The mean length of the stria vascularis (SV) and the basilar membrane of four normalguinea pigs measured by means of surface preparation was 21.11 mm and 19. 90 mm respectively,and the mean width of their apical turns...The mean length of the stria vascularis (SV) and the basilar membrane of four normalguinea pigs measured by means of surface preparation was 21.11 mm and 19. 90 mm respectively,and the mean width of their apical turns of SV and the turns of the cochlear basis was 0. 44 mmand 0. 86 mm respectively. The ultrastructure of SV, spiral ligament (SL) and spiral prominence(SP) of both ears of eight guinea pigs were observed by scanning electron microscopy(SEM) andtransmission electron microsoopy(TEM). There were a large number of coated vesicles in thesupranuclear region of SV, some opened to the endolymph. A great number of folding cytoplasmicprojections were filled with small vesicles The capillary network was extremely rich indicating thatthe endolymph could be secreted and absorbed by SV. The cellular conjunction in the SV. SL andSP formed an effective barrier. It has not been proved in this study that the melanin offers resistanceto acoustic stimulation.展开更多
Background:Optical coherence tomography angiography(OCTA)is a novel non-invasive angiography technology that has recently been extensively studied for its utility in anterior segment imaging.In this study,we compared ...Background:Optical coherence tomography angiography(OCTA)is a novel non-invasive angiography technology that has recently been extensively studied for its utility in anterior segment imaging.In this study,we compared a split-spectrum amplitude decorrelation angiography(SSADA)OCTA and an optical micro-angiography(OMAG SD)OCTA system to current angiographic technique,indocyanine green angiography(ICGA),to assess corneal vascularisation in an animal model.Methods:We imaged 16 rabbits,(one eye per animal)with corneal vascularisation using SSADA OCTA(AngioVue;Optovue Inc.,USA),OMAG OCTA(Angioscan;RS-3000 Nidek Co.Ltd.,Japan)and ICGA in the same region of interest of the cornea at successive time-points.We then analysed all scanned images for vessel density measurements and used paired t-tests and Bland-Altman plots to examine for significant differences.The en-face segmentation images from each of the OCTA scans were also extracted and were matched at every 50μm segmentation to be compared for vessel density at the respective depths.Results:Bland-Altman plots revealed a good agreement between all three imaging techniques(P>0.05)for all vessel density measurements computed,and the ranges of 95%limit of agreement were acceptable from a clinical perspective.No significant difference was reported,with ICGA(μ=16.52±8.94%)being more comparable to the OMAG OCTA(μ=16.23±9.51%;p=0.50)than the SSADA OCTA(μ=17.09±7.34%;p=0.33)system.Also,a good correlation value(r>0.9)was obtained when comparing the vessel density measurements of the en-face segmentations between the OCTA systems.Conclusions:Comparable vessel density quantification between the two OCTA systems,and with ICGA was obtained.Segmentation analysis of the vasculature at different depths showed varied performance in the two OCTA systems relative to each other.The implications of the study may help to aid in the development of better OCTA algorithms for the anterior segment and its use in clinical translational research.展开更多
The distribution and location of atrial natriuretic peptides(ANP) in the cochlear stria vaseularis of normal guinea pigswere studied to find out regional regulating factors of cochlearblood flow (CBF) and productive f...The distribution and location of atrial natriuretic peptides(ANP) in the cochlear stria vaseularis of normal guinea pigswere studied to find out regional regulating factors of cochlearblood flow (CBF) and productive foundation of cochlearendolymph by ABC immunocytochemistry and immunoele-ctronmicroscopy. The ANP-IR products were seen in the striavascularis of the 1-4 turns of the lateral wall of the cochlea,more markedly along its margin; and were negative in the spi-ral ligaments. Immunoelectronmicroscopically, a plenty ofsphericals of 250-350nm in diameter were noted in thecytoplasm of marginal and intermediate cells, but few in thebasal cells. The results suggest that the cochlear striavascularis had the function of secreting ANP in the guinea pig.展开更多
