Z-shaped incision without epithelial resection in pterygium surgery

AIM:To introduce a novel surgical technique using a Z-shaped incision without epithelial resection in ophthalmic pterygia.METHODS:This was a prospective study.During pterygium surgery,all proliferative tissues were separated from the cornea and conjunctiva without resection of the tissues.The unaffected conjunctiva was incised in a Z-shape.The upper(or lower)conjunctival flap was sutured to the lower(or upper)normal conjunctiva on the limbal sclera,while the proliferative tissue was sutured to the upper conjunctiva(or lower)near the fornix.RESULTS:Ten patients with pterygia were eligible for this study.Eight patients with primary pterygia and 2 with recurrent pterygia were included.The age of patients at surgery ranged from 47 to 90y(average:71.9y).Five patients each showed right and left-sided pterygia.The postoperative follow-up periods were from 8 to 78mo(average:25.0mo).The surgery was successfully conducted and wounds were favorably reconstructed in all patients.The proliferative tissues sutured to the normal conjunctiva showed palor and attenuated neovessles,and never showed re-growth after surgery.Nine patients did not show recerrence.Recerrent pterygium was noted in 1 patient,but additional treatments were not required.CONCLUSION:The procedure involves the reconstruction of pterygial tissue and normal conjunctiva using a Z-shaped incision.The scleral limbal wound can be covered with nonaffected conjunctiva without any excision of conjunctival epithelia in patients with primary or recurrent pterygia.

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery:a technique note

AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.

改进YOLOv5su模型检测桃树缩叶病

为实现自然环境下桃树缩叶病的检测,该研究提出了一种基于YOLOv5su的桃树缩叶病识别改进模型DLLYOLOv5su。首先,针对桃树缩叶病目标特征变化较大的问题,在骨干网络最后一层C3模块中加入可变形自注意力模块(deformable attention,DA),使模型更加关注目标区域,降低背景对模型的影响,提高模型在复杂背景下的拟合能力。其次在SPPF(fast spatial pyramid pooling)模块中引入LSKA(large separable kernel attention)结构,大核卷积增大了模型的感受野,使模型能够关注更多信息。最后,提出了LAWD(lightweight adaptive weighted downsampling)模块,使用轻量化的下采样结构替换卷积模块,减少计算开销。在桃树缩叶病数据集上进行试验,结果显示,DLL-YOLOv5su模型权重大小为17.6 MB,检测速度为83帧/s。识别准确率P、召回率R和平均精度均值mAP_(50)分别达到了80.7%、73.1%和80.4%,相较于原始YOLOv5su分别提高了4.2、2.4和4.3个百分点。与YOLOv3-tiny、Faster R-CNN、YOLOv7和YOLOv8相比mAP_(50)分别高出了28.5、11.8、2.1和4.1个百分点。改进模型识别精度高,误检、漏检率低,检测速度满足实时检测的要求,可以为桃树缩叶病的实时监测和预警提供参考。

Bare sclera resection followed by mitomycin C and/or autograft limbus conjunctiva in the surgery for pterygium:a Meta-analysis

AIM: To evaluate the recurrence and complications after bare sclera resection (BSR) combined with mitomycin C (MMC) treatment and/or autograft limbus conjunctiva (ALC) in the surgery for pterygium. METHODS: Meta -analysis was used to evaluate the differences in patient outcomes between BSR of pterygium with or without MMC and/or ALC. All included studies were randomized trials of patients with pterygium who received BSR followed by MMC and/or ALC in the surgery. The recurrence of pterygium and other complications resulting from different treatments were extracted for analysis. RESULTS: Thirteen studies met the inclusion criteria. The recurrence of pterygium with intraoperative (10) MMC was higher than that with ALC (OR=2.38,95% confidence interval 1.45-3.91, I-2=29%). Postoperative MMC resulted in an incidence of recurrence similar to that of ALC (OR= 0.66, 95% confidence interval 0.30-1.42, I-2=0%), and 10 MMC treatment in combination with ALC produced similar patient outcomes to ALC alone (OR =0.41, 95% confidence interval 0.16-1.01, I-2=16%). Other complications such as punctate epitheliopathy, scleral thinning and ischemia, irritation and persistent epithelium defect, were more common in patients in the MMC group as compared to those treated with ALC. CONCLUSION: The recurrence of pterygium with BSR followed by ALC is lower than that of BSR followed by MMC, and the incidence of other complications is lower. While ALC is a more effective strategy for treating pterygium, the quality of the ALC transplant should be considered when the patient has a history of glaucoma.

