Comparison of the Effectiveness of Mitomycin-C and Viscoat on Delayed Adjustable Strabismus Surgery in Rabbits

2005 ◽  
Vol 15 (5) ◽  
pp. 530-535 ◽  
Author(s):  
Y. Cengiz ◽  
Ö. Altintas ◽  
G. Manav Ay ◽  
Y. Çaglar
Keyword(s):  
Mitomycin C ◽  
Chondroitin Sulphate ◽  
Adhesion Formation ◽  
Sodium Hyaluronate ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Early Postoperative Period ◽  
Group V ◽  
Significant Difference ◽  
Group 6

Purpose To determine a way to prevent the formation of adhesions and delay the time of suture adjustment in the course of adjustable strabismus surgery, an animal study was performed to assess and compare the effects of mitomycin C (Mit-C) and viscoelastic material Viscoat (sodium hyaluronate 3% and chondroitin sulphate 4%, Alcon, Fort Worth, TX). Methods Right eyes of 47 rabbits were divided into three groups. After recession of the superior rectus muscle (SRM), Mit-C was administered beneath and over the SRM in Group M (16 eyes), Viscoat was administered beneath and over SRM in Group V (16 eyes), and ringer lactate was administered in Group C (15 eyes). SRM then recessed 5 mm with adjustable strabismus surgery technique. Animals in each group were subdivided into 1 and 2, where 1 = adjustment 1 week postoperatively and 2 = adjustment 3 weeks postoperatively. Delayed adjustment was performed in M1 group (6 eyes), V1 group (6 eyes), and C1 group (7 eyes) after 1 week; in M2 group (6 eyes), V2 group (6 eyes), and C2 group (6 eyes) after 3 weeks. Histopathologic examinations were performed for the remaining 10 eyes without suture adjustment at the end of first and third weeks after adjustable strabismus surgery. The possible length and the necessary force to adjust and the degree of adhesions were recorded. Results When length and strength of the adjustment, adhesions between muscle and sclera, and adhesions between muscle and conjunctiva were taken into consideration, there was no statistically significant difference among M, V, and C groups at postoperative weeks 1 and 3. The force needed for adjustment in M1 group was statistically lower than M2 group. Conclusions The intraoperative use of Mit-C (0.4 mg/mL) may decrease adhesion formation in the early postoperative period, especially in the first week. The intraoperative use of Viscoat was not effective in reducing postoperative adhesions and delaying adjustment.

scholarly journals Non-Conservative Therapy in the Prevention of Subepithelial Fibroplasia after LASEK Hypermetropia Correction

2018 ◽  
Vol 15 (2) ◽  
pp. 200-206
Author(s):  
S. A. Korotkikh ◽  
A. E. Bogachev ◽  
A. S. Shamkin
Keyword(s):  
Dry Eye ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Dry Eye Syndrome ◽  
Control Group ◽  
Study Group ◽  
Postoperative Therapy ◽  
Significant Difference

The results of observation of patients who underwent vision eximerlaser correction by the LASEK method regarding medium degree of hyperopia were analyzed.Purpose:to investigate the severity of the «dry eye» syndrome and corneal subepithelial fibroplasia in patients after laser correction of  hyperopia by the LASEK method, and their prevention by reducing  the preservative action on the eye surface.Patients and methods.The study included 40 patients (76 eyes), aged 21–46 years (32.98 ± 1.79) who underwent LASEK surgery for  moderate hyperopia (4.03 ± 0.38 D). Patients were divided into two  groups: 1) control group (20 patients, 37 eyes) — postoperative  therapy included the corneoprotector “Stilavit®” and the preparation  of hyaluronic acid “Oksial®”, containing preservatives;  2) the study group (20 patients, 39 eyes) — postoperative therapy  included the corneoprotector “Hilozar-comod®” and the artificial tear  preparation “Hilo-comod®”, which did not contain reservatives. Ophthalmic examination included, in addition to standard diagnostic  methods, the Norn test, the Schirmer test, the staining of the eye  surface with lissamine green. In addition, a questionnaire was  conducted on a modified OSDI questionnaire; there a section  characterizing the quality of vision (section B) was removed.Results.The analysis of the obtained data showed that in the study group there was less pronounced “dry eye” syndrome at 3,6,12  months after the operation. The maximum difference in the  indicators of the “dry eye” syndrome between the groups was at 3  and 6 months of the postoperative period. When evaluating corneal  subepithelial fibroplasia, maximum attention was paid to the  frequency and the intensity index. It was shown a significant  difference in the intensity of the haze between the study group and the control group by 26.1 % at 3 months, by 62.2 % at 6  months and by 65.3 % 12 months after the operation. Conclusion.Nonconservative therapy with sodium hyaluronate and  dexapanthenol in the early postoperative period and only sodium  hydrolurate allows to reduce the severity of the dry eye syndrome  after laser correction of hypermetropia and, as a result, to reduce  the intensity of haze development by 65.3 %, and its frequency on 11,5 %.

