两种超声乳化系统对白内障手术前后角膜内皮细胞的影响

目的观察应用Infiniti视觉系统与Millennium超声乳化系统对超声乳化术中及术后的效果是否有差异。方法选取在温州医学院眼视光医院行超声乳化白内障吸除折叠人工晶体植入术的年龄相关性白内障患者34例（36只眼），其中男13例13眼，女21例23眼，年龄50～86岁，平均68岁。按照术中使用超声乳化仪的不同分为Infiniti组与Millennium组。Infiniti组共20例（21只眼），其中二级核组10只眼，三级核组6只眼；Millennium组共16例（17只眼），其中二级核组9只眼，三级核组7只眼。术前常规检查术眼的角膜内皮，选取角膜中央计数。手术由同一手术者完成。术中分别记录两组超声乳化所使用的平均能量及超声时间。术后第一天观察角膜、前房及视力情况。术后一周门诊随访，观察术眼的最佳矫正视力，并复查术眼的角膜内皮计数。所有分析过程由同一检查者完成。结果术后第一天两组的角膜均透明，前房形成良好，术后一周最佳矫正视力≥0．5者36只眼（100％）。术后一周门诊随访结果比较，用同样的粘弹剂和灌注液，随机使用不同型号超声乳化仪完成的手术的各个年龄段及不同晶体分级的年龄相关性白内障患者的角膜内皮细胞丢失率无显著相关性。结论应用Infiniti视觉系统与Millennium超声乳化仪对超声乳化手术及术后效果的比较无差异性，说明两种机器都具有良好的性能。     

Limitations of digital subtraction angiography in evaluating potential renal donors

Six potential renal donors were evaluated by both conventional and digital subtraction angiography to determine the number of renal arteries to each kidney. The digital examination missed an accessory renal artery in one of six patients for an error rate of 17%.     

Ethanol thrombotherapy of esophageal varices: further experience

Fifty patients with liver cirrhosis (13 Child class B, 37 class C) were treated for variceal hemorrhage during a 3-year period using the transhepatic selective catheterization and injection of absolute ethanol. Technical failure of the procedure was encountered in 13 instances. The causes were the presence of massive ascites and rigidly contracted liver, cavernous transformation of the main portal vein, and severe coagulopathy. Of the 13 failures, 12 were in Child class C and one in class B. Of 37 initially successfully treated patients, 13 rebled subsequently. Nine of these were Child class C and four were class B. Rebleeding was fatal in five of nine class C patients. Rebleeding was due to recanalization of previously thrombosed access channel in two of 13 patients. Nine patients died, despite successful thrombosis of varices, due to underlying medical conditions. Fifteen patients survived 6 months or more after initial thrombosis without rebleeding. Child class B patients are better candidates for this treatment technique because more favorable treatment results are expected in them. Child class C patients with massive ascites and severely contracted and rigid liver pose a significant technical challenge, but in about one-third, successful control of variceal bleeding can be achieved. Most of those who survived more than 6 months showed varying degrees of improvement in clinical signs and symptoms.     

Renal tumor infarction with absolute ethanol

Sixteen renal tumors were infarcted with intraarterial absolute ethanol. Renal tumor infarction was performed for one of three indications: for palliation of symptoms in patients with metastatic disease, as a preoperative measure to reduce blood loss during radical nephrectomy, or as a primary therapy in selected circumstances. In most cases, absolute ethanol was injected into the main renal artery through a balloon occlusion catheter. In all cases, ethanol produced effective infarction of the renal tumor. Only one complication developed, a perinephric abscess that developed several weeks after the infarction. Results indicate that absolute ethanol is a safe and effective agent for the infarction of renal tumors.     

Detection of adrenal tumors by computerized tomographic scan in endocrine hypertension.

Localization of adrenal lesions in various adrenal disorders can be difficult. An attempt to identify the adrenal tumors in ten patients with pheochromocytoma, Cushing's syndrome, or primary aldosteronism was made using computerized tomographic (CT) scans. The adrenal tumor was visualized in eight patients. The CT scan appears to be a promising noninvasive technique for localization of adrenal tumors.     

The Hidden Culprit: A Case of Repeated Anaphylaxis to Cremophor

Drug-induced anaphylaxis is a big pitfall in patients receiving antineoplastic chemotherapy. We report a case of lung cancer patient who experienced two near-fatal anaphylactic reactions that resulted from paclitaxel and multivitamin, seperately. Recurrent severe reactions to different agents led to further investigation to which material the patient was hypersensitive. The skin prick test revealed sensitization to cremophor, which is a commonly used emulsifying agent. This case emphasizes the importance of correctly identifying the culprit drug of anaphylaxis to avoid potentially fatal reaction.     

Familial branchio-oto-renal dysplasia: A new addition to the branchial arch syndromes

The present report concerns a two-generation family of nine individuals in which the father and three of the six living children all had: (1) a mixed hearing loss with a Mondini type cochlear malformation and stapes fixation; (2) cup-shaped, anteverted pinnae with bilateral prehelical pits: (3) bilateral branchial cleft fistulas; and (4) bilateral renal dysplasia and anomalies of the collecting system. The father and one affected son also had aplasia of the lacrimal ducts. A fourth child who died at 5 months of age was reported to have branchial cleft fistulas and bilateral polycystic kidneys at autopsy. In addition, the concept of noso-embryologic communities is presented. Such groups are composed of syndromes whose total phenotypic spectra not only overlap but also share common elements in embryogenesis. This concept is illustrated with a group of branchial arch syndromes that are related in this way.