Preliminary results of Preserflo Microshunt versus Preserflo Microshunt and Ologen implantation

Abstract Purpose To report preliminary 6-month results on the use of the Preserflo Microshunt implant with and without Ologen in 50 pseudophakic eyes with moderate to advanced primary open-angle glaucoma (POAG). Methods Fifty pseudophakic eyes underwent ab externo Preserflo Microshunt implantation. Data was gathered retrospectively and two groups were then created, group A with application of MMC 0.2 mg/ml and group B with MMC 0.2 mg/ml and Ologen collagen matrix (OCM) implantation. Absolute success was regarded as the percentage of eyes achieving: a) 5 ≤ intraocular pressure (IOP) ≤ 13 mmHg, b) 5 ≤ IOP ≤ 16 mmHg, and c) 5 ≤ IOP ≤ 21 mmHg without additional medication or surgery and qualified success was regarded as the percentage of eyes achieving a) IOP ≤ 13 mmHg, b) IOP ≤ 16 mmHg, and c) IOP ≤ 21 mmHg with or without medication. Evaluation was performed using a log-rank Kaplan-Meier test. A scatterplot analysis presented the treatment effect data of all eyes with a minimum of 20% IOP reduction per case. Failure was defined as requiring additional surgery, IOP greater than 21 mmHg with or without medication and failure to reach 20% IOP reduction. Results Mean postoperative IOP was significantly lower in both groups. IOP decreased by 49.06% in group A and by 53.01% in group B at 6 months (P < 0.88), respectively. Medication use was lower in both groups (Wilcoxon test, P < 0.001). The absolute and qualified success rates were not statistically significant between the groups (all P > 0.05). Cumulative IOP results per case were not statistically different in group A compared with group B. One revision surgery in group A (4% failure rate) and three in group B (12% failure rate) were performed. Conclusions Both groups showed equal results in terms of cumulative and mean IOP reduction, medication reduction as well as in absolute and qualified success rates. No significant difference was found in any parameters tested between Preserflo Microshunt with MMC 0.2 mg/ml and with or without OCM implantation at 6 months. Long-term follow-up is required to further evaluate this data.

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Treatment of Major Laparoscopic Bile Duct Injury: A Long-Term Follow-up Result

The American Surgeon ◽

10.1177/000313481107701226 ◽

2011 ◽

Vol 77 (12) ◽

pp. 1584-1588 ◽

Cited By ~ 3

Author(s):

Xiao Dong Xu ◽

You Cheng Zhang ◽

Pen Gao ◽

Farah Bahrani-Mougeot ◽

Ling Yi Zhang ◽

...

Keyword(s):

Bile Duct ◽

Bile Duct Injury ◽

Tertiary Care ◽

Secondary Operation ◽

Significant Difference ◽

Long Term Follow Up ◽

Group A ◽

Group B ◽

Group D

The goal of this study is to present the multiple institutions experience comparing the outcome of management between initial laparoscopic cholecystectomy (LC) surgeon and specialist as well as the outcome of different operative procedures to major bile duct injury (BDI) after LC. We have retrospectively collected data of 77 cases of perioperatively detected major BDI in LC at 15 general surgical institutions from 1997 to 2007. We classified 42 cases treated by an experienced biliary surgeon as Group A and 35 cases treated by the initial LC surgeon as Group B. Forty-eight cases were treated with duct-to-duct anastomosis as Group C and 29 cases were treated with Roux-en-Y choledochojejunostomy as Group D. The median duration of follow-up was 62 months. The outcome of groups was compared. In Group A, 7 of 42 (16.7%) patients developed a failure. Two of seven (28.6%) patients were treated by a secondary operation. In Group B, 24 of 35 (68.6%) patients developed a failure. Seventeen of 24 (70.8%) patients were treated by a secondary operation. One of 35 (2.85%) patients died. The significant differences were observed in failure and secondary operations (16.7 vs 68.6%, P < 0.01 and 28.6 vs 70.8%, P < 0.01). There is no significant difference Group C and Group D in failure rate (28.5 vs 11.7%, P > 0.05). A multiple institutional cooperative methodology between the local surgical institution and tertiary care centers provided a good way to limit further operations, failure. The reconstructive strategy is important and should be selected according to the type of injury and the diagnosed status of major BDI.

