.There were a total of 19 CAFs which originated from right coronary （n =5）,left circumflex （n =3）,left anterior descending artery （n =10） and left main trunk （n =1）.Median number of coil deployment for each fistula was 3 （range：1 to 6）.The pulmonary artery was the most common site of the distal communication of CAFs （n =14）,followed by right atrium （n =3）,left atrium （n =1） and left ventricle （n =1）.Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 （63.2％） CAFs,significant reduction of the flow in 5 （26.3％）,while 2 （10.5％） could not be closed due to small size.Nine （90％） patients underwent a repeated angiography within 3 to 8 months.Among 12 CAFs that were occluded immediately post-deployment,there were 2 CAFs with insignificant residual flow.Among 6 CAFs with significantly decreased flow immediately post-deployment,2 were occluded totally in the follow-up angiography.In total,12 （70.5％） CAFs were occluded completely and 5 （29.5％） CAFs still had insignificant residual flow,which did not need any additional coil deployment.During a mean follow up of 4.3 ± 0.7 year,all patients remained symptom and complication free.Conclusions The fibered GDC is a safe and effective method for percutaneous closure of the CAFs.

Usefulness of the Guglielmi detachable coil for embolization of a systemic venous collateral after Fontan operation:A case report

Embolization of collateral veins is often treated with rigid coils(Gianturco and interlocking detachable coils type).However,when dealing with tortuous and dilated collateral veins,there is a high risk for technical failure and coil migration due to inflexibility of the coils.To safely and successfully solve this problem,Guglielmi detachable coils(GDC) can be used for embolization.Their flexibility allows for easy navigation in tortuous veins,low risk of unintended coil release or coil migration,and safe deployment.A 12-year-old girl with a single ventricle had severe cyanosis and a low exercise tolerance 5 years after Fontan procedure.The symp-toms were caused by a tortuous and dilated collateral from the left phrenic vein into the left pulmonary vein,forming a right-to-left shunt.The collateral,which had a large diameter and high flow,and therefore a high risk of coil migration,was successfully embolized with 8 GDC.There were no complications such as coil migration or cerebral infarction.Transcatheter embolization increased her systemic oxygen saturation from 81%-84% to 94%-95%,and increased her ability to exercise.The embolization procedure using flexible GDC was low risk compared with other rigid coil embolization techniques when performing embolization of tortuous and dilated collateral veins.

Nomogram for predicting non-proliferative vitreoretinopathy probability after vitrectomy in eyes with rhegmatogenous retinal detachment

AIM:To identify the risk factors for postoperative proliferative vitreoretinopathy(PVR)in patients with primary rhegmatogenous retinal detachment(RRD)and develop a nomogram for predicting postoperative PVR-free probability.METHODS:A total of 741 patients(741 eyes)diagnosed with primary RRD who underwent first surgery in the same hospital were retrospectively reviewed and randomly assigned with 521 to the training set and 220 to the validation set.Univariate and multivariate logistic regression analyses were performed in the training cohort to determine risk factors to construct a nomogram for predicting the 3-,4-,5-,and 6-month postoperative PVR-free probabilities.Nomogram performance was estimated by the concordance index(C-index),calibration plot,and the area receiver operating characteristic(ROC)curve.RESULTS:A nomogram was constructed based on the preoperative PVR,silicone oil tamponade time(SOTT),photocoagulation energy(PE),retinal tear size(RTS),and hypertension.In the training set,the C-index of the nomogram was 0.896,0.936,0.961,and 0.972 at 3,4,5,and 6mo,respectively.The C-index values in the validation set were 0.860,0.936,0.951,and 0.965 at 3,4,5,and 6mo,respectively.Decision-curve analysis indicated that only the 4-,5-,and 6-month nomograms had significant net benefits over a large threshold probabilities interval.CONCLUSION:Preoperative PVR,SOTT,PE,RTS,and hypertension are significant risk factors for postoperative PVR formation in patients with primary RRD.The proposed nomogram can effectively predict the 4-,5-,and 6-month PVR-free probabilities after surgery and assist in making clinical decisions during follow-up.

