Recent Advances in Surgery of the Fallopian Tubes

The “new pathology” seen in fertility clinics is the blocked fallopian tube without palpable disease. The cornu is a common site of occlusion, and bilateral tubal implantation can be highly successful. A less common site of occlusion is the fimbrial end of the tube. Here the surgical technics includes temporary use of a hood to protect the newly opened oviduct. Corrective technics for both types of occlusion are described.     

Indications for Exploratory Surgery

Generally, the chief indication for exploratory abdominal surgery is an increasing amount of abdominal pain accompanied by loss of weight or changes in eating habits. Roentgenographic studies and clinical symptoms sometimes are misleading and result in erroneous diagnoses of abdominal conditions.

Surgical exploration frequently reveals unsuspected diverticula, benign lesions simulating malignant ones, scirrhous carcinoma, ulcers, or various biliary disorders.

Abdominal exploration is accompanied by minimal risk. In the author's experience, this procedure has revealed the presence of a lesion in 50 per cent of cases.     

Indications for Thyroid Surgery

Research is proving that the effects of various mediators and changes in microcirculation bring about the cellular and metabolic consequences recognized clinically as shock. In this article, the authors approach diagnosis and treatment of the different types of shock through evaluation of hemodynamic variables. They summarize underlying causes of shock, the signs of its progressive stages, and diagnostic studies needed to guide treatment decisions.     

Clinical Indications for Pelvic Surgery

Pelvic lesions which require surgical treatment are primarily inflammatory, neo-plastic or mechanical, or a combination of any of these types. Surgery is recommended for conditions such as certain benign ovarian tumors, hydrosalpinx, ectopic pregnancy, large uterine fibroids, etc. Surgery is not advisable in such conditions as corpus luteum cysts and acute salpingitis or postabortal inflammatory disease.     

影像技术评价冠状动脉粥样硬化的进展

传统上,冠心病(coronary artery disease;CAD)的发展为血管内膜处的粥样斑块逐渐生长的过程。事实上冠心病不是管腔而是管壁的疾病。近来,冠心病的影像学检测有了很大发展,尤其是血管内超声、电子束CT、多层螺旋CT和MRI等检查,可能成为21世纪心血管疾病医学影像技术的热点。下面就有关的进展作一综述。1 冠脉造影、定量冠脉造影和血管内超声 自冠脉造影(coronary angiography;CAG)问世以来,尤其是定量冠脉造影(quantitative coronary angiography;QCA),因能检测动脉病变、指导冠心病介入治疗和评价药     

Trochleoplasty: Indications and Technique

Purpose of Review

Trochlear dysplasia is a well-described risk factor for patellar instability. Trochleoplasty has emerged as a procedure within the surgical armamentarium for patellar instability, yet its role is unclear. A variety of trochleoplasty procedures have emerged. The purpose of this review is to clarify indications for trochleoplasty, outline the technical steps involved in performing common trochleoplasties and report the published outcomes and potential complications of these procedures.

Recent Findings

Patellar instability with severe trochlear dysplasia is the main indication for trochleoplasty. Three types of trochleoplasty have emerged: (1) lateral facet elevation; (2) sulcus deepening; and (3) recession wedge. Deepening and recession wedge trochleoplasties are the most commonly performed.

Summary

Trochleoplasty is a surgical option for addressing patellar instability in patients with severe trochlear dysplasia. Deepening and recession wedge trochleoplasties that address Dejour B and D dysplastic trochleas are the most studied, with both short- and midterm outcomes reported. Long-term outcomes are lacking and comparative studies are needed.

     

抗青光眼滤过术后白内障超声乳化人工晶体植入术

目的:探讨抗青光眼滤过术后行经透明角膜切口的白内障超声乳化人工晶体植入术的疗效。方法:对35例37眼抗青光眼滤过术后白内障患者行颞上方透明角膜切口白内障超声乳化吸出人工晶体植入术,观察术中术后并发症、视力、眼压、滤过泡情况。结果:37眼术后视力均有不同程度提高,其中33眼(89．19%)视力≥0．3。眼压较术前下降,功能性滤过泡无瘢痕化。虹膜反应、角膜水肿是术后主要并发症。结论:超声乳化人工晶体植入术可有效改善青光眼滤过术后白内障患者视功能。     

Recent Advances in the Pathogenesis of Mucormycoses

Purpose

The purposes of this review are to describe the pathogenesis of mucormycosis and to address recent research advances in understanding the mechanisms of fungal invasion and dissemination.