Die polykondensationsprodukte des phloroglucins mit hexamethylendiamin

By the polycondensation of phloroglucine and hexamethylendiamine in toluol or water solution a new, dark green resin has been received. The mechanical and some electrical properties of the obtained resin have been examined and its structure determined.     

Applicability of ultrasound in ocular tumors in children and adolescents

PURPOSE: Evaluation of the applicability of ultrasound in children diagnosed for neoplasm of the eye. Evaluation of Doppler ultrasound in visualizing blood vessels within the lesion in eye ball, eye socket and eye lids. Establishing the value of the obtained data concerning the image of vessels and blood flow for the diagnosis, monitoring the course of disease and results of treatment. MATERIAL AND METHODS: The study comprised 80 patients diagnosed and treated for neoplasm of the eye. The study group included 48 girls and 32 boys aged 2 weeks to 18 years. All the patients were subject to full ophthalmologic examination, ultrasound and other imaging techniques. RESULTS: Echogenicity of lesions, focality of growth and the comparison of echostructure did not allow for establishing the degree of malignancy. The presence of vessels in tumor mass and blood flow in tumors were useful for differentiation between malignant and benign tumors. CONCLUSIONS: Ultrasound methods used significantly improve diagnostic possibilities in orbital tumors in children. The obtained pictures of vessels and flow character are typical for some tumors, which together with histopathology of tumors enables establishing of correct diagnosis. CD/PD ultrasound is helpful in monitoring treatment of selected orbital tumors, enables evaluation of biological evolution of capillary hemangioma and assessment of vascularization degree of tumors treated with chemo- and radiotherapy.     

New biological temporary skin cover Xe-Derma(®) in the treatment of superficial scald burns in children

Background

Xe-Derma^® is a new dry sterile biological cover derived from acellular pig dermis. Hydrated Xe-Derma^® displays bio-mechanical features similar to the normal skin. The aim of the present study was to compare the efficacy of Xe-Derma^® with hydrocolloid dressing Askina THINSite^® for treatment of superficial burns in children in a prospective study.

Materials and methods

In a prospective study, 86 patients (5 months to 7 years of age) with superficial scald burns on a surface area of 1-35% BSA were enrolled. In the course of the study, 43 patients were treated with Xe-Derma^® and 43 patients with Askina THINSite^®. We collected data including the percentage of BSA covered with biological or synthetic material, epithelization time, the number of complete conversions (deepening of 100% of covered area into deep dermal wound) under each cover, the number and extent of partial conversions (deepening of less then 100% of covered area into deep dermal wound), infectious complications, the number of reapplications of the temporary cover and the extent in square centimetres of dressing material needed for successful healing of 1% BSA.

Results

No significant difference in the epithelization time, percentage of conversion from superficial to deep dermal burns and percentage of infectious complication was detected between the two groups. However, patients in the Xe-Derma^® group were burned on a more extensive burn surface area (p ≤ 0.028). Xe-Derma^® showed adherence to the wound and therefore there has been no need to be changed The number of reapplications and therefore also the number of square centimetres needed for successful healing of 1% BSA were statistically higher in the Askina THINSite^® group (p < 0.01) due to increased secretion and accumulation of fluid underneath this hydrocoloid cover. The minimal frequency of changes of this biological cover material brings a significant benefit to pediatric patients.

Conclusion

Acellular pig dermis Xe-Derma^® represents a reliable biological cover material. It is an advantageous alternative to synthetic temporary skin covers in the treatment of superficial scald burns in children.     

Posterior Wall Capture and Femoral Artery Stenosis Following Use of StarClose Closing Device: Diagnosis and Therapy

A case of femoral artery obstruction following application of a StarClose type arterial puncture closing device (APCD) is presented. Ultrasonographic and angiographic imaging of this complication was obtained. The posterior wall of the vessel was accidentally caught in the anchoring element of the nitinol clip. This complication was successfully resolved by endovascular treatment and the implantation of a stent.     

Color Doppler imaging of the retrobulbar circulation in non-exudative and exudative age-related macular degeneration

PURPOSE: To study ocular perfusion in the ophthalmic artery, central retinal artery, nasal and temporal posterior ciliary : arteries in non-exudative and exudative age-related macular degeneration. MATERIAL AND METHODS: Twenty five subjects with non-exudative age-related macular degeneration were compared to twenty five subjects with exudative age-related macular degeneration and to twenty five age-matched control subjects. Color Doppler imaging measured peak systolic velocity (PSV) and end diastolic velocity (EDV) in the ophthalmic artery, central retinal artery, nasal and temporal posterior ciliary arteries of one eye. The resistivity index (RI) and the pulsatility index (PI) were calculated. RESULTS: There were statistically significant differences between: subjects with non-exudative age-related macular degeneration and subjects with exudative age-related macular degeneration in EDV, RI and PI in the ophthalmic artery and PSV in the temporal posterior ciliary artery, subjects with non-exudative age-related macular degeneration and control subjects in RI in central retinal artery, subjects with non-exudative age-related macular degeneration and control subjects in RI and PI in nasal posterior ciliary artery, subjects with exudative age-related macular degeneration and control subjects in PI in nasal posterior ciliary artery. CONCLUSIONS: The study results showed reduced ocular blood flow in patients with non-exudative age-related macular degeneration compared to patients with exudative age-related macular degeneration and to control subjects. The higher RI in central retinal artery in non-exudative age-related macular degeneration compared to control subjects, suggest there may be a more generalized perfusion abnormality beyond the choroid.     