Application of immersion B-scan ultrasonography in diagnosis of complex retinal detachment,persistent hyperplastic primary vitreous and intraocular tumors

AIM:To evaluate the diagnostic value of panoramic immersion B-scan ultrasonography(Pano-immersion B-scan,PIB)in complex retinal detachment(RD),persistent hyperplastic primary vitreous(PHPV)and intraocular tumors.METHODS:The clinical data of 44 patients collected from May 2012 to December 2019 in Chinese PLA General Hospital was retrospectively studied.All of these patients underwent PIB of the eye,because it was difficult to diagnose by routine ocular fundus examination,conventional ultrasound or/and ultrasonic biomicroscope(UBM)due to opacity of refractive media,pupillary occlusion,large involvement or special location of the lesion.The imaging features of difficult cases in PIB were analyzed.The diagnosis accuracy rating of PIB were evaluated and contrasted with conventional ultrasound or UBM by the standard of intraoperative diagnosis or/and pathological results.RESULTS:According to intraoperative diagnosis or pathological results as gold standard,among the 44 cases,there were 19 cases missed diagnosis,misdiagnosed or difficult-to-diagnose by conventional ultrasound or UBM,including 4 cases of long-standing RD difficult to diagnose,4 cases misdiagnosed,and 11 cases incompletely observed or miss diagnosed.The diagnostic accuracy rate of PIB and conventional ultrasound or UBM were 100%(44/44)and 56.82%(25/44),and the sensitivity of them were 100%and 56.82%.All the patients underwent PIB and were diagnosed as RD(15 cases),retinal and choroidal detachment(4 cases),subchoroidal hematocele(1 case),vitreous opacity and/or organic membrane formation(4 cases),PHPV(12 cases),iris and/or ciliary body tumors(3 cases),and choroidal tumors(6 cases).According to the intraoperative diagnosis or pathological results,the diagnostic coincidence rate of PIB was 100%,which was significantly higher than conventional ultrasound and UBM.CONCLUSION:PIB can help to accurately diagnose complex RD,PHPV,and intraocular masses with special location or/and excessive size.It has important diagnostic value for patients with equivocal findings at conventional ultrasound examination.

INITIAL COMPARISON OF INTRACRANIAL ANEURYSM EMBOLIZATION WITH MECHANICAL DETACHABLE SPIRALS AND WITH GUGLIELMI DETACHABLE COILS

Objective. To compare the embolization effects of intracranial aneurysms with mechanical detachable spirals (MDS) and with Guglielmi detachable coils (GDC).Methods. One hundred and twenty cases with 125 intracranial aneurysms were embolized in Beijing Hospital from March 1995 to July 1999. Sixty - six aneurysms in 64 cases were embolized with MDS, 51 in 48 with GDC, and 8 in 8 with both MDS and GDC. Clinical data including sex, age, subarachnoid hemorrhage (SAH), Hunt & Hess grading, diameter and neck width of aneurysms, number and length of coils used per aneurysm, occlusive ratio, and complications were compared between MDS and GDC groups.Results. MDS and GDC groups were comparable (t-test or x2 -test, all P value > 0. 10) in terms of age, sex, diameter of aneurysms [ (8. 46 ± 3. 42) mm vs. (7. 38 ± 3. 45) mm], neck width [ (3. 49 ± 1. 50) mm vs. (3. 26 ± 1. 52) mm], coils number[ (4. 65 ± 3. 01) vs. (4. 24 ± 2. 65) ] and their length[ (460. 2 ± 398. 5) mm vs. (422. 9 ±387. 1) mm] used per aneurysm, occlusive ratio in aneurysms embolized ≥80% [ (95. 00% ± 6. 32% ) vs. (94. 19% ± 7. 63% ) ], mortality and permanent complications (7. 8% vs. 4. 2% ).Conclusions. MDS and GDC are all materials for embolization of intracranial aneurysms. MDS is less expensive, but more difficult to control and of propensity to complications while GDC is more compliant, easier to be used, safer, and have many alternative types for use as well as more extensive indications.