Clinical analysis of risk factors contributing to recurrence of pterygium after excision and graft surgery

AIM: To find the risk factors related to the reproliferation of the pterygial tissue after excision and graft surgery.METHODS: Charts of 130 eyes of 130 patients who had pterygial excision from March 2006 to April 2011 were reviewed. Preoperative pterygium morphology, surgical methods, and adjunctive treatments were statistically analyzed for their relationship with recurrence.RESULTS: During the follow-up period, recurrence was observed in 20 eyes(15.4%). None of the preoperative morphologic features were affected the rate of the recurrence. However, an age 【40y [P =0.085, odds ratio(OR) 3.609, 95% confidence interval(CI) 0.838-15.540]and amniotic membrane graft instead of conjunctival autograft(P =0.002, OR 9.093, 95% CI 2.316-35.698) were statistically significant risk factors for recurrence.Multivariate analysis revealed that intraoperative mitomycin C(MMC)(P =0.072, OR 0.298, 95% CI 0.080-1.115)decreased the rate of recurrence. CONCLUSION: Younger age is a risk factor for reproliferation of pterygial tissue after excision and amniotic membrane transplantation(AMT) are less effective in preventing recurrence of pterygium after excision based on the comparison between conjunctival autograft and AMT. Intraoperative MMC application and conjunctival autograft reduce recurrence.

Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery

AIM： To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques： combined conjunctival autograft and overlay amniotic membrane transplantation （CAT with AMT）, conjunctival autograft transplantation （CAT） alone and amniotic membrane transplantation （AMT） alone. METHODS： In this retrospective study, 142 eyes of 142 pterygium patients （104 primary, 38 recurrent）who underwent CAT （group A）, AMT （group B） or CAT with AMT （group C） respectively following surgical excision were reviewed and compared based on the recurrences and post-operative complications. RESULTS： The number of recurrence post-surgery were 17 （9 from primary, 8 from recurrent; the same description below）, 18 （10, 8） and 2 （1, 1） in groups A, B, and C respectively; dry eyes were 22 （16, 6）, 27 （18, 9） and 7 （3, 4）; conjunctival inflammations were 30 （17, 13）, 27 （16, 11） and 11 （6, 5）. Patients in group C （either pdmary or recurrent or both） mainly showed significantly better results than those in group A or B （P〈0.05） regarding above-mentioned clinical effects. CONCLUSION： Combined CAT and overly AMT have significantly lower rates of recurrence and postoperative complications for primary and recurrent pterygium surgery than CAT or AMT alone.

Suppression of fibrosis in human pterygium fibroblasts by butyrate and phenylbutyrate

AIM：To evaluate the antifibrogenic effects of butyrate or phenylbutyrate,a chemical derivative of butyrate,in human pterygium fibroblasts.METHODS：Human pterygium fibroblasts obtained from patient pterygium tissue were treated with butyrate or phenylbutyrate for 48h.Expression ofα-smooth muscle actin,collagen I,collagen III and matrix metalloproteinase-1m RNA was measured by quantitative real-time reverse transcription polymerase chain reaction,and acetylated histone was evaluated by Western blotting.RESULTS：Butyrate inhibitedα-smooth muscle actin,type III collagen and matrix metalloproteinase-1 expressions,and phenylbutyrate inhibited types I and III collagen and matrix metalloproteinase-1 expressions without changing cell viability as well as both of these increased histone acetylation.These results suggested that butyrate and phenylbutyrate suppress fibrosis through a mechanism involving histone deacetylase inhibitor.CONCLUSION：This indicates that butyrate or phenylbutyrate have antifibrogenic effects in human pterygium fibroblasts and could be novel types of prophylactic and/or therapeutic drugs for pterygium,especially phenylbutyrate,which does not have the unpleasant smell associated with butyrate.

