Surgical Approaches in Primary Rhegmatogenous Retinal Detachment: A Systematic Review and Meta-Analysis Comparing Vitrectomy vs. Vitrectomy Combined with Scleral Buckling, Lens-Sparing vs. Phako Procedures

Aim: This study aimed to assess and compare the functional and anatomical results of pars plana vitrectomy (PPV) alone versus PPV combined with scleral buckling (SB), and lens-sparing versus phaco-procedures for treating rhegmatogenous retinal detachment. Methods: A comprehensive literature search was performed using the Web of Science, MEDLINE, EMBASE, and Cochrane Library databases to retrieve comparative studies. The main objective was to assess the BCVA, while reattachment rates and ocular adverse events were considered secondary measures. Rev Manager software was used for statistical analysis. Results: The literature search identified 10 articles comprising 1518 eyes, with 682 eyes in the PPV group, 193 eyes in the lens-sparing versus phaco-procedure group, and 643 eyes in the combined PPV and SB surgery group. Quality assessment revealed a low risk of bias in most domains. The meta-analysis results revealed a significant difference in postoperative BCVA between the PPV and PPV combined with SB groups (WMD = −0.17, 95% CI [0.27, 0.07], p = 0.001). The primary reattachment rates were 82.80% for PPV alone and 87.52% for PPV combined with SB (p = 0.34). The final reattachment rates did not differ significantly between PPV and PPV combined with SB (99% vs. 99.8%;RR = 1.00, 95% CI [1.01, 0.99], p = 0.96). PPV alone demonstrated a significantly reduced risk of macular edema compared to PPV combined with scleral buckling (9.9% vs. 23%;p = 0.006). The incidences of macular hole development (p = 0.46), recurrent retinal detachment (p = 0.27), proliferative vitreoretinopathy development (p = 0.48), epiretinal membrane proliferation (p = 0.77), and limited choroidal hemorrhage (p = 0.69) were not significantly different between the two groups. Conclusions: These findings suggest that PPV alone may be a more effective treatment option in terms of visual acuity (VA) improvement, lower risk of macular edema and cataract development. However, there was no significant difference in VA improvement or complication rates between the lens-sparing and phaco-procedure groups. .

Resolving Myopic Foveoretinal Detachment by Fovea-Saving Internal Limiting Membrane Peeling: A Case-Series Report

Background: In highly myopic eyes, myopic foveoschisis (MF), the earliest stage of myopic traction maculopathy (MTM), is present in up to 34% of patients with pathologic myopia and slowly progresses to form foveoretinal detachment (FRD) or macular hole (MH) with or without macular hole retinal detachment (MHRD) as a part of its natural history. Aim: To describe the microstructural and functional results in three highly myopic eyes that underwent macular surgery for early-stage MTM. The last postoperative structural findings were correlated with the final vision and macular automated microperimetry evaluation. Methods: We retrospectively reviewed three highly myopic eyes that underwent successful fovea-saving internal limiting membrane (FS-ILM) macular surgery for chronic FRD at Oftalmologia Integral ABC, Mexico City, Mexico. We performed postoperative multimodal microstructural and functional evaluations, including SD-OCT, SS-OCT, and microperimetric macular examinations. Results: There was a substantial difference between best-corrected visual acuity (BCVA) preoperatively and postoperatively in all three cases. Postoperative surgery was associated with significant improvement in visual acuity confirmed using a paired-sample permutation test. The mean presurgical BCVA value (LogMAR;mean ± SE) was ~0.83 ± 0.15, and the postsurgical value was ~0.43 ± 0.52 (P = 0.00065). The myopic foveoretinal detachment evaluation was ~7.3 ± 3.5 months, with a mean postoperative follow-up time of ~14 ± 4.08 months. Furthermore, postoperative multimodal imaging tests demonstrated an abnormal microstructural foveal SS-OCT pattern without evidence of macular hole (MH) development at the postoperative follow-up. Macular microperimetry confirmed a subclinical reduced macula threshold sensitivity with an anomalous retinal sensitivity analysis map and a stable central foveal fixation site. Conclusions: Even with the successful microstructural disappearance of myopic macular detachment, the last multidisciplinary functional and structural assessments demonstrated different subclinical macular alterations.