Incidence of rhegmatogenous retinal detachments is increasing in Wenzhou,China

AIM:To estimate and compare the incidence and characteristics of rhegmatogenous retinal detachments(RRDs)in the Wenzhou area in 2015 to 2019.METHODS:All newly developed RRD cases among residents of the Wenzhou area,from January 2015 to December 2019,were retrospectively retrieved from hospital records.Annual population data were extracted from the Wenzhou Statistical Yearbook.RESULTS:There were 3629 eligible cases.The average incidence of RRD was 7.79 cases per 100000 population(95%confidence interval,7.24-8.34),and the incidences were 7.99 and 7.56 for males and females,respectively.The annual incidence increased gradually from 7.26 cases per 100000 in 2015 to 10.00 cases per 100000 in 2019,with an overall increase of 37.74%.The highest rate of increase occurred in the age group from 60 to 69 years.Of 2750 eyes with axial length(AL)data,1675(60.91%)had an AL greater than 24 mm.CONCLUSION:A trend to increasing RRD incidence is observed in the Wenzhou area over the past 5-year period.

4D label-free proteomic analysis of vitreous from patients with rhegmatogenous retinal detachment

AIM:To identify metabolites,proteins,and related pathways involved in the etiology of rhegmatogenous retinal detachment(RRD)for use as biomarkers in diagnosing and treating RRD.METHODS:Vitreous specimens were collected and liquid chromatography-tandem mass spectrometry analysis was per formed using the four-dimensional label-free technique.Statistically significant differentially expressed proteins,gene ontology(GO)terms,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway representations,and protein interactions were analyzed.RESULTS:Nine specimens were subjected to proteomic analysis.In total,161 proteins were identified as differentially expressed proteins(DEPs),including 53 upregulated proteins and 108 downregulated proteins.GO functional analysis revealed that some DEPs were enriched in neuron-related terms and membrane protein terms.Moreover,KEGG analysis indicated that the cell adhesion molecule metabolic pathway was associated with the greatest number of DEPs.Finally,the evaluation of protein-protein interaction network revealed that DEPs were clustered in neuronal adhesion,apoptosis,inflammation and immune responses,correct protein folding,and glycolysis.CONCLUSION:Proteomic profiling is useful for the exploration of molecular mechanisms that underlie RRD.This study reveals increased expression levels of proteins related to heat shock protein content,glycolysis,and inflammatory responses in RRD.Knowledge regarding biomarkers of RRD pathogenesis may help to prevent the occurrence of RRD in the future.

COMPARISON OF CELLULOSE ACETATE POLYMER AND ELECTROLYTIC DETACHABLE COILS FOR TREATMENT OF CANINE ANEURYSMAL MODELS

Electrolytic detachable coils (EDC) have been the main embolic materi als for intracranial aneurysms. Liquid aneurysmal embolic materials represented by cellulose acetate polymer (CAP) are still in controversy. In this research, t he embolization results and pathological reactions after embolization of canine aneurysmal models with EDC or CAP were observed and compared. Methods. The canine aneurysmal models constructed by anastomosis of venous pouch es were randomly grouped. The aneurysms were respectively occluded with CAP and electrolytic detachable coils that was named by Wu electrolytic detachable coil (WEDC) and made by us. Angiogram follow ups were performed at 24 hour, 2 week , and 2 month after embolization. The occluded aneurysms were dissected in each stage for light microscopic, electron microscopic, and histochemical research. Results. The effect of embolization was significantly better with WEDC than that with CAP . Post embolized complications such as aneurysm rupture and stenosis of parent arteries could only be found in CAP group. Pathol ogical research showed that CAP mass could packed the aneurysms more densely tha n coils. Acute chemical damage of aneurysmal wall and inflammatory cell infiltra tion was prominently found in early stage after CAP embolization. Organization of thrombus inside aneurysms and formation of endothelial tissue over the orific es of aneurysmal necks could be found in both groups 2 months after embolization . But parts of coils might be exposed outside endothelial layer. Conclusions. EDC are still the most safe, efficient, and reliable instruments to embolize aneurysm. CAP should be improved further to solve the problem of stron g chemical corrosion and difficulty in control before it is widely used.