Lymphoedema is a chronic debilitating disease of the lymphatic system that occurs due to either abnormal development or damage of the lymphatics resulting from cancer or infection.The optimal treatment of lymphoedema ...Lymphoedema is a chronic debilitating disease of the lymphatic system that occurs due to either abnormal development or damage of the lymphatics resulting from cancer or infection.The optimal treatment of lymphoedema is still elusive.Management is tailored according to clinical features,investigations and expectations of each patient.Lymphoedema patients should undergo a trial of conservative management with compression therapy,manual lymphatic drainage and external sequential compression devices.Early lymphoedema is treated by lymphovascular anastomosis,where the lymph vessels are connected to the subdermal veins by supermicrosurgery.In late cases when the limb is fibrotic,vascularised lymph node transfers are done,where lymph nodes are transferred from a healthy area to the affected area.In advanced cases,when the limb is fibrotic with cutaneous folds and skin changes,surgical debulking is done.In lymphoedema,along with accumulation of lymphatic tissue,there is also fat deposition,which can be removed by liposuction.One should be conversant with all treatment modalities to provide the lymphoedema patient with optimal care.展开更多
目的:探讨术前CT血管造影在游离腓骨瓣移植中的临床应用价值。方法:对13例利用腓骨瓣或腓骨肌皮瓣修复颌骨缺损患者的临床资料进行回顾性分析,应用三维重建软件SimPlant Pro 11.04对其术前CTA原始DICOM数据进行分析。结果:腓动脉起始外...目的:探讨术前CT血管造影在游离腓骨瓣移植中的临床应用价值。方法:对13例利用腓骨瓣或腓骨肌皮瓣修复颌骨缺损患者的临床资料进行回顾性分析,应用三维重建软件SimPlant Pro 11.04对其术前CTA原始DICOM数据进行分析。结果:腓动脉起始外径为(3.03±0.57)mm,腓骨头尖距腓动脉起始垂直距离为(43.11±10.11)mm,腓骨头尖距穿支血管垂直距离为(172.46±27.99)mm。腓动脉起于胫后动脉。结论:动脉走行恒定,起始外径较粗。术前CT血管造影无创、准确、直观,对游离腓骨瓣移植具有重要手术指导价值。展开更多
Over the past two decades considerable progress has been made in understanding the ototoxic effects and mechanisms underlying loop diuretics. As typical representative of loop diuretics ethacrynic acid or furosemide o...Over the past two decades considerable progress has been made in understanding the ototoxic effects and mechanisms underlying loop diuretics. As typical representative of loop diuretics ethacrynic acid or furosemide only induces temporary hearing loss, but rarely permanent deafness unless applied in severe acute or chronic renal failure or with other ototoxic drugs. Loop diuretic induce unique pathological changes in the cochlea such as formation of edematous spaces in the epithelium of the stria vascularis, which leads to rapid decrease of the endolymphatic potential and eventual loss of the cochlear microphonic potential, summating potential, and compound action potential. Loop diuretics interfere with strial adenylate cyclase and Nat/Kt-ATPase and inhibit the Na-K-2Cl cotransporter in the stria vascularis, however recent reports indicate that one of the earliest effects in vivo is to abolish blood flow in the vessels supplying the lateral wall. Since ethacrynic acid does not damage the stria vascularis in vitro, the changes in Nat/Kt-ATPase and Na-K-2Cl seen in vivo may be secondary effects results from strial ischemia and anoxia. Recent observations showing that renin is present in pericytes surrounding stria arterioles suggest that diuretics may induce local vasoconstriction by renin secretion and angiotensin formation. The tight junctions in the blood-cochlea barrier prevent toxic molecules and pathogens from entering cochlea, but when diuretics induce a transient ischemia, the barrier is temporarily disrupted allowing the entry of toxic chemicals or pathogens.展开更多
Objective To record the endocochlear potential (EP) and calculate potassium concentration [K+] in Minipig cochleae. Methods We used multi-barreled electrodes to measure the EP and the potential, [K + ]. EP and potassi...Objective To record the endocochlear potential (EP) and calculate potassium concentration [K+] in Minipig cochleae. Methods We used multi-barreled electrodes to measure the EP and the potential, [K + ]. EP and potassium electrode recording were made in 9 cochleae from 5 minipigs to get normal EP values. Results The average EP value in the cochlea from the minipigs was 77.3 ± 14 mV. The average [K+] for the minipigs was 147.1 ± 13 mM. Conclusions The EP and potential, [K + ] in minipigs are lower than in the human and rodents. This may be the reason why porcine ABR thresholds are slightly higher than humans and rodents.展开更多