scholarly journals Clinical comparision of intravesical hyaluronic acid and hyaluronic acid-chondroitin sulphate therapy for patients with bladder pain syndrome/interstitital cystitis

2014 ◽  
Vol 8 (9-10) ◽  
pp. 610 ◽  
Author(s):  
Ömer Gülpınar ◽  
Aytaç Kayış ◽  
Evren Süer ◽  
Mehmet İlker Gökçe ◽  
Adil Güçal Güçlü ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Interstitial Cystitis ◽  
Chondroitin Sulphate ◽  
Sodium Hyaluronate ◽  
Previous Treatment ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Symptom Index ◽  
Bladder Pain ◽  
Significant Difference

Introduction: Patients with a history of bladder pain syndrome/interstitial cystitis (BPS/IC) and who responded poorly or unsatisfactorily with previous treatment were compared taking intravesical hyaluronic acid (HA) or hyaluronic acid-chondroitin sulphate (HA-CS).Methods: Patients were treated with intravesical instillation with 50 mL sterile sodium hyalurinic acid (Hyacyst, Syner-Med, Surrey, UK) (n = 32) and sodium hyaluronate 1.6% sodium chondroitin sulphate 2% (Ialuril, Aspire Pharma, UK) (n = 33). Intravesical instillations were performed weekly in first month, every 15 days in the second month and monthly in third and fourth months, for a total of 8 doses. Patients were evaluated using a visual analog pain scale (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), voiding diary for frequency/nocturia, cystometric bladder capacity and voided volume at the beginning and at 6 months. All patients had a potassium sensitivity test (PST) initially. Wilcoxon and Mann-Whitney U tests were used for statistical analysis.Results: In total, 53 patients met the study criteria. There were 30 patients in the HA-CS group (mean age: 48.47) and 23 patients in the HA group (mean age: 49.61) (p > 0.05). The initial PST was positive in 71.7% patients (38/53) overall with no difference between groups (p > 0.05). Responses for VAS, ICCS, ICPS, 24-hour frequency/nocturia statistically improved in both groups at 6 months. There was no significant difference in symptomatic improvement (p > 0.05). Eight patients had mild adverse events.Conclusion: HA and HA/CS instillation can be effective in BPS/IC patients who do not respond to conservative treatment. An important limitation of our study is that the HA dosage of the 2 treatment arms were different. It would be more appropriate with same HA dosage in both groups; however, there was no commercially available glycosaminoglycan (GAG) substance with same HA dosage for single and combination therapy. Large, long-term randomized studies are required to determine if there is a difference between these treatments.

Short-Term Response of Mitomycin C on the Human Rectus Muscle Following Strabismus Surgery: Histological, Ultrastructural, and Biomechanical Evaluation

2013 ◽  
Vol 19 (1) ◽  
pp. 227-232 ◽  
Author(s):  
Samjin Choi ◽  
Youjin Cheong ◽  
Jae-Ho Shin ◽  
Kyung A Kim ◽  
Jae Beum Bang ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Mitomycin C ◽  
Adhesion Force ◽  
Rectus Muscle ◽  
Strabismus Surgery ◽  
Collagen Fibrils ◽  
Control Group ◽  
Biomechanical Property ◽  
Type I ◽  
Microscopy Analysis

AbstractThis study investigated the inflammatory effect of intraoperative mitomycin C (MMC) on adhesion reformation in human rectus muscles. Ten consecutive patients who underwent medial rectus resection had their postoperative rectus muscles divided into two groups: control group (n = 10) and MMC group (n = 10). In the MMC group, the muscle was soaked for 2 min with MMC, prepared as a 0.2 mg/mL (0.02%) solution. The 0.02% MMC reactions were examined using histological analysis with hematoxylin-eosin (inflammatory response) and Masson's trichrome (collagen fibrils), immunoreactivities of cyclooxygenase-II (inflammatory response), and collagen type I and III, scanning electron microscopy analysis to quantify the diameter and D-periodicity of collagen fibrils, and atomic force microscopy analysis to quantify the diameter, D-periodicity, and adhesion force of collagen fibrils. The rectus muscles treated with 0.02% MMC showed a significantly increased inflammatory response (p < 0.05), increased collagen density (p < 0.0001), increased fibril diameter (p < 0.001 or p < 0.05), and decreased fibril adhesion force (p < 0.005) compared to the rectus muscles in the control group. MMC simultaneously caused an inflammatory response as well as nanostructural and biomechanical property changes in the collagen fibril network.

scholarly journals An effect of hyaluronan as abdominal post-operative anti-adhesive in dogs, macroscopic, laparoscopic and histopathological study