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Effect of abdominal compression on target movement and extension of the external boundary of peripheral lung tumours treated with stereotactic radiotherapy based on four-dimensional computed tomography

Radiation Oncology ◽

10.1186/s13014-021-01889-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yuanjun Qi ◽

Jianbin Li ◽

Yingjie Zhang ◽

Qian Shao ◽

Xijun Liu ◽

...

Keyword(s):

Computed Tomography ◽

Lower Lobe ◽

Target Volume ◽

Wilcoxon Test ◽

External Boundary ◽

Abdominal Compression ◽

Significant Difference ◽

Target Volumes ◽

Group A ◽

Group B

Abstract Background This study aimed to investigate the effect of abdominal compression on tumour motion and target volume and to determine suitable planning target volume (PTV) margins for patients treated with lung stereotactic body radiotherapy (SBRT) based on four-dimensional computed tomography (4DCT). Methods Twenty-three patients diagnosed to have a peripheral pulmonary tumour were selected and divided into an all lesions group (group A), an upper middle lobe lesions group (group B), and a lower lobe lesions group (group C). Two 4DCT scans were performed in each patient, one with and one without abdominal compression. Cone beam computed tomography (CBCT) was performed before starting treatment. The gross target volumes (GTVs) were delineated and internal gross target volumes (IGTVs) were defined. IGTVs were generated using two methods: (1) the maximum intensity projections (MIPs) based on the 4DCT were reconstructed to form a single volume and defined as the IGTVMIP and (2) GTVs from all 10 phases were combined to form a single volume and defined as the IGTV10. A 5-mm, 4-mm, and 3-mm margin was added in all directions on the IGTVMIP and the volume was constructed as PTVMIP5mm, PTVMIP4mm, and PTVMIP3mm. Results There was no significant difference in the amplitude of tumour motion in the left–right, anterior–posterior, or superior-inferior direction according to whether or not abdominal compression was applied (group A, p = 0.43, 0.27, and 0.29, respectively; group B, p = 0.46, 0.15, and 0.45; group C, p = 0.79, 0.86, and 0.37; Wilcoxon test). However, the median IGTVMIP without abdominal compression was 33.67% higher than that with compression (p = 0.00), and the median IGTV10 without compression was 16.08% higher than that with compression (p = 0.00). The median proportion of the degree of inclusion of the IGTVCBCT in PTVMIP5mm, PTVMIP4mm, and PTVMIP3mm ≥ 95% was 100%, 100%, and 83.33%, respectively. Conclusions Abdominal compression was useful for reducing the size of the IGTVMIP and IGTV10 and for decreasing the PTV margins based on 4DCT. In IGTVMIP with abdominal compression, adding a 4-mm margin to account for respiration is feasible in SBRT based on 4DCT.

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Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-019-0386-z ◽

2019 ◽

Vol 48 (1) ◽

Cited By ~ 2

Author(s):

Kadir Özdamar ◽

Alper Sen

Keyword(s):

Retention Rates ◽

Success Rates ◽

Temporal Muscle ◽

Type 1 Tympanoplasty ◽

Significant Difference ◽

The Status ◽

Group A ◽

Group B ◽

Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

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Single-Dose Ibuprofen-Arginine as a Preventive for Pain, Edema, and Trismus After Impacted Lower Third Molar Surgery: A Randomized Split-Mouth Clinical Trial

European Journal of Dentistry ◽

10.1055/s-0041-1735910 ◽

2021 ◽

Author(s):

Edith Umasi Ramos ◽

Luan Pier Benetti ◽

Júlio César Silva Oliveira ◽

Ana Paula Farnezi Bassi

Keyword(s):

Statistical Significance ◽

Third Molar ◽

Wilcoxon Test ◽

Total N ◽

Study Results ◽

Significant Difference ◽

Group A ◽

Facial Edema ◽

Anti Inflammatory ◽

Group B

Abstract Objective We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone. Materials and Methods The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura. Statistical Analysis For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05. Results The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B. Conclusion As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.