LaminB1,a major component of the nuclear lamina,is a potent regulator of cellular proliferation and senescence and also known to be essential for neuronal migration and brain development.However,the expression pattern...LaminB1,a major component of the nuclear lamina,is a potent regulator of cellular proliferation and senescence and also known to be essential for neuronal migration and brain development.However,the expression patterns of LaminB1 in the rat cochleae are still not fully revealed.Utilizing immunofluorescence.Western blotting,and quantitative real-time PCR,we identified the distribution and expression of LaminB1 in the rat cochleae.Immunofluorescence staining indicated that LaminBl was mainly localized in the auditory hair cells(HCs),spiral ganglion cells(SGC),stria vascularis(STV,including spiral ligament),Reissner's membrane(RM),and limbus laminae spiralis(LLS).Western blotting analysis illustrated that the distribution of LaminBl in rat cochleae was characterized by tissue specificity.The LaminB1 protein was expressed more in SGC and basilar membrane(BM)than in STV.Meanwhile,the mRNA expression of LaminB1 displayed difference in cochlear tissues.These observations preliminarily revealed the expression patterns of LaminB1,providing a theoretical basis for further study on the role of LaminB1 in auditory function.展开更多
Primary cardiac tumours are rare, with myxoma being the most common benign heart tumour. The prevalence of coronary disease or neovascular in patients with atrial myxomas is high, yet angiography is not routinely perf...Primary cardiac tumours are rare, with myxoma being the most common benign heart tumour. The prevalence of coronary disease or neovascular in patients with atrial myxomas is high, yet angiography is not routinely performed. Echocardiography is preferred for evaluation of myxoma, where coronary angiography clarifies the vascular supply of the tumour and may alter the surgical planning. We here report an interesting and rare case of a left atrial myxoma hyper vascularised by two anomalous arteries, from right coronary artery and circumflex artery demonstrated by preoperative coronary angiography. The mass was successfully excised and the diagnosis of cardiac myxoma was confirmed via histopathology. A review of the value of coronary angiography in detecting myxoma neovascularization is provided. Offering additional valuable information, coronary angiography can alter the surgical approach and may therefore be considered prior to myxoma resection.展开更多
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 co...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.展开更多
Here we present the case of a 79-year-old woman who complained of acute abdominal pain,vomiting and diarrhoea.Laboratory exams demonstrated a severe metabolic imbalance.Abdominal X-rays showed bowel overdistension and...Here we present the case of a 79-year-old woman who complained of acute abdominal pain,vomiting and diarrhoea.Laboratory exams demonstrated a severe metabolic imbalance.Abdominal X-rays showed bowel overdistension and pneumatosis of the stomach wall.Abdominal tomography revealed infarction of the stomach,duodenum and small bowel due to thrombosis of the celiacomesenteric trunk.Exploratory laparotomy revealed ischemia of the liver,spleen infarction and necrosis of the gastro-intestinal tube(from the stomach up to the first third of the transverse colon).No further surgical procedures were performed.The patient died the following day.To our knowledge,this is the first reported case about severe gastro-intestinal ischemia due to thrombosis of the celiacomesenteric trunk,a rare anatomic variation of the gastrointestinal vascularisation.展开更多
Optical coherence tomography angiography(OCTA)is a rapid and non-invasive technique for imaging vasculature in the eye.As OCTA can produce high-resolution cross-sectional images and allow depth-resolved analysis for a...Optical coherence tomography angiography(OCTA)is a rapid and non-invasive technique for imaging vasculature in the eye.As OCTA can produce high-resolution cross-sectional images and allow depth-resolved analysis for accurate localization of pathology of interest,it has become a promising method for anterior segment imaging.Furthermore,OCTA offers a more patient-friendly alternative to the conventional invasive dye-based fluorescent angiography.However,conventional OCTA systems are typically designed and optimized for the posterior segment of the eye,and thus using OCTA for anterior segment imaging can present several difficulties and