小麦SUS基因家族鉴定与生物信息学分析

【目的】对小麦蔗糖合成酶(sucrose synthase,SUS)基因家族进行鉴定和生物信息学分析,为探究小麦SUS(TaSUS)基因家族的作用机制提供理论参考。【方法】采用生物信息学方法在小麦全基因组上鉴定TaSUS基因家族成员,并对其系统进化关系、染色体位置、基因结构、保守结构域、启动子顺式作用元件和基因表达模式进行分析。【结果】在小麦基因组中共鉴定到分布于14条染色体上的24个TaSUS基因,可分为3个亚组。TaSUS基因含有多个外显子,但部分基因缺失非翻译区结构。TaSUS基因家族成员启动子区域包含45种顺式作用元件,涉及植物生长发育和逆境胁迫响应。大多数TaSUS基因在小麦穗中显著表达,在叶、茎和根中的相对表达量较低。【结论】研究结果有助于了解小麦SUS基因家族的进化,为后期小麦SUS基因家族的生物功能研究奠定理论基础。

Does topical bevacizumab prevent postoperative recurrence after pterygium surgery with conjunctival autografting?

AIM:To assess the effect of topical bevacizumab use on postoperative pterygium recurrence in eyes who underwent pterygium excision with limbal-conjunctival autograft transplantation(LCAT).METHODS:eighty-eight eyes of 88 patients with primary pterygium were included.Pterygia were graded preoperatively from type 1 to type 3(type 1 atrophic,type3 inflamed)according to the inflammatory status.The eyes were preoperatively randomized to receive topical steroid and antibiotic treatment(group 1,46 eyes)and additional topical bevacizumab(5 mg/mL;group 2,42eyes)in the postoperative period.All eyes underwent pterygium excision and LCAT.Medications were tapered and discontinued at one month.Postoperative complications and recurrence rates were recorded.RESULTS:The mean follow-up duration was 29.3±4.2mo(24-52mo)and 28.5±3.4(24-48mo)in group 1 and2,respectively(P】0.05).There were no statistically significant differences regarding the age or gender between groups(P】0.05).Also,the difference between groups with respect to pterygium type was not significant.During the follow-up period,recurrence developed in 2 eyes(4.3%)in group 1,whereas in one eye(2.4%)in group 2.No statistically significant difference between groups was found in recurrence rates(P】0.05).No re-operation for recurrence was necessary during the follow-up period in both groups.CONCLUSION:Topical bevacizumab seems to have no additonal effect on pterygium recurrence after LCAT.

Novel sutureless transplantation for primary pterygium associated with cysts

AIM: To evaluate the efficacy and safety of a novel sutureless AMT (amniotic membrane transplantation) or CAT (conjunctivolimbal autograft transplantation) using fibrin glue for reconstructing corneoconjunctival surfaces for primary pterygium associated with cysts. METHODS: A prospective descriptive study was made of the period 1 January 2006-1 May 2009. Nine patients with primary pterygium associated with cysts underwent pterygium and cyst excision followed by sutureless AMT or CAT using fibrin glue. RESULTS: During a mean follow-up of 8.00 +/- 0.67 months, all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect. The limbal donor site showed the presence of mild depressions without the formation of pseudopterygium. All eyes have good tear secretion function, tear film stability and ocular motility. CONCLUSION: Sutureless transplantation using fibrin glue is safe and effective for restoring a stable corneoconjunctival epithelium in primary pterygium associated with cysts.

Survivin and p53 expression in primary and recurrent pterygium in Chinese patients

AIM: To assess the expression of anti-apoptotic protein survivin and tumor suppressor p53 protein in primary and recurrent pterygium and to investigate the relationship between them. METHODS: Survivin was assessed immunohistochemically using rabbit polyclonal antibody and p53 using mouse monoclonal antibody in a study sample of 20 cases of primary pterygium, 10 cases of recurrent pterygium and 10 cases of normal conjunctiva. RESULTS: In our study, 35% of primary (7 of 20) and 40% of recurrent (4 of 10) pterygium specimens were positive for survivin staining; 45% of primary (9 of 20) and 50% of recurrent (5 of 10) pterygium specimens were positive for p53 expression; and all normal conjunctiva showed no staining of either survivin or p53. The p53 and survivin immunoreactivity in primary and recurrent pterygium groups was greater than those in normal conjunctiva group (P<0. 05). There were no differences in p53 and survivin immunoreactivity between groups of primary and recurrent pterygium (P >0.05). The expression of survivin clearly segregated with p53-positive pterygium as compared with p53-negative cases [8 of 14 cases (57.1%) vs ersus 3 of 16 cases (15.2%)]. The Fisher's exact test analysis confirmed a highly statistically significant correlation between survivin and p53 expression (P <0.05). CONCLUSION: The survivin and p53 are overerpressed with correlation between them in primary and recurrent pterygium.