Long-Term Postoperative Perfusion Indices in Surgically Resolved Myopic Traction Maculopathy

Background: Pathological myopia can be complicated by the presence of posterior staphyloma, macular atrophy, ruptures in Bruch’s membrane, pathologic choroidal neovascularization, and different degrees of myopic traction maculopathy. Purpose: To report the structural, functional and perfusional outcomes in patients underwent surgery for different stages of myopic traction maculopathy (MTM). Methods: A retrospective, consecutive, comparative, interventional, one-surgeon, case-control study was conducted in 46 eyes of 34 individuals between April 2015 and May 2021. Participants included normal emmetropic eyes (Control emmetropia, n = 25), healthy myopic eyes (Control high myopia, n = 20), and operated and structurally fully resolved myopic eyes with different stages of MTM (Surgically treated group, n = 46). Long-term postoperative functional and perfusional follow-up evaluations were performed with spectral domain-optical coherence tomography (SD-OCT) and OCT angiography. The primary outcome measure included long-term functional, structural and perfusion macular status across groups. Results: Forty-six eyes in 34 patients were included in the study group, with both eyes affected in 12 (26.3%) patients. The mean axial length was 29.89 ± 1.67 mm. The preoperative logMAR was 1.29 ± 0.54 and the postoperative logMAR was 0.60 ± 0.52 (P Conclusion: Compared to emmetropic and healthy myopic eyes, surgically-resolved MTM eyes generally have larger superficial foveal avascular zone area, lower vessel density, smaller choriocapillaris flow area, thinner central subfoveal thickness, and more macular defects. Eyes with stage III or IV MTM had larger deviation compared to eyes at earlier stages. Visual function change after surgery was associated with superficial foveal avascular zone area. Better functional, structural and perfusion index outcomes were observed when highly myopic eyes underwent early surgery.

Acute liver failure in Chinese children:a multicenter investigation

BACKGROUND: Currently, no documentation is available regarding Chinese children with acute liver failure(ALF). This study was undertaken to investigate etiologies and outcomes of Chinese children with ALF.METHODS: We retrospectively enrolled 32 pediatric patients with ALF admitted in five hospitals in different areas of China from January 2007 to December 2012. The coagulation indices, serum creatinine, serum lactate dehydrogenase,blood ammonia and prothrombin activity were analyzed; the relationship between these indices and mortality was evaluated by multivariate analysis.RESULTS: The most common causes of Chinese children with ALF were indeterminate etiology(15/32), drug toxicity(8/32),and acute cytomegalovirus hepatitis(6/32). Only 1 patient(3.13%)received liver transplantation and the spontaneous mortality of Chinese children with ALF was 58.06%(18/31). Patients who eventually died had higher baseline levels of international normalized ratio(P=0.01), serum creatinine(P=0.04), serum lactate dehydrogenase(P=0.01), blood ammonia(P<0.01) and lower prothrombin activity(P=0.01) than those who survived.Multivariate analysis showed that the entry blood ammonia was the only independent factor significantly associated with mortality(odds ratio=1.069, 95% confidence interval 1.023-1.117,P<0.01) and it had a sensitivity of 94.74%, a specificity of 84.62%and an accuracy of 90.63% for predicting the death. Based on the established model, with an increase of blood ammonia level,the risk of mortality would increase by 6.9%.CONCLUSIONS: The indeterminate causes predominated in the etiologies of ALF in Chinese children. The spontaneous mortality of pediatric patients with ALF was high, whereas the proportion of patients undergoing liver transplantation was significantly low. Entry blood ammonia was a reliable predictor for the death of pediatric patients with ALF.