limitations.In this review,we summarized the recent developments and clinical applications in anterior segment OCTA(AS-OCTA)imaging,such as for the cornea,iris,sclera and conjunctiva.We also compared commercially available OCTA systems,discussed the limitations of adapting current OCTA technology for the anterior segment imaging,and proposed possible future directions for AS-OCTA systems.AS-OCTA provides potential for future clinical applications such as diagnosis of corneal and iris pathologies,pre-operative surgical planning,assessment of new antiangiogenic therapeutics or evaluation of limbal stem cell deficiency.With further development,OCTA for anterior segment imaging in the clinics may become common in the near future.展开更多
文摘The mean length of the stria vascularis (SV) and the basilar membrane of four normalguinea pigs measured by means of surface preparation was 21.11 mm and 19. 90 mm respectively,and the mean width of their apical turns of SV and the turns of the cochlear basis was 0. 44 mmand 0. 86 mm respectively. The ultrastructure of SV, spiral ligament (SL) and spiral prominence(SP) of both ears of eight guinea pigs were observed by scanning electron microscopy(SEM) andtransmission electron microsoopy(TEM). There were a large number of coated vesicles in thesupranuclear region of SV, some opened to the endolymph. A great number of folding cytoplasmicprojections were filled with small vesicles The capillary network was extremely rich indicating thatthe endolymph could be secreted and absorbed by SV. The cellular conjunction in the SV. SL andSP formed an effective barrier. It has not been proved in this study that the melanin offers resistanceto acoustic stimulation.
文摘Background:Optical coherence tomography angiography(OCTA)is a novel non-invasive angiography technology that has recently been extensively studied for its utility in anterior segment imaging.In this study,we compared a split-spectrum amplitude decorrelation angiography(SSADA)OCTA and an optical micro-angiography(OMAG SD)OCTA system to current angiographic technique,indocyanine green angiography(ICGA),to assess corneal vascularisation in an animal model.Methods:We imaged 16 rabbits,(one eye per animal)with corneal vascularisation using SSADA OCTA(AngioVue;Optovue Inc.,USA),OMAG OCTA(Angioscan;RS-3000 Nidek Co.Ltd.,Japan)and ICGA in the same region of interest of the cornea at successive time-points.We then analysed all scanned images for vessel density measurements and used paired t-tests and Bland-Altman plots to examine for significant differences.The en-face segmentation images from each of the OCTA scans were also extracted and were matched at every 50μm segmentation to be compared for vessel density at the respective depths.Results:Bland-Altman plots revealed a good agreement between all three imaging techniques(P>0.05)for all vessel density measurements computed,and the ranges of 95%limit of agreement were acceptable from a clinical perspective.No significant difference was reported,with ICGA(μ=16.52±8.94%)being more comparable to the OMAG OCTA(μ=16.23±9.51%;p=0.50)than the SSADA OCTA(μ=17.09±7.34%;p=0.33)system.Also,a good correlation value(r>0.9)was obtained when comparing the vessel density measurements of the en-face segmentations between the OCTA systems.Conclusions:Comparable vessel density quantification between the two OCTA systems,and with ICGA was obtained.Segmentation analysis of the vasculature at different depths showed varied performance in the two OCTA systems relative to each other.The implications of the study may help to aid in the development of better OCTA algorithms for the anterior segment and its use in clinical translational research.
文摘The distribution and location of atrial natriuretic peptides(ANP) in the cochlear stria vaseularis of normal guinea pigswere studied to find out regional regulating factors of cochlearblood flow (CBF) and productive foundation of cochlearendolymph by ABC immunocytochemistry and immunoele-ctronmicroscopy. The ANP-IR products were seen in the striavascularis of the 1-4 turns of the lateral wall of the cochlea,more markedly along its margin; and were negative in the spi-ral ligaments. Immunoelectronmicroscopically, a plenty ofsphericals of 250-350nm in diameter were noted in thecytoplasm of marginal and intermediate cells, but few in thebasal cells. The results suggest that the cochlear striavascularis had the function of secreting ANP in the guinea pig.