Comparison of Clinical Efficacy of Three Surgical Methods in the Treatment of Pterygium

Purpose:To investigate and compare the efficacy of amniotic membrane transplantation,corneal limbus stem cell conjunctival transplantation and pedicle conjunctival flap transposition in the treatment of pterygium.Methods:.A total of 155 patients with pterygium were retrospectively analyted:.53 cases who received amniotic membrane transplantation,.41 who underwent corneal limbus stem cells conjunctival transplantation,and 61 patients who had pedicle conjunctival flap transposition.Results:Patients in the three groups had no significant differences in terms of age,times since surgery,or extent of pterygium extension onto the cornea (F:1.194,0.639,0.140 respectively;all P>0.05)..A total of 137 out of 155 patients (88.4%) completed 6 months of follow up.The recurrence rates of pterygium for the three surgeries (amniotic membrane transplantation,.corneal limbus stem cells conjunctival transplantation and pedicle conjunctival flap transposition) were 14.6%,13.9% and 7.7%,respectively.No significant difference was identified when comparing the recurrence rate between any two groups(X2:.0.008,1.211 and 0.890;P:0.593,0.218 and 0.276)..Five patients presented with postoperative complications,.including 3 cases of sub-conjunctival hemorrhage,1 case of amniotic membrane dissolution,and 1 case of conjunctival cyst,accounting for 3.64% of all participants.Conclusion:These three surgical methods are equally effective in preventing the recurrence of pterygium after excision.

Comparison of the Efficacy of Pterygium Resection Combined with Conjunctival Autograft versus Pterygium Resection Combined with Amniotic Membrane Transplantation

Purpose:To compare the efficacy of pterygium resection combined with conjunctival autograft versus pterygium resection combined with amniotic membrane transplantation in the treatment of pterygium. Methods: A total of 118 cases (133 eyes) were randomly assigned to receive pterygium resection combined with conjunctival autograft (n=81) or pterygium resection combined with amniotic membrane transplantation(n=52)..Corneal wound healing and neovascularization and the presence or absence of conjunctival proliferation and hyperemia were analyzed at 12 months post-operatively. Results: In the conjunctival autograft group, 6 eyes (7.4%) had recurrent pterygium,.while in the amniotic membrane transplantation group, 10 eyes showed recurrence (19.2%,P<0.05,.chi-square)..Patients in the conjunctival autograft group recovered significantly faster compared with those in the amniotic membrane transplantation group. Conclusion:.Patients receiving pterygium surgery combined with conjunctival autograft had lower recurrence rates and experience faster recovery compared with those undergoing pterygium resection combined with amniotic membrane transplantation.

Assessment of the Most Common Pterygium Symptoms Leading to the Decision for Its Surgical Removal

Purpose: Pterygium is a benign growth of conjunctival tissue frequently related to chronic sunlight exposure and hot and dry climate. Purpose of this study was to evaluate the predominant symptoms in patients with pterygium leading to its surgical removal decision. Methods: 31 patients (19 males, 12 females), mean age 48.75 years old (SD 8.5), with primary pterygium and no other eye disease participated in the study. The predominant symptoms caused by the pterygium were assessed using a questionnaire. Results: The predominant symptoms associated with the pterygium were: discomfort/feeling of foreign body in 31 patients (100%), redness in 23 (74%), increased lacrimation in 17 (55%), aesthetic reasons in 12 (39%), visual disturbance (astigmatism/extension of the pterygium to the optical axis) in 4 (13%). In one case, despite the absence of annoying symptoms, surgical excision was proposed due to the atypical appearance of pterygium. For younger patients, the predominant reason for choosing surgical removal was that the patients are not content with external appearance caused by pterygium and in contrast lacrimation was the predominant reason for the older. In most patients, visual disturbance was not a significant cause although astigmatism in eyes with pterygium was 3.51 D (SD 1.82) and 0.95 D (SD 0.78) in healthy eyes respectively. Discussion: The main symptom in patients with pterygium is foreign body sensation;meanwhile aesthetic consideration and increased lacrimation are the main reasons leading to surgical removal decision for younger and older patients, respectively.