Active compounds of medicinal plants,mechanism for antioxidant and beneficial effects

An increased interest in the antioxidant effects of medicinal plants has developed in recent years.Identifying antioxidant compounds present in medicinal plants and elucidating the mechanism by which they prevent oxidation have been the focus of the research community.We performed a systematic and exhaustive review aimed at analyzing the available data regarding the beneficial effects of secondary metabolites in plants.The result of this review is presented as a description of free radicals,as well as cellular and physiological oxidative stress,is provided.The origin and source of antioxidant compounds,and the cellular and molecular mechanism by which they exert antioxidant effects,have been reported.The absorption,distribution and,elimination of antioxidants are mentioned.The beneficial effects of secondary metabolites of medicinal plants in various high incidence disease conditions were also reviewed.Finally,disease states that benefit from antioxidant compounds includes diabetes,cancer,cardiovascular diseases,and liver,brain and,intestinal diseases.

Extraction and Stability of Anthocyanins Present in the Skin of the Dragon Fruit (<i>Hylocereus undatus</i>)

The extraction of anthocyanins present in the skin of the dragon fruit was performed using trifluoroacetic acid (TFA) plus a mixture of methanol, acetic acid and water;the anthocyanins were then purified with a LC-18 cartridge, using methanol acidified with TFA as eluent, reaching concentrations of 44.3865 ± 1.3125 mg/100g of sample. The extracts were put through stability tests under different storage conditions, modifying the pH of the extracts (pH of 1, 4 and 6), the temperature (4℃, 25℃ and 68℃) and the absence and presence of light for a time period of 4 days;the tests indiated that anthocyanins remain more stable at a temperature of 4℃?with a pH of 4 in the absence of light, retaining up to 80% of the pigment. Three anthocyanins were partially identified in the extracts by high performance liquid chromatography (HPLC);they were: cyanidin 3-O-glucoside, cyanidin 3,5 O-glucoside and pelargonidin 3,5 O-glucoside.

Two-dimensional gel electrophoresis and surface-enhanced laser desorption ionization-time of flight-mass spectrometry for detection of protein expression profiles in the hippocampus following closed brain injury

Gene expression profile changes in brain regions following traumatic brain injury at the gene level cannot sufficiently elucidate gene expression time, expression amount, protein post-translational processing or modification. Therefore, it is necessary to quantitatively analyze the gene expression profile using proteomic techniques. In the present study, we established a rat model of closed brain injury using Marmarou＇s weight-drop device, and investigated hippocampal differential protein expression using two-dimensional gel electrophoresis and surface-enhanced laser desorption ionization-time of flight-mass spectrometry. A total of 364 protein peaks were detected on weak cation exchange-2 protein chips, including 37 differential protein peaks. 345 protein peaks were detected on immobilized metal affinity capture arrays-Cu, including 12 differential protein peaks Further examination of these differential proteins revealed that glucose-regulated protein and proteasome subunit alpha type 3 expression were significantly upregulated post-injury. These results indicate that brain injury can alter protein expression in the hippocampus, and that glucose-regulated protein and proteasome subunit alpha type 3 are closely associated with the occurrence and development of traumatic brain injury.

Purification and Partial Characterization of Polyphenol Oxidase from Sapodilla Plum (<i>Achras sapota</i>)

The browning of fruits can be considered as an enzymatic oxidation which is believed to be one of the main causes of quality loss during post-harvest handling. The enzymes responsible for this are the oxidoreductases;the polyphenol oxidase (PPO) (monophenol, o-diphenol, oxygen oxidoreductase;EC 1.14.18.1) belongs to this group. This enzyme, which is found in the sapodilla plum (Achras sapota), was purified using a phenylsepharose and a SephacrylS-200 columns. The molecular weight of the purified enzyme was estimated to be about 66 kDa by gel filtration and 29 kDa by SDS-PAGE. A single protein band was found using the latter system (SDS-PAGE), which shows that the PPO of the pulp of the sapodilla plum may be composed of two protein subunits with similar molecular weight. The optimum pH was 7.0 and the optimum temperature 60℃. The most effective inhibitors tested were ascorbic acid, sodium metabisulfite and acetic acid.