文摘Lymphoedema is a chronic debilitating disease of the lymphatic system that occurs due to either abnormal development or damage of the lymphatics resulting from cancer or infection.The optimal treatment of lymphoedema is still elusive.Management is tailored according to clinical features,investigations and expectations of each patient.Lymphoedema patients should undergo a trial of conservative management with compression therapy,manual lymphatic drainage and external sequential compression devices.Early lymphoedema is treated by lymphovascular anastomosis,where the lymph vessels are connected to the subdermal veins by supermicrosurgery.In late cases when the limb is fibrotic,vascularised lymph node transfers are done,where lymph nodes are transferred from a healthy area to the affected area.In advanced cases,when the limb is fibrotic with cutaneous folds and skin changes,surgical debulking is done.In lymphoedema,along with accumulation of lymphatic tissue,there is also fat deposition,which can be removed by liposuction.One should be conversant with all treatment modalities to provide the lymphoedema patient with optimal care.
文摘目的:探讨术前CT血管造影在游离腓骨瓣移植中的临床应用价值。方法:对13例利用腓骨瓣或腓骨肌皮瓣修复颌骨缺损患者的临床资料进行回顾性分析,应用三维重建软件SimPlant Pro 11.04对其术前CTA原始DICOM数据进行分析。结果:腓动脉起始外径为(3.03±0.57)mm,腓骨头尖距腓动脉起始垂直距离为(43.11±10.11)mm,腓骨头尖距穿支血管垂直距离为(172.46±27.99)mm。腓动脉起于胫后动脉。结论:动脉走行恒定,起始外径较粗。术前CT血管造影无创、准确、直观,对游离腓骨瓣移植具有重要手术指导价值。
基金supported in part by a grant from National Natural Science Foundation of China 81470706a grant from Guangdong Natural Science Foundation No 2015A030313180
文摘Over the past two decades considerable progress has been made in understanding the ototoxic effects and mechanisms underlying loop diuretics. As typical representative of loop diuretics ethacrynic acid or furosemide only induces temporary hearing loss, but rarely permanent deafness unless applied in severe acute or chronic renal failure or with other ototoxic drugs. Loop diuretic induce unique pathological changes in the cochlea such as formation of edematous spaces in the epithelium of the stria vascularis, which leads to rapid decrease of the endolymphatic potential and eventual loss of the cochlear microphonic potential, summating potential, and compound action potential. Loop diuretics interfere with strial adenylate cyclase and Nat/Kt-ATPase and inhibit the Na-K-2Cl cotransporter in the stria vascularis, however recent reports indicate that one of the earliest effects in vivo is to abolish blood flow in the vessels supplying the lateral wall. Since ethacrynic acid does not damage the stria vascularis in vitro, the changes in Nat/Kt-ATPase and Na-K-2Cl seen in vivo may be secondary effects results from strial ischemia and anoxia. Recent observations showing that renin is present in pericytes surrounding stria arterioles suggest that diuretics may induce local vasoconstriction by renin secretion and angiotensin formation. The tight junctions in the blood-cochlea barrier prevent toxic molecules and pathogens from entering cochlea, but when diuretics induce a transient ischemia, the barrier is temporarily disrupted allowing the entry of toxic chemicals or pathogens.
文摘Objective To record the endocochlear potential (EP) and calculate potassium concentration [K+] in Minipig cochleae. Methods We used multi-barreled electrodes to measure the EP and the potential, [K + ]. EP and potassium electrode recording were made in 9 cochleae from 5 minipigs to get normal EP values. Results The average EP value in the cochlea from the minipigs was 77.3 ± 14 mV. The average [K+] for the minipigs was 147.1 ± 13 mM. Conclusions The EP and potential, [K + ] in minipigs are lower than in the human and rodents. This may be the reason why porcine ABR thresholds are slightly higher than humans and rodents.