A Clinical Study of Pterygium and Results of Treatment by Excision and Limbal Autograft or Augmented with Post-Op Mitomycin C

Aim: To prospectively analyze the clinical profile of pterygium and to compare results of management by excision with limbal conjunctival autograft or postoperative topical Mitomycin C drops. Methodology: Study was conducted over a period of 23 months, at a tertiary eye care hospital including 80 eyes of 80 patients who underwent surgery, out of which 40 underwent limbal conjunctival autograft and the remaining 40 underwent pterygium excision followed by Mitomycin C after fulfilling the inclusion criteria. A detailed history was taken and recorded regarding the disease with reference to age, occupation, residence, exposure to dust and hot wind. The extent of corneal involvement by the pterygium was noted. The patients were followed after one week and then monthly for a year. BCVA were noted on every visit and slit lamp examination was done for recurrence, sclera thinning and corneal vascularisation. Result: 80 eyes of 80 patients were enrolled with male preponderance, out of which 40 underwent limbal conjunctival autograft (gr. A) and the remaining 40 underwent pterygium excision followed by Mitomycin C (gr. B). All patients were in the age group of 23 to 70 years. The study showed a higher incidence of pterygium in the age group of 41-50 years with male preponderance probably due to chronic dryness, and exposure to ultraviolet light, dust, and hot winds. The right eye was more affected than the left eye, and nasal side was more involved than the temporal side. The recurrence among group A was 2 out of 40 with a recurrence rate of 5% and among group B was 3 out of 40 with a recurrence rate of 7.5%. Scleral thinning was seen in two cases (5%) in patients who underwent pterygium excision followed by Mitomycin C. Conclusion: Conjunctival limbal autograft and postoperative MMC (0.02%) are both safe and effective adjuncts to primary pterygium surgery. The main prejudices against autografting are the expertise and time required for the procedure. The recent use of biologic adhesives to fixate the autograft in place may simplify the procedure. Age of the patients was strongly associated with recurrence regardless of which procedure was used. More research needs to be done to delve into this seemingly innocuous pathology of conjunctiva to effectively manage the disease condition.

温度对SUS410/BNi-2/Hastelloy X钎焊接头界面组织及力学性能的影响

目的针对汽封部件的高质量制造需求,系统研究了温度对SUS410/BNi-2/Hastelloy X钎焊接头微观组织及力学性能的影响。方法将以SUS410/BNi-2/Hastelloy X搭接结构装配的试样放入真空炉中在不同温度(1060~1140℃)下进行钎焊连接,利用SEM和EDS等手段分析钎料与母材之间的相互作用,测试接头的力学性能并分析接头断裂行为,研究温度对接头界面组织演化和力学性能的影响。结果钎缝主要由Ni(s,s)与Cr-B相组成,B元素扩散进入两侧母材,在晶界处聚集形成硼化物相。随着钎焊温度的升高,钎缝中富Cr的硼化物和浅灰色Ni(s,s)相消失,形成均匀的Ni(s,s)组织,两侧母材中B元素扩散深度增加。随着钎焊温度不断升高,钎焊接头的抗剪强度逐渐上升,上升到某一强度后,温度继续升高,但强度反而下降,断裂位置由钎缝中心先转移至Hastelloy X基体,随着温度继续升高,断裂位置又转移至SUS410扩散区。断裂形式由脆性断裂转变为韧性断裂。结论采用BNi-2黏带钎料实现了SUS410与Hastelloy X合金的可靠连接,接头典型界面组织为SUS410/扩散区((Fe,Cr)+(Fe,Cr)-B)/钎缝区(Ni(s,s)+Cr-B+β_(1)-phases)/扩散区(γ-phase+(Cr,Ni)-B+(Cr,Ni,Mo)-B)/Hastelloy X;钎焊接头的最大抗剪强度为235.6 MPa(1100℃)。

Complications of Fibrin Glue in Pterygium Surgery with Amniotic Membrane Transplant