Visual Outcomes and Risk of Rhegmatogenous Retinal Detachment Following Posterior Capsule Rupture during Cataract Surgery: With vs without Dropped Nuclear Lens Fragments

Background: Cataract surgery is the most frequently performed surgery worldwide. Posterior capsule rupture (PCR) remains one of the most common complications of cataract surgery and a major risk factor for poor visual outcomes. Cataract surgeries complicated by PCR and vitreous loss are managed with anterior vitrectomy at the time of surgery. However, the situation can be further complicated by dropping lens particles into the vitreous cavity necessitating a secondary pars plana vitrectomy (PPV). Purpose: To compare the visual outcomes and risk of rhegmatogenous retinal detachment (RRD) between eyes that required anterior vitrectomy (AV) alone for the management of vitreous loss and eyes that required AV and subsequent PPV for the management of dropped nuclear lens fragments (DNLF) following cataract surgery complicated by PCR in a tertiary care teaching hospital in Saudi Arabia. Methods: Medical records of patients in whom PCR occurred during phacoemulsification cataract surgery requiring AV or subsequent PPV for DNLF were retrospectively reviewed over a 6-year period from January 2016 to December 2021. Results: PCR occurred in 183 (2.3%) of 7757 consecutive eyes that underwent phacoemulsification cataract surgery during the study period. Seven eyes were excluded from analysis for missing data or short follow-up. Of the 176 eyes, 147 eyes (83.5%) were managed with AV alone, and the remaining 29 eyes (16.5%) underwent a secondary PPV for DNLF. After excluding eyes with pre-existing ocular pathology, final best-corrected visual acuity (BCVA) was similar in both groups with a mean of 0.32 logMAR (P = 0.99). Two of 147 eyes (1.4%) in the AV group developed RRD with poor final BCVA whereas none of the eyes in DNLF group developed RRD. Conclusion: The risk of RRD is lower in eyes that required PPV for DNLF than in eyes that were managed with AV alone following PCR during cataract surgery. The poor visual outcomes in eyes that suffered RRD underscore the importance of postoperative retinal examination and early detection of retinal breaks.

Evolution of edge turbulent transport induced by L-mode detachment in the HL-2A tokamak

This paper presents the characteristics of L-mode detachment,together with the behavior of edge turbulent transport and plasma confinement on the HL-2A tokamak.Partially detached and pronounced detached states have been achieved in L-mode plasma.Stored energy was maintained before and after detachment.Edge turbulence and its transport have increased obviously in the partially detached state.In the pronounced detached state,redistribution of the density and temperature profiles due to detachment leads to low amplitude of electron temperature and pressure,as well as very weak edge turbulence and transport.Despite strong plasma radiation in the pronounced detached state,reduced edge turbulent transport contributes to maintaining stored energy in detached L-mode plasma in HL-2A.Different detachment states play an important role in the redistribution of density and temperature profiles,which requires further study.

Predictive factors of epiretinal membrane in complicated rhegmatogenous retinal detachment tamponaded with silicone oil

AIM:To determine the incidence and predictive factors for epiretinal membrane(ERM)formation in eyes with complicated primary rhegmatogenous retinal detachment(RRD)tamponaded with silicone oil(SO).METHODS:This retrospective case-control study included 141 consecutive patients with(51 eyes)and without(90 eyes)ERM formation after primary pars plana vitrectomy(PPV)and SO tamponade for complicated RRD.The risk factors for ERM were assessed using logistic regression analysis.RESULTS:The prevalence of postoperative ERM was 36.2%(51/141).Multivariate logistic regression analysis showed that the risk factors for ERM in SO-tamponaded eyes included preoperative proliferative vitreoretinopathy[PVR;odds ratio(OR),2.578;95%confidence interval(CI)1.580–4.205,P<0.001],preoperative choroidal detachment(OR,4.454;95%CI 1.369–14.498,P=0.013),and photocoagulation energy(OR,2.700;95%CI 1.047–6.962,P=0.040).The duration of the preoperative symptoms,intraocular SO tamponade time,giant retinal tear,preoperative vitreous hemorrhage,preoperative bestcorrected visual acuity,number of breaks,quadrants of RRD,axial length,and photocoagulation points were not predictive factors for ERM formation.CONCLUSION:Preoperative PVR,choroidal detachment,and photocoagulation energy are risk factors of ERM formation after complicated RRD repair.Better ophthalmic care as well as patient education are necessary for such patients with risk factors.