基金the National Natural Science Foundation of China(No.81771004,No.81500791,and No.81300827).
文摘LaminB1,a major component of the nuclear lamina,is a potent regulator of cellular proliferation and senescence and also known to be essential for neuronal migration and brain development.However,the expression patterns of LaminB1 in the rat cochleae are still not fully revealed.Utilizing immunofluorescence.Western blotting,and quantitative real-time PCR,we identified the distribution and expression of LaminB1 in the rat cochleae.Immunofluorescence staining indicated that LaminBl was mainly localized in the auditory hair cells(HCs),spiral ganglion cells(SGC),stria vascularis(STV,including spiral ligament),Reissner's membrane(RM),and limbus laminae spiralis(LLS).Western blotting analysis illustrated that the distribution of LaminBl in rat cochleae was characterized by tissue specificity.The LaminB1 protein was expressed more in SGC and basilar membrane(BM)than in STV.Meanwhile,the mRNA expression of LaminB1 displayed difference in cochlear tissues.These observations preliminarily revealed the expression patterns of LaminB1,providing a theoretical basis for further study on the role of LaminB1 in auditory function.
文摘Primary cardiac tumours are rare, with myxoma being the most common benign heart tumour. The prevalence of coronary disease or neovascular in patients with atrial myxomas is high, yet angiography is not routinely performed. Echocardiography is preferred for evaluation of myxoma, where coronary angiography clarifies the vascular supply of the tumour and may alter the surgical planning. We here report an interesting and rare case of a left atrial myxoma hyper vascularised by two anomalous arteries, from right coronary artery and circumflex artery demonstrated by preoperative coronary angiography. The mass was successfully excised and the diagnosis of cardiac myxoma was confirmed via histopathology. A review of the value of coronary angiography in detecting myxoma neovascularization is provided. Offering additional valuable information, coronary angiography can alter the surgical approach and may therefore be considered prior to myxoma resection.
文摘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.
文摘Here we present the case of a 79-year-old woman who complained of acute abdominal pain,vomiting and diarrhoea.Laboratory exams demonstrated a severe metabolic imbalance.Abdominal X-rays showed bowel overdistension and pneumatosis of the stomach wall.Abdominal tomography revealed infarction of the stomach,duodenum and small bowel due to thrombosis of the celiacomesenteric trunk.Exploratory laparotomy revealed ischemia of the liver,spleen infarction and necrosis of the gastro-intestinal tube(from the stomach up to the first third of the transverse colon).No further surgical procedures were performed.The patient died the following day.To our knowledge,this is the first reported case about severe gastro-intestinal ischemia due to thrombosis of the celiacomesenteric trunk,a rare anatomic variation of the gastrointestinal vascularisation.
基金supported by the National Medical Research Council(NMRC)Centre Grant(CG)(NMRC/CG/C010A/2017).
文摘Optical coherence tomography angiography(OCTA)is a rapid and non-invasive technique for imaging vasculature in the eye.As OCTA can produce high-resolution cross-sectional images and allow depth-resolved analysis for accurate localization of pathology of interest,it has become a promising method for anterior segment imaging.Furthermore,OCTA offers a more patient-friendly alternative to the conventional invasive dye-based fluorescent angiography.However,conventional OCTA systems are typically designed and optimized for the posterior segment of the eye,and thus using OCTA for anterior segment imaging can present several difficulties and limitations.In this review,we summarized the recent developments and clinical applications in anterior segment OCTA(AS-OCTA)imaging,such as for the cornea,iris,sclera and conjunctiva.We also compared commercially available OCTA systems,discussed the limitations of adapting current OCTA technology for the anterior segment imaging,and proposed possible future directions for AS-OCTA systems.AS-OCTA provides potential for future clinical applications such as diagnosis of corneal and iris pathologies,pre-operative surgical planning,assessment of new antiangiogenic therapeutics or evaluation of limbal stem cell deficiency.With further development,OCTA for anterior segment imaging in the clinics may become common in the near future.