Main Polysaccharides Isolated and Quantified of Aloe vera Gel in Different Seasons of the Year

We developed and implemented a methodology that allowed extracting and evaluating high molecular weight polysaccharides present in the gel of Aloe barbadensis Miller. One of the fractions evaluated revealed the presence of high molecular weight carbohydrates (200 kDa) with a behavior similar to that of acemannan and another fraction with compounds of molecular weights between 17 and 47 kDa. We quantified the concentration of acemannan for two different growing periods. The concentration of acemannan in the high molecular weight fraction was 99.97 ppm in the rainy season and 106.03 ppm in the dry season. The concentration of acemannan in the fraction of low molecular weight was 9.364 ppm during the season of greatest rainfall and 26.939 ppm in the dry season.

Long-Term Postoperative Perfusion Status in Giant Retinal Tears: A Preliminary Case Report

Background: Information on the long-term perfusion status of patients after successful surgery for giant retinal tear (GRT) macula-off rhegmatogenous retinal detachment (RRD) is limited. Purpose: To examine long-term structural, functional, and perfusion outcomes in normal control eyes and eyes treated for different degrees of GRT-associated extensions of RRD. Methods: One emmetropic normal eye (control), one healthy highly myopic eye (control myopic), and three eyes surgically treated for GRT (surgical), were included in the study for a long-term comparison of study outcomes. The surgical eyes were classified based on the degree of GRT-associated RRD extension as follows: one eye with GRT-associated RRD extension &#730;one eye with GRT-associated RRD extension between 180&#730;- 270&#730;and one eye with GRT-associated RRD extension > 270&#730;. Structural, functional, and perfusion outcomes were compared with those of the control eyes. Results: All three eyes were phakic and the condition was monocular. The mean age of the patients was 48.67 ± 8.50 years (range, 39 - 55 years). All three eyes had GRT macula-off RRD. The mean preoperative time for GRT surgery was 1.2 weeks. The mean pre- and postoperative best corrected visual acuities (BCVA) were 1.87 logMAR and 0.46 logMAR, respectively. The mean postoperative follow-up period was 19.67 ± 5.69 months. Proliferative vitreoretinopathy resulted in multiple surgeries in one eye (31.5%). Long-term postoperative optical coherence tomography (OCT) showed abnormal retinal thickness, ellipsoid zone disruption, and external limiting membrane line discontinuities in one eye. OCT angiography yielded abnormal perfusion indices in the surgically treated eyes. Conclusions: Our data showed multiple structural alterations in spectral-domain OCT biomarkers. One eye that developed secondary epiretinal membrane (ERM) proliferation showed a significantly improved BCVA after proliferation and internal limiting membrane were removed. Perfusion findings were correlated with the final BCVA. Despite a fully reattached retina without ERM proliferation, GRT-associated RRD has a guarded functional prognosis.

Identification and Quantification of Monosaccharides in Aloe vera Gel by Acid and Enzymatic Hydrolysis and Wet Heat Treatment

Aloe vera (Aloe barbadensis Miller) possesses curative and therapeutic properties attributed to the polysaccharides found in its tissue. This work aimed to study hydrolyzed (chemical and enzymatical) Aloe vera gel extracts using ultrafiltration membranes with a pore size of 0.22 micron (μm). Nine chemical treatments were achieved with H2SO4 and three wet heat treatments were carried out at a pressure of 1.2 lbf/in2 for 15 minutes;in both cases, three different concentrations of Aloe vera gel juice (AGJ) were used: 1.5%, 2.5% and 3.5% w/w. The concentrations of H2SO4 were 0.10%, 0.25% and 0.40% w/w. Chemical experiments are performed over a factorial 32 design and results were analyzed using SPSS software (version 17, SPSS Inc.), finding the one labeled T7 (15 ml of AGJ 3.5% with 15 ml of H2SO4 0.10% added) the best of them, as it leaded to 0.0446 mg/ml of liberated glucose. Among the three wet heat treatments, the one labeled TC3 (15 ml of AGJ 3.5% with 15 ml of H2O added) was the best-performing one, as it leaded to 0.292 mg/ml of liberated glucose. Furthermore, an enzymatic hydrolysis was carried out using Novozymes’ Pectinex? AR and Viscozyme?. Hydrolisis with both enzymes yield to better results than acid hydrolysis: in the treatment with Pectinex? AR, 3.282 mg/ml of liberated glucose were obtained and 3.302 mg/ml in the treatment with Viscozyme?. The hydrolyzed substances obtained by acid and enzymatic hydrolysis, as well as by wet heat treatment, were subsequently analyzed by thin layer chromatography (TLC), using glucose, galactose and arabinose 1000 ppm solutions as reference patterns. Among the treatments by H2SO4, the one labeled T4 obtained an Rf value of 50, the same as on the galactose reference pattern.

