Clinical evidence supporting the use of donor sclera as spacer material in complicated cases of strabismus surgery - retrospective evaluation of surgical results in 117 patients with thyroid-associated ophthalmopathy or congenital strabismus

Pulled-in-two syndrome (PITS) is a serious intraoperative complication of strabismus surgery in which an extraocular muscle manipulated during the procedure is ruptured and potentially lost. Usually, there is a systemic or local condition that determines muscle weakness when put under tension. If the proximal portion of the broken muscle can be found, it can be reattached to the ocular globe or remaining muscle. If this is not possible, there are multiple varying approaches. We present three cases of PITS of the inferior rectus muscle, treated with good results with anterior and nasal transposition of the inferior oblique muscle. We propose this surgery as another potential technique if the muscle can not be retrieved.

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Axis instrumentation: surgical results

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2012001100007 ◽

2012 ◽

Vol 70 (11) ◽

pp. 857-863 ◽

Cited By ~ 5

Author(s):

Andrei F. Joaquim ◽

Enrico Ghizoni ◽

Diogo V. Anderle ◽

Evandro de Oliveira ◽

Helder Tedeschi

Keyword(s):

Spinal Cord ◽

Screw Fixation ◽

Spinal Cord Trauma ◽

Surgical Results ◽

Retrospective Evaluation ◽

Common Cause ◽

Radiological Data ◽

The Mean ◽

Axis Fixation ◽

Hybrid Construction

OBJECTIVE: Evaluate the surgical results of axis screw instrumentation. METHODS: Retrospective evaluation of the clinical and radiological data of patients submitted to axis fixation using screws. RESULTS: Seventeen patients were surgically treated. The mean age was 41.8 years (range: 12-73). Spinal cord trauma was the most common cause of instability (8 patients - 47%). Bilateral axis fixation was performed in all cases, except one, with laminar screw (total of 33 axis screws). Seven patients (41.1%) underwent bilateral pars screws; laminar screws were used in six cases and pedicular screws were used in two. In two cases, we performed a hybrid construction (laminar + pars and pedicle + pars). There was no neurological worsening or death, nor complications directly related to use axis screws. CONCLUSION: Axis instrumentation was effective and safe, regardless of the technique used for stabilization. Based on our learnt experience, we proposed an algorithm to choose the best technique for axis screw fixation.

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Ultrastructural Study of Human Testicular Biopsies in Infertility

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100090762 ◽

1976 ◽

Vol 34 ◽

pp. 156-157

Author(s):

Shirley Siew ◽

Philip Troen ◽

Howard R. Nankin

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Basement Membrane ◽

Leydig Cells ◽

Clinical Evidence ◽

Young Male ◽

Germinal Epithelium ◽

Transmission Electron ◽

Age Range ◽

Male Subjects

Testicular biopsies were obtained from six young male subjects (age range 24-33) who complained of infertility and who had clinical evidence of oligospermia. This was confirmed on histological examination which showed a broad spectrum from profound hypospermatogenesis to relatively normal appearing germinal epithelium. Thickening of the tubular walls was noted in half of the cases and slight peritubular fibrosis in one. The Leydig cells were reported as normal or unremarkable.Transmission electron microscopy showed that the thickening of the supporting tissue of the germinal epithelium was caused more by an increase in the thickness of the layers of the lamina propria than of the tubular wall itself. The changes in the basement membrane of the tubular wall consisted mostly of a greater degree of infolding into the tubule and some reduplication which gave rise to a multilayered appearance.

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Severe Drooling and Treatment With Botulinum Toxin

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.1.15 ◽

2012 ◽

Vol 21 (1) ◽

pp. 15-21

Author(s):

Merete Bakke ◽

Allan Bardow ◽

Eigild Møller

Keyword(s):

Botulinum Toxin ◽

Side Effects ◽

Health Risk ◽

Flow Rate ◽

Clinical Evidence ◽

Acetylcholine Release ◽

Psychosocial Problems ◽

Rate Reduction ◽

Local Inhibition ◽

Surgical Treatments

Severe drooling is associated with discomfort and psychosocial problems and may constitute a health risk. A variety of different surgical and non-surgical treatments have been used to diminish drooling, some of them with little or uncertain effect and others more effective but irreversible or with side effects. Based on clinical evidence, injection with botulinum toxin (BTX) into the parotid and submandibular glands is a useful treatment option, because it is local, reversible, and with few side effects, although it has to be repeated. The mechanism of BTX is a local inhibition of acetylcholine release, which diminishes receptor-coupled secretion and results in a flow rate reduction of 25–50% for 2–7 months.

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