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The Efficacy of Ab Externo Canaloplasty by Using a Nonabsorbable Suture and No Viscoelastics; IOP Results, Intraoperative and Early Complication Rates within 6-Month Follow-Up Period

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1386-3170 ◽

2021 ◽

Author(s):

Iraklis Vastardis ◽

Sofia Fili ◽

Georgios Perdikakis ◽

Kalliopi Kontopoulou ◽

Zisis Gatzioufas ◽

...

Keyword(s):

Open Angle Glaucoma ◽

Glaucoma Surgery ◽

Complication Rates ◽

Success Rates ◽

Intraoperative Complication ◽

Nonabsorbable Suture ◽

Group A ◽

The Mean ◽

Group B

Abstract Background To report the efficacy of ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification in terms of mean intraocular pressure (IOP), medication reduction, and intra- and postoperative complication rates as well as additional glaucoma surgery. Patients and Methods Forty-eight patients with primary open-angle glaucoma (POAG) and 50 eyes were divided into two groups according to the operation performed (Group A canaloplasty, n = 34 and Group B canaloplasty combined with phaco, n = 16), respectively. The success criteria were evaluated between three IOP ranges: a) IOP ≤ 16 mmHg, b) ≤ 18 mmHg, and c) ≤ 21 mmHg. Complete success was considered the percentage of eyes reaching these goals with no medication and qualified success with or without medication. Groups A and B were compared with the Kaplan-Meier test. Mean IOP and medication reduction as well as additional glaucoma surgery were also evaluated. The follow-up time was 6 months. Statistical importance was given at p < 0.05. Results Fail rate and intraoperative conversion of canaloplasty to other surgery (trabeculotomy due to extensive cheese-wiring) accounted for 12% (6 eyes), while a mandatory usage of the iTrack 250A microcatheter to successfully overcome intracanalicular bridging of the Schlemmʼs canal accounted for 20% (10 eyes). The most common early postoperative complications in both groups were hyphema, cheese wiring, and transient IOP rising. The mean IOP in Group A reduced from 23.67 ± 6.06 mmHg to 13.35 ± 4.23 mmHg and in Group B, it reduced from 23.55 ± 6.19 mmHg to 12.75 ± 1.5 mmHg at 6 months (p < 0.001). Group Aʼs absolute success rates accounted for a) 44%, b) 47.1%, and c) 52.9% in comparison to Group B [a) 50%, b) 50%, and c) 56.3%] at 6 months (p < 0.05). Qualified success with or without medication showed no statistical differences between the groups. The mean medication reduction was significantly lower (p < 0.001) in both groups (Group A from baseline 3.2 ± 1.23 to 0.95 ± 1.35 and Group B from 3.12 ± 0.88 to 1.12 ± 0.75 at 6 months, respectively). Five eyes (10%) required additional glaucoma surgery. Conclusions Ab externo canaloplasty by exclusively using only a nonabsorbable suture as a standalone operation or combined with phacoemulsification seems to lower the mean IOP and medication sufficiently. However, they pose a greater surgical challenge and intraoperative complication rate. Additional glaucoma surgery or medication following both procedures may be necessary to achieve an optimal target IOP.

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Endonasal Dacryocystorhinostomy done with and without Silicon Tube Stents: A Comparative Case Series Analysis Study

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1116 ◽

2012 ◽

Vol 3 (3) ◽

pp. 147-153 ◽

Cited By ~ 1

Author(s):

Sudhir Naik ◽

Sarika S Naik ◽

S Ravishankara ◽

Mohan K Appaji ◽

MK Goutham ◽

...

Keyword(s):

Case Series ◽

Study Groups ◽

Success Rates ◽

Analysis Study ◽

Series Analysis ◽

Significant Difference ◽

Silicon Tube ◽

Group A ◽

Group B ◽

Primary Healing

ABSTRACT Background/objectives Neo-ostium cicatrization and closure is considered a major factor for surgical failure in endoscopic dacryocystorhinostomy (EnDCR). Wide neo-ostium, mucosal flaps, sac marsupialization with primary healing and silicone tube stent improves surgical outcomes of EnDCR. Materials and methods EnDCR were done in 238 patients. Group A included 172 patients where no stents were used and group B included 66 patients where silicon tube stents were used. All the surgeries were done under general anesthesia. Results In our study, 89.53% success in syringing patency was seen in group A, 89.39% success in syringing patency was seen in group B at 6 months of follow-up. No significant difference in success rate were seen in the two study groups. Conclusion No significant difference in EnDCR success rates were seen with the use of stents in our study. So stenting probing and dilatation are not advocated routinely in all cases and a wide neo-ostium with mucosal flaps and primary healing is the secret to success. How to cite this article Naik SM, Mushannavar AS, Ravishankara S, Appaji MK, Goutham MK, Devi NP, Naik SS. Endonasal Dacryocystorhinostomy done with and without Silicon Tube Stents: A Comparative Case Series Analysis Study. Int J Head Neck Surg 2012;3(3):147-153.