Technical concept of patient-specific,ultrahigh molecular weight polyethylene orbital wall implant

IntroductionThe authors have been using patient-specific implants since 2006 and are constantly looking for new reconstructive materials, in order to create precise implants for orbital reconstruction. Such materials should be biocompatible and stable in the human body, as well as easy to machine and form into complex 3D shapes. Biocompatible ultrahigh molecular weight polyethylene (UHMW-PE) has several unique properties including high impact strength and a low friction coefficient that result in self-lubricating and thus non-sticking surfaces after processing.AimTo present the concept of a patient-specific, UHMW-PE orbital wall implant.Materials and methodsThe material used to manufacture the orbital implant was UHMW-PE converted into a solid block of medical polymer from a powder material. A delayed treatment unilateral orbital fracture case was chosen for reconstruction with patient-specific orbital wall implant. On the basis of computerized tomography, a virtual model of both orbits was prepared. The injured orbit was significantly enlarged due to dislocation of its walls. The 3D model of the facial skeleton was symmetrically divided into two parts. This resulted in two models – left and right orbit, then the uninjured orbit was superimposed onto the contralateral side. As a result two surfaces were created; the outer surface (taken from the injured orbit) was used to design the outer surface of the implant, and the inner (taken from the uninjured orbit) for the inner surface. By combining both these surfaces it was possible to determine the unique shape and thickness of the UHMW-PE implant that would allow for accurate reconstruction of the orbit. Following this, the CAD model was transferred to CAM software and a numerical code for a 5-axis milling machine was generated. The manufactured implant was sterilized in gas plasma and used to reconstruct three orbital walls.ResultsThe thickness of the manufactured implant ranged from 0.2 mm to 1.5 mm and was successfully inserted via transconjunctival approach. The lower, medial and lateral walls were reconstructed. The correct position of the right eyeball was re-established by moving it upward and medially, which resulted in enophthalmos and diplopia correction. The described method features several advantages: accurate reconstruction of the original shape of the orbit, precise modification of local implant thickness during design of the CAD model, structural globe support combined with a thin implant, the possibility of repairing large orbital floor defects, corrections using scissor/scalpel during surgery are relatively uncomplicated, low level of morbidity, smooth edges and gradual, controlled variations in implant thickness between different regions. Disadvantages: changes to the curvature of the implant cannot be made during surgery, implant may require fixing with screws to be stabilized during the early phase of healing, long time required to design and manufacture implants (pre-op) and also UHMW-PE implants are radiolucent and cannot be imaged using X-rays.ConclusionUHMW-PE appears to have numerous advantages as a material for precise reconstruction of the orbits. Such patient-specific implants are durable, can even be used to reconstruct very thin walls, do not exhibit the high degree of morbidity typical for autogenous bone grafts and result in restoration of vision function.     

Indirekte Immunfluoreszenzreaktion in der Serodiagnostik der Candidosis

Mit Hilfe der indirekten Immunfluoreszenzreaktion (IFR) sind Seren von 120 gesunden Personen und 21 Candidosis-Kranken untersucht worden. In der Kontrollgruppe ist die positive IFR (Titer 450) nur bei 3 Personen (2,5 % der Untersuchten), die zweifelhafte Reaktion (Titer 150) bei 18 (15%) festgestellt worden. Bei alien übrigen Untersuchten (82,5 %) war die Reaktion negativ. In der Krankengruppe war dagegen bei 11 Personen — also bei mehr als der Hälfte der Untersuchten — die IFR positiv (Titer 450 oder 1350), bei weiteren 7 Kranken zweifelhaft (Titer 150) und nur bei 3 Personen negativ. Diese Ergebnisse beweisen, daß die Immunfluoreszenzreaktion eine bedeutende Rolle in der Diagnostik der Candidosis spielen kann. Das betrifft besonders die Candidosis der inneren Organe.     

A comparative analysis of K-ras mutation and carcinoembryonic antigen in pancreatic cyst fluid

Background/aimsAnalysis of cystic fluid may be useful in distinguishing between benign and malignant cysts which has significant impact on their management. The aim of our study was to assess the diagnostic utility of carcinoembryonic antigen (CEA) and K-ras gene mutation in pancreatic cysts fluid.MethodsThe study included 56 patients with pancreatic cystic fluid collected for analysis. The cysts were classified as benign (simple cysts, pseudocysts, serous cystadenoma) - 39 patients or premalignant/malignant (mucinous cystadenoma, IPMN, cystadenocarcinoma) - 17 patients. The patients history, CEA fluid concentrations and presence of K-ras mutation were analyzed.ResultsCEA were higher in patients with malignant cysts (mean levels 238 ± 12.5 ng/ml; range 32.8–4985 ng/ml) compared to benign lesions (mean levels 34.5 ± 3.7 ng/ml; range 3.9–693 ng/ml; p < 0.001). K-ras mutation correctly classified 11 of 17 patients with premalignant/malignant lesions. It was also detected in 1 patient with final diagnosis of benign cyst (the sensitivity 64.7% and the specificity 97.4%; p < 0.01). If CEA and molecular analysis were combined in that cysts with either CEA level>45 ng/ml or presence of K-ras mutation, than 16 of 17 premalignant/malignant cysts were correctly identified (94.1%).ConclusionMolecular analysis of pancreatic cyst fluid adds diagnostic value to the preoperative diagnosis and should be considered when cyst cytologic examination is negative for malignancy.