Intravitreal aflibercept for submacular hemorrhage secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate the efficacy of intravitreal aflibercept monotherapy for submacular hemorrhage secondary to neovascular age-related...     

Effect of prolonged inspiratory time on gas exchange during robot-assisted laparoscopic urologic surgery

Background

Gas exchange disturbance may develop during urologic robotic laparoscopic surgery with the patient in a steep Trendelenburg position. This study investigated whether prolonged inspiratory time could mitigate gas exchange disturbances including hypercapnia.

Methods

In this randomized cross-over trial, 32 patients scheduled for robot-assisted urologic surgery were randomized to receive an inspiratory to expiratory time ratio (I:E) of 1:1 for the first hour of pneumoperitoneum followed by 1:2 for last period of surgery (group A, n?=?17) or I:E of 1:2 followed by 1:1 (group B, n?=?15). Arterial blood gas analysis, airway pressure and hemodynamic variables were assessed at four time points (T1: 10?min after induction of general anesthesia, T2: 1?h after the initiation of pneumoperitoneum, T3: 1?h after T2 and T4: at skin closure). The carry over effect of initial I:E was also evaluated over the next hour through arterial blood gas analysis.

Results

There was a significant decrease in partial pressure of oxygen in arterial blood (PaO₂) for both groups at T2 and T3 compared to T1 but in group B the PaO₂ at T4 was not decreased from the baseline. Partial pressure of carbon dioxide in arterial blood (PaCO₂) increased with I:E of 1:2 but did not significantly increase with I:E of 1:1; however, there were no differences in PaO₂ and PaCO₂ between the groups.

Conclusion

Decreased oxygenation by pneumoperitoneum was improved and PaCO₂ did not increase after 1 h of I:E of 1:1; however, the effect of equal ratio ventilation longer than 1 h remains to be determined. There was no carryover effect of the two different I:E ratios.

     

The Result of Revision Total Hip Arthroplasty in Patients with Metallosis Following a Catastrophic Failure of a Polyethylene Liner

BackgroundWear cannot be completely prevented after total hip arthroplasty. If severe polyethylene (PE) liner wear develops, the so-called catastrophic failure occurs and metallosis develops. We postulated that longevity of the new implant may be affected after revision surgery for metallosis following a catastrophic failure of a PE liner due to the substantial amount of PE wear particles and infiltration of the metal particles in this catastrophic condition.MethodsTwenty-three hips of 23 patients were identified because they showed metallosis during revision total hip arthroplasties performed in Seoul National University Hospital between January 1996 and August 2004. They were followed for at least 6.5 years after the index revision total hip arthroplasty. The clinical and radiological results of revision total hip arthroplasties in these patients were evaluated.ResultsThe median Harris hip score increased from 60 points before revision total hip arthroplasties to 90 points at the final follow-up. Osteolysis was detected at an average of 9.3 years after revision total hip arthroplasties in 13 hips and acetabular cup loosening at average 9.8 years after revision total hip arthroplasties in 9 hips. With radiographic evidence of osteolysis and loosening as the end points, the 15-year survival rates were 28.2% and 56.0%, respectively.ConclusionsThe survival rate of revision total hip arthroplasty in patients with metallosis following a catastrophic failure of a PE liner was low.     

Venom allergen-like protein 28 in Clonorchis sinensis: four epitopes on its surface and the potential role of Cys124 for its conformational stability

Parasitology Research - Venom allergen-like (VAL) proteins are important to host-parasite interactions. We previously demonstrated that a Clonorchis sinensis VAL (CsVAL) protein-derived synthetic...