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The optimal timing of additional surgery after non-curative endoscopic resection to treat early gastric cancer: long-term follow-up study

Scientific Reports ◽

10.1038/s41598-019-54778-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Jae Hwang Cha ◽

Jie-Hyun Kim ◽

Hyoung-Il Kim ◽

Da Hyun Jung ◽

Jae Jun Park ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Resection ◽

Oncological Outcomes ◽

Additional Surgery ◽

Significant Difference ◽

Long Term Follow Up ◽

Group B

AbstractPatients with early gastric cancer (EGC) who undergo non-curative endoscopic resection (ER) require additional surgery. The aim of the study was to validate surgical and oncological outcomes according to the timing of additional surgery after non-curative endoscopic resection. We retrospectively analyzed long-term follow-up data on the 302 patients enrolled between January 2007 and December 2014. We validated our earlier suggestion that the optimal time interval from non-curative ER to additional surgery was 29 days. All patients were divided into two groups by reference to time intervals from ER to additional surgery of ≤29days (n = 133; group A) and >29 days (n = 169; group B). The median follow-up duration was 41.98 ± 21.23 months. As in our previous study, group B exhibited better surgical outcomes. A total of 10 patients developed locoregional or distant recurrences during the follow-up period, but no significant difference was evident between the two groups. Interestingly, the survival rate was better in group B. Group B (>29 days) exhibited better surgical and oncological outcomes. Thus, additional gastrectomy after non-curative ER should be delayed for 1 month to ensure optimal surgical and oncological outcomes.

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Efficacy and safety of 5-fluorouracil in infrared monitor guided bleb revision

BMC Ophthalmology ◽

10.1186/s12886-021-01843-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rumi Kawashima ◽

Kenji Matsushita ◽

Ryo Kawasaki ◽

Kohji Nishida

Keyword(s):

Proportional Hazards ◽

Anterior Segment ◽

Significant Risk ◽

Cox Proportional Hazards ◽

Subconjunctival Injection ◽

Success Rates ◽

Additional Surgery ◽

Group A ◽

Group B

Abstract Purpose Infrared monitor-guided bleb revision (IRGBR), an alternative needling system, visualizes anterior-segment tissues around the bleb not visible during needle revision after trabeculectomy. This study determined the safety and efficiency of 5-fluorouracil (5-FU) as an adjunctive anti-metabolite in IRGBR. Methods We retrospectively analyzed 43 consecutive eyes (40 patients; 14 eyes, primary open-angle; 29 eyes, secondary glaucoma) treated with IRGBR for failing filtering blebs. The patients were divided into two groups. The first one had IRGBR without adjunctive 5-FU subconjunctival injection, and the second one had IRGBR with 5-FU. We performed Kaplan-Meier survival analysis using log-rank tests after 2 years of follow-up and Cox proportional hazards regression model to analyze the dependence of the survival time on predictor variables. Two failure criteria were defined as the need for additional surgery for intraocular pressure (IOP) reduction and the IOP at two consecutive follow-up visits based on definition 1, IOP ≧22 mmHg and definition 2, IOP ≧17 mmHg. Results Thirty eyes (29 cases) underwent IRGBR with subconjunctival 5-FU injection (group A in the second term) and 13 eyes (11 cases) without 5-FU (group B in the first term). The success rates 24 months after IRGBR were 73.3 and 23.1%, respectively, in groups A and B based on the definition 1 failure and 56.7 and 7.7% based on the definition 2 failure. Complications included transient bleb leaks (group A, 3 eyes; group B, none) and choroidal detachment (group A, 1 eye; group B, none). No use of 5-FU and IOPs ≧10 mmHg 1 week after IRGBR were significant risk factors. Conclusions Adjunctive 5-FU in IRGBR achieved a better success rate for failing trabeculectomy blebs.