2016 ◽  
Vol 40 (1) ◽  
pp. 108-115
Author(s):  
Shatha M. Hashim
Keyword(s):  
Connective Tissue ◽  
Abdominal Wall ◽  
Histopathological Examination ◽  
Adhesion Formation ◽  
Sodium Hyaluronate ◽  
Control Group ◽  
Low Grade ◽  
Significant Difference ◽  
Group A ◽  
Group B

     The aim of this study was to evaluate the effectiveness of hyaluronan as abdominal anti-adhesive. Sixteen healthy adult local breed dogs, aged between (1-2 years) and weighed (15-20) kg were used. They were divided into two equal groups. First group is considered as a control group (A), the second group is the hyaluronic acid group (B); both groups underwent celiotomy under the effect of general anesthesia (combination of ketamine-xylazine at the dose rate of 15mg /kg and 5mg/kg B.W, respectively). Three sero-muscular incisions were 3cm long created at anti-mesenteric border in the descending colon and sutured with simple continuous suture using4-0chromic cat gut, abdominal wall closed in routine manner, in control group. The same procedure was performed in group B but 2 ml of 1%sodium hyaluronate was applied intra peritoneally prior to abdominal closure. Evaluation of the results was based on macroscopic, laparoscopic and microscopic examinations. Macroscopic examination showed severe adhesions in all animals in both 7th, 30thpost operative days with high grade scores (grade 3-4), except in one animal there was no adhesion in group A. While in group B, all dogs had developed mild adhesion formation at 7thpost operative day in low grade score (grade, 1). By 30thpost operative day there was no adhesion (grade, zero) except mild adhesion, in one case between omentum and abdominal wall (grade, 1). Histopathological examination showed dense fibrous connective tissue with congested blood vessels and irregular collagen fibersin group A. While in group B there were fine bundles of cellular connective tissue, granulation tissue with mononuclear cells infiltration. There were significant differences (P<0.05) between group B (1.00±0.00) and group A (3.50±0.28) at 7th, also at 30thpost operation a significant difference (P<0.05) was found between group B (*0.25±0.25) and group A (2.75±0.94) macroscopically. Histopathological examination also revealed a significant difference (P < 0.05) between group B(*1.00±0.81)and group A(2.75±0.50) at 7th and 30thpost operative days group B(*1.00±0.81) and group A(2.25±0.95).The study revealed, the effectiveness of hyaluronan in reducing intra-abdominal adhesions that occurred after abdominal surgery in dogs, in comparison with control group.

scholarly journals Effect of Sirolimus on Intra-Abdominal adhesion development in a rat model

2021 ◽  
Vol 8 (6) ◽  
pp. 373-378
Author(s):  
Salim Balin ◽  
Kemal Eyvaz ◽  
Kayhan Başak ◽  
Mehmet Eser
Keyword(s):  
Rat Model ◽  
Adhesion Formation ◽  
Sodium Hyaluronate ◽  
Control Group ◽  
Bioresorbable Membrane ◽  
Intraabdominal Adhesions ◽  
Severity Scores ◽  
Significant Difference ◽  
Group 2 ◽  
Adhesive Effect

Objective: Postoperative intraabdominal adhesions still cause significant morbidity in surgical patients. This study aims to evaluate the effects of an immunosuppressor known as Sirolimus and an antiadhesive membrane which is formed with sodium hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm™) to the intraabdominal adhesion formation in a rat model. Materials and Methods: This experimental study was performed at an experimental research center, Yeditepe University Faculty of Medicine, Istanbul. Spraque-Dawley Rats, at a weight of about 250±20 gr, were used. Group 1 (n=8): Abdomen was closed after applying cecal abrasion (control group), group 2 (n=8): 10 x 30 mm Seprafilm™ was applied under the abdominal wall after cecal abrasion ( Seprafilm™ group ). Group 3 (n =8): Sirolimus (0,5 mg/kg) was applied (Sirolimus group).  Adhesions quantitatively evaluated by a blinded assessor according to the classification of Nair and his colleagues. Results: Statistically significant difference in terms of adhesion severity scores according to the Nair classification was found between the Sirolimus and the control group (p=0,03). Whereas, no statistically significant difference was found between the Seprafilm™ and the control group (p=0,17). Similarly, no statistically significant difference was found between Seprafilm™ and sirolimus group (p=0,64). Conclusion: Although there was no statistically significant difference between intraperitoneal application of Sirolimus and Seprafilm™ group (p = 0.57), a statistically significant difference was found when each group compared with the control group (p=0,03). Combined anti-adhesive effect of Sirolimus and Seprafilm™ can be evaluated in future studies.

scholarly journals Abdominal adhesions: Surgical treatment and prevention (literature review)

