Vitrectomy for macular pucker and vitreomacular traction syndrome

During the course of a so-called posterior vitreous detachment, a thin layer of the posterior vitreous cortex often remains adherent to the underlying retina. Tangential stretch of this vitreous pseudomembrane may cause vitreomacular traction syndrome, edema, and macular hole formation. The same process appears to underlie the development of true epimacular membranes (idiopathic macular pucker). Vitrectomy is generally agreed to be the most appropriate treatment for these clinical situations. We evaluated the incidence of vitreomacular adhesion and of visual improvement after vitrectomy of eyes with macular pucker (group 1; n=60) and vitreomacular traction syndrome (group 2; n=50). Vitreomacular attachment was assessed during vitrectomy under the condition of continuous air infusion. In the two groups, complete or partial vitreous attachment to the macula was observed in 57.4% and 74%, respectively. We conclude that vitreomacular adhesion is a common feature of the two clinical situations. Visual improvement was achieved in 73% of both groups. High rates of postoperative visual acuities of 20/50 or better (60.6% in group-1; 65.7% in group-2 cases) occurred only in eyes with preoperative values of 20/100 or better. It is reported that the visual outcome of vitreoretinal surgery for the two clinical conditions deteriorates with increasing duration after initial manifestation. Vitrectomy should not be postponed in patients who complain of disturbing visual symptoms such as reduced visual acuity, metamorphopsia and disturbance of binocular reading. This revised version was published online in July 2006 with corrections to the Cover Date.     

Diabetic maculopathy induced by vitreo-macular traction: evaluation by optical coherence tomography (OCT)

Aim: To evaluate the role and efficacy of optical coherence tomography (OCT) in the evaluation of diabetic maculopathy induced by vitreo-retinal traction. Methods: 12 patients affected by diabetic maculopathy induced by vitreo-retinal traction were examined using biomicroscopy with a three-mirror contact lens, fluorescein angiography (FA) and OCT scanning in order to identify the presence of a vitreomacular traction. Results: OCT revealed two patterns of maculopathy which were characterised by a thickening of the superior profile of the OCT tomogram or by the disappearance and inversion of the physiologic foveal depression respectively. Conclusions: OCT may be useful in the characterisation and monitoring of diabetic maculopathy induced by vitreo-retinal traction. This revised version was published online in July 2006 with corrections to the Cover Date.     

Lumbar disc herniation in teenagers

Summary We report 48 patients operated on for lumbar disc herniation in the second decade of life (aged 13–20 years) in our Neurosurgical Division. To analyze the clinical and diagnostic features and surgical outcome of the disease in teenagers and to point out any differences from adults, we made a detailed study of over 900 juvenile cases and compared them with 11000 adult cases reported in the literature. Low-back pain proved to be less frequent among youngsters both as a first symptom and at diagnosis, while sensorimotor deficits have the same frequency in the two age groups. Herniation occurs more often at L4–L5 and is more frequently median among teenagers. The long-term surgical results in children and adolescents are better than in adults.     

针刺、自主牵引、药物外敷治疗腰椎间盘突出症疗效观察

目的 :观察针刺、自主牵引、药物外敷治疗腰椎间盘突出症 (简称治疗组 )的疗效。方法 :随机分为针刺、自主牵引、药物外敷组和单纯针刺组进行对比观察。结果 :治疗组总有效率 94 .1% ,明显高于对照组 75 .8% ,经统计学处理 ,P <0 .0 5 ,具有显著性差异。结论 :治疗组疗效优于对照组     

腰穿置管稳压引流治疗蛛网膜下腔出血后脑积水

目的探讨蛛网膜下腔出血(SAH)后脑积水简便、安全、有效的治疗方法。方法所收治的283例SAH病人中有90例发生了急性脑积水,在内科治疗基础上,其中46例进行了腰穿置管稳压引流治疗结果与无脑积水者对照比较。结果上法治疗后32例(32/46,70%)意识水平均有所改善;所有受治病人12d内再出血和脑缺血的发生率与无脑积水的病人组无显著性差异〔5/46(11%),24/193(12%);16/46(35%)60/193(31%)。P>0.05〕。治疗组未发生脑室炎或脑膜炎。结论腰穿置管稳压引流是一种治疗SAH后脑积水简便、安全、有效的方法。     

防滑钢针及Y形酒精滴管在下肢骨牵引病人中的应用

为探讨自制防滑钢针及Y形酒精滴管在下肢骨牵引病人中的应用效果.选择需行下肢骨牵引的病人100例,随机分成实验组和对照组各50例.实验组采用自制防滑钢针及Y形酒精滴管;对照组采用传统钢针及酒精点滴.观察2组病人钢针滑动、压疮、针道感染情况.结果实验组钢针牵引滑动率显著低于对照组(P＜0.01).针道感染率明显低于对照组(P＜0.01).表明应用自制防滑钢针及Y形酒精滴管效果确切,经济实用,使用方便,可有效避免并发症的发生.     

挑刺阳性反应点治疗腰椎骨质增生38例

试用三棱针挑刺腰部阳性反应点,治疗腰椎骨质增生38例,结果有效率100%,具有疗效好,费用低,疗程短,应用方便的特点.     

Acupuncture treatment of 32 cases of lumbar intervertebral disc protrusion

Yaoyangguan (GV 3), Shiqizhui (Ex-B 8) and Yanglingquan (GB 34) were selected as main points and a three-part needle insertion technique was used to treat 32 cases of lumbar intervertebral disc protrusion. The curative rate was 96.9%. Deep puncture is the key to the treatment. Author: Chen Feng(1962-), male, junior consultant doctor Translator: Wang Si-you     

穴注野木瓜治疗腰椎骨质增生108例疗效观察

方法：采用肾俞穴位注射野木瓜注射液治疗腰椎骨质增生108例，并没针刺对照组52例进行临床对照观察。结果：穴位注射有效率98％，对照组有效率85％。结论：野木瓜注射波穴位注射治疗腰椎骨质增生有显著疗效。     

腰椎间盘巨大突出手术治疗的回顾性分析

目的探讨腰椎间盘巨大突出的临床特点及治疗方法。方法回顾性分析本院1999～2002年住院手术并有随访资料的77例。结果随访6～36个月,平均17.2个月,按Nakal疗效评价,优61例,良10例,可6例。优良率92.2%。结论手术治疗腰椎间盘巨大突出疗效确切,明确诊断后,应尽早手术治疗。