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Trabeculectomy with OloGen versus Mitomycin C for the Treatment of Silicone Oil-Induced Glaucoma

Klinische Monatsblätter für Augenheilkunde ◽

10.1055/a-1500-8230 ◽

2021 ◽

Author(s):

Hisham Samy Shalaby ◽

Noureldin Hussein Hashem

Keyword(s):

Intraocular Pressure ◽

Mitomycin C ◽

Silicone Oil ◽

Success Rates ◽

Kaplan Meier ◽

Significant Difference ◽

Pressure Lowering ◽

Group A ◽

Group B

Abstract Aim To compare the intraocular pressure-lowering effect and success rate of trabeculectomy with OloGen to that of trabeculectomy with mitomycin C (MMC) in cases of silicone oil-induced glaucoma. Materials and Methods Forty eyes of forty patients with elevated intraocular pressure (IOP) after vitrectomy and silicone oil injection (followed by silicone oil removal) were assigned to two groups. Group A included 20 cases who underwent trabeculectomy with OloGen, while group B cases contained 20 cases undergoing trabeculectomy with MMC. The follow-up period was 24 months. Patients enrolled had IOP > 21 mmHg despite being on antiglaucoma medications. Results The mean postoperative IOP reduction was lower in group A than in group B at all follow-up visits, but this difference was not statistically significant (p > 0.05). Moreover, group A and B patients were found to be similar as regards the need for postoperative antiglaucoma medications on all follow-up visits. The Kaplan-Meier survival analysis curves for the two groups revealed slightly higher success rates in group B than in group A. However, these differences were not statistically significant for both qualified success (IOP ≤ 21 mmHg with or without antiglaucoma medications) and complete success (IOP ≤ 21 mmHg without antiglaucoma medications). There was no significant difference in the postoperative complication rate between the two groups. Conclusion OloGen implant lowers IOP to a similar extent as MMC when combined with trabeculectomy for the treatment of silicone oil-induced glaucoma, and with comparable success rates. The rate of postoperative complications is similar for OloGen implantation and MMC.

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Lower Dosages of Intravenous Immunoglobulin (IVIg) in Treating Immune Thrombocytopenia with Long-Term Follow-up of Three Years

Blood ◽

10.1182/blood.v126.23.3480.3480 ◽

2015 ◽

Vol 126 (23) ◽

pp. 3480-3480

Author(s):

Zeping Zhou ◽

Zhuoqing Qiao ◽

Huiyuan Li ◽

Xian Zhang ◽

Feng Xue ◽

...

Keyword(s):

Intravenous Immunoglobulin ◽

Immune Thrombocytopenia ◽

Conflicts Of Interest ◽

Ivig Treatment ◽

High Dose ◽

Significant Difference ◽

Long Term Follow Up ◽

Group A ◽

Group B

Abstract This study compared the effects of different dosages of intravenous immunoglobulin (IVIg) against immune thrombocytopenia. A total of 167 patients, 91 adults and 76 children, with ITP, followed-up for 3 years in the case-control study, were each divided into three subgroups according to the dosages of IVIg administered: group A (0.2g/kg/day), group B (0.3g/kg/day), group C (0.4g/kg/day). The therapeutic response in 91 adult patients did not differ significantly among the three groups of IVIg dosages (P=0.459). The response rate of IVIg treatment in the three adult groups was 97.1% for group A, and 97.2% for group B, 100% for group C. The mean time for raising platelets to 30 ×109/L in group A was 2.5 days, group B 3.2 days, group C 2.9 days (P=0.324). The median IVIg consumption in group A was 0.83 g/kg, group B 1.22 g/kg, and group C 1.64 g/kg (P<0.01). Similar results were shown in the children groups. The follow-up results showed no significant difference of clinical outcome between groups A, B and C. In conclusion, low-dose IVIg treatment is shown to be as effective as high-dose regimen without increasing the risk of developing the patients into chronic ITP conditions, suggesting that ITP patients could be treated more cost-effectively by lower than conventional dosage of IVIg regimen. Disclosures No relevant conflicts of interest to declare.

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