Purpose:To compare the complications and the recurrence rate between fibrin glue (TISSEEL) and Vicryl 8-0 sutures in amniotic membrane transplant during pterygium surgery.Methods:Patients who underwent pterygium surgery with amniotic membrane transplant (AMT) in the Wang Eye Clinic (Doraville,USA).were randomly categorized into two groups:one group received TISSEEL and the other group received Vicryl 8-0 sutures.All procedures for both groups were performed by one ophthalmologist.Twenty-four patients (24 eyes) participated in the TISSEEL group (22 eyes with primary surgery and 2 eyes with surgery for recurrence) and 19 patients (19 eyes) took part in the suture group (18 primary eyes and 1 recurrence).The patients with recurrent pterygium in both groups had not received AMT previously.Post-operatively,patients were followed up for one week and then one year to check for any signs of complications and recurrence.Results:Conjunctival inflammation occurred in 3 eyes (12.5%) in the TISSEEL group,and 6 eyes (31.6%) in the suture group.(P<0.05,Chi-square test).In the TISSEEL group,1 eye (4.2%) showed recurrence,while there were no recurrences in the sutures group.There were 3 dry eyes (15.8%) in the suture group and 2 dry eyes (8.3%) in the TISSEEL group (P>0.05).No dislocated conjunctival grafts,Dellen,inflammation,infection,bleeding,pyogenic granuloma,or scleromalacia was observed in either group.Conclusion:Pterygium surgery with AMT had less conjunctival inflammation and dry eye in patients receiving fibrin glue than those with Vicryl 8-0 sutures.

Pulsed current-assisted twelve-roll precision rolling deformation of SUS304 ultra-thin strips with exceptional mechanical properties

Innovative pulsed current-assisted multi-pass rolling tests were conducted on a 12-roll mill during the rolling deformation processing of SUS304 ultra-thin strips.The results show that in the first rolling pass,the rolling reduction rate of a conventionally rolled sample(at room temperature)is 33.8%,which can be increased to 41.5%by pulsed current-assisted rolling,enabling the formation of an ultra-thin strip with a size of 67.3μm in only one rolling pass.After three passes of pulsed current-assisted rolling,the thickness of the ultra-thin strip can be further reduced to 51.7μm.To clearly compare the effects of a pulsed current on the microstructure and mechanical response of the ultra-thin strip,ultra-thin strips with nearly the same thickness reduction were analyzed.It was found that pulsed current can reduce the degree of work-hardening of the rolled samples by promoting dislocation detachment,reducing the density of stacking faults,inhibiting martensitic phase transformation,and shortening the total length of grain boundaries.As a result,the ductility of ultra-thin strips can be effectively restored to approximately 16.3%while maintaining a high tensile strength of 1118 MPa.Therefore,pulsed current-assisted rolling deformation shows great potential for the formation of ultra-thin strips with a combination of high strength and ductility.

Pterygium Popliteal Syndrome Concerning a Case in the Pediatric Surgery Department of the Donka National Hospital (Conakry CHU)

Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1st Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.

Efficacy of postoperative short-term therapy of topical bevacizumab in recurrent pterygium surgery

Background:The study aimed to evaluate the efficacy of postoperative short-term therapy(for 2 weeks)of topical bevacizumab in recurrent pterygium surgery regarding to corneal vascularization and pterygium recurrence.Methods:This prospective randomized comparative study included two groups of patients with recurrent pterygium,all eyes were subjected to pterygium excision with conjunctiva auto graft,and group A(30 eyes of 30 patients)was treated with postoperative topical tobramycine and dexamethazone for 2 weeks.Group B(30 eyes of 30 patients)was treated also with postoperative topical tobramycine and dexamethazone in addition to topical bevacizumab 5 mg/mL 4 times daily for 2 weeks.Follow-up of cases up to 6 months was performed recording corneal vascularization and pterygium recurrence.Results:The results revealed that after 6 months,group A treated with postoperative tobramycine and dexamethazone reported 5 eyes of recurrence(16.7%)which not significantly(P=0.44726)(P>0.05)different from group B treated with the addition of topical bevacizumab which reported 3 eyes of recurrence(10%).But group B showed significantly different in decreasing corneal neovascularization than group A(P=0.000805)(P<0.05).Conclusions:Postoperative short-term therapy of topical bevacizumab in recurrent pterygium surgery by conjunctiva auto graft showed lower recurrence rate but not statistically significant,But it reduced significantly corneal neovascularization.