2021 ◽  
Vol 16 (1) ◽  
pp. 43-49
Author(s):  
Dmitry Kluiko ◽  
◽  
Vladimir Korik ◽  
Alexey Sivets ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intestinal Obstruction ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Recurrent Abdominal Pain ◽  
Early Postoperative Period ◽  
Pulmonary Complications ◽  
Important Place ◽  
Treatment And Prevention ◽  
Significant Difference

The ongoing discussion on the diagnosis and tactics of surgical treatment of painful forms of adhesions of the abdominal cavity and adhesive intestinal obstruction testifies to the persistent urgency of this problem. The presence of a postoperative scar and recurrent abdominal pain are interpreted by surgeons and gastroenterologists as adhesive disease, with the appointment of the same type of treatment. At the same time, patients have a reduced critical attitude to their condition, which leads them to late seeking medical help. For the occurrence of the adhesion process, a long-term effect of a complex of factors is necessary, an important place among which is blood supply, oxygen access to tissues and peristalsis in the early postoperative period. The most effective methods of treatment and prevention of intestinal obstruction are low-traumatic surgical technologies. There was no statistically significant difference between open and laparoscopic adhesiolysis in the number of intraoperative intestinal injuries, wound infections and mortality. Laparoscopic operations have fewer general and pulmonary complications than open ones. Reducing fibroblast proliferation, minimizing hypoxia and inflammation are a new preventive solution to the problem of adhesion formation.

Effects of mitomycin C on delayed adjustment in experimental strabismus surgery

1995 ◽  
Vol 9 (1) ◽  
pp. 51 ◽  
Author(s):  
Se Oh Oh ◽  
Bong Leen Chang ◽  
Jaeheung Lee
Keyword(s):  
Mitomycin C ◽  
Strabismus Surgery

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

Optimization of postoperative management of patients undergoing functional endoscopic sinus surgery

2018 ◽  
pp. 26-31
Author(s):  
Sergey Bezshapochny ◽  
Andrey Loburets ◽  
Valery Loburets
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Sinus Surgery ◽  
Control Group ◽  
Nasal Breathing ◽  
Traditional Therapy ◽  
Significant Difference ◽  
Water Salt ◽  
Experimental Group

Topicality: The result of surgical treatment depends largely on the chosen method of management of the postoperative period, the main purpose of which is to reduce the effects of surgical trauma. Despite the wide variety of drugs for local and systemic use, the question of pharmacotherapy of the operated sinus remains open to this day. The main properties that a modern drug should possess are safety and high clinical efficacy. Aim: to study the clinical efficacy of topical application of a complex preparation based on a saline solution containing sodium hyaluronate and dexpanthenol in patients with chronic sinusitis after functional endoscopic sinus surgery (FESS). Materials and Methods: Clinical and laboratory studies were conducted on 47 patients with chronic rhinosinusitis who underwent surgery using the FESS technique. Patients were divided into 2 groups according to the principle of the postoperative period. Patients of research group (n=21), except for traditional therapy, was used locally NASOMER (a preparation based on a water-salt solution containing sodium hyaluronate and dexpanthenol); to the control group (n=26) patients entered, in the postoperative period received traditional therapy. Traditional therapy included a toilet of the nasal cavity, the use of short-course topical decongestants, irrigation of the nasal cavity with water-salt solutions. Criteria of clinical effectiveness: data of endoscopy of the nasal cavity, rhinomanometry, activity of the mucociliary transport system. The effectiveness of functional research methods in the postoperative period was determined on the 7th and 14th day of treatment. Results: On the 3rd day of the study, an increase in the swelling of the nasal cavity was observed in patients of both clinical groups, correlated with difficulty in nasal breathing. On the 7th day, a decrease in edema was observed in patients of both groups, but in the experimental group, the index of nasal breathing, according to rhinomanometry, was significantly (p<0.05) different from the control group, and was respectively 1.54±0.14 and 2.04±0.19 kPa/l*s. On the 14th day of the study, no significant difference was observed between these indicators. When studying the activity of the ciliated epithelium of the mucous membrane of the nasal cavity, it was proved that patients of the experimental group on day 7 after surgery showed a statistically significant difference in this indicator compared to the control group (17.8±1.0 and 22.7±2.1 min. respectively). Conclusions: The use of NASOMER after surgical intervention in patients with chronic rhinosinusitis contributes to more effective treatment compared with traditional therapy, as evidenced by the rapid recovery of the main functional parameters according to active posterior rhinomanometry and mucociliary clearance. Based on the results of the studies performed, the use of NASOMER for pharmacotherapy in the postoperative period is recommended for patients who have undergone rhinosurgical interventions with the aim of reducing the period of postoperative rehabilitation as an effective anti-inflammatory and wound-healing agent.

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