DETERMINATION OF ITERATION VALUES IN NUMERICAL SIMULATION OF HYDRAULIC TURBINE TRANSIENTS

One of the most important technical problems in a computer simulation of hydraulic turbine transient is the quick convergency of iteration calculation. The author has presented a method of error function correction to determine the appropriate iteration values in the next calculation step depending on the series of iteration errors in preceding steps of calcu-

TRANSIENT STUDIES OF TUBULAR TURBINE IN THE FIELD TEST

Much attention has been paid to the tubular turbine following the development in exploitation of the low-head water power resources. Owing to the constructional particularities, there is a notable difference on the hydraulic transient be-

THE PHYSICAL MODEL OF TWO REGULATING ELEMENTS FORANALYSIS OF TURBINETRANSIENT

The commonly used physical model for the analysis of turbine transient is one in which the turbine runner and guide vane are considered as a whole regulating element, nnd the difference between the specific energy at sections of the inlet of guide vane and the outlet of tail tube

THE ULTRA-MICROCOMPUTER SIMULATION OF TURBINE TRANSIENT

Following the arithmetic method, graphic method and computer simulation method, the fourth generation method of analysing the hydraulic transient, simulating method by the programmable counter, presented by Anderson and Monself appeared around 1980. But it is difficult to simul-

METHOD AND PROGRAM OF CONVERGENCY FOR COMPUTER SIMULATION OF HYDRAULIC TRANSIENTS IN HYDRAULIC INSTALLATION

The iteration convergency is one of the key problems for computer simulation of a hydraulic transient in a hydroelectrie power station. The speed of convergency is quite important for an ultramicrocomputer simulation of turbine transient because of the low computing speed. Even for a large computer, a fast convergency is also desirable.

A novel highly specialized functional flap: omohyoid inferior belly muscle

Aim: There is no previous description on the anatomy of the inferior belly of the omohyoid muscle. This muscle has specific morphological characteristic that make it appealing when solving specialized reconstructive problems. Our objective is to describe the microsurgical anatomy of the inferior belly from the omohyoid muscle. Methods: Supraclavicular bilateral dissection in 5 anatomic models (fresh human cadavers). Measurements were taken with a millimetric caliper. Statistical analysis was performed with measures of central tendency. Results: Eight muscles were dissected in 5 anatomic models. Average dimensions were: 93 mm long, 12 mm wide, and 7.5 mm thickness. The vascular pedicles showed great anatomical variability. In 2 flaps (1 model) irrigation came exclusively from transverse cervical vessels, in the remaining models the pedicles came directly from the subclavian vessels;2 flaps had an accessory minor pedicle from the transverse cervical vessels. The diameter of all vascular pedicles was less than 0.8 mm, with an average length of 22.3 mm. The nerve pedicle came from ansa cervicalis in all flaps, with an average length of 27.8 mm. Conclusion: Based on the findings we conclude that omohyoid muscle could be a reconstructive option when small functional flaps are required, such as facial reanimation surgery, sphincters, ptosis and vocal cord reconstruction, and blink restoration surgery although more anatomical studies are required to determine the microsurgical feasibility, excursion and strength of the muscle, and axonal load in this new myofunctional flap.