Evisceration with autogenous scleral graft and bioceramic implantation within the modified scleral shell: 133 cases over 17 years

Introduction: To present long-term follow-up data on evisceration performed with autogenous scleral grafting and ceramic implantation in a modified scleral shell.

Methods: This was a retrospective analysis of all consecutive eviscerations performed in the Department of Ophthalmology, Montpellier University Hospital, France, between February 1998 and October 2015. For all patients, the technique used was a conventional anterior evisceration after total keratectomy, disinsertion of the medial rectus muscle, sectioning of the optic nerve and excision of sclera centered on the papilla. The scleral graft was then sutured just behind the sutured keratectomy, and the bioceramic implant was inserted by posterior way in the scleral shell. Demographic characteristics, implant size and type, cosmetic results from pictures of all patients and complications were recorded. This study was performed with Ethics Review Committee Approval, and in compliance with the Declaration of Helsinki.

Results: In total, 133 patients (36.6% women) were identified during the study period. The mean (SD) implant size was 17.32 (1.84) mm. The median follow-up after evisceration was 57.43 (24.7, 68.3) months. Two cases of implant exposure (1.5%) were recorded. For 24 patients (17.9%), additional surgeries were performed for ptosis (2.2%), conjunctival cyst (1.5%), or post-evisceration socket syndrome (6.7%). Cosmetics results were excellent for 50.1% of cases, good for 33.3% and fair for 16.6%; using a grading scale based on the superior sulcus deformity.

Conclusion: Evisceration with autogenous scleral grafting and ceramic implantation can result in a high volume of restoration, good cosmetic results, and low risk of exposure of the implant.     

Isolation of sixteen microsatellite loci for Rhoadsia altipinna (Characiformes: Characidae) from an impacted river basin in western Ecuador

Sixteen polymorphic, dinucleotide microsatellite loci were developed for Rhoadsia altipinna, a small characid fish from impacted rivers in south western Ecuador. None of the loci were in linkage disequilibrium or deviated significantly from Hardy–Weinberg equilibrium after sequential Bonferroni correction. Variability was relatively high with allelic richness ranging between 2 and 22 alleles per locus (average = 9.125), observed heterozygosity ranging between 0.125 and 0.958 (average = 0.695), and expected heterozygosity ranging between 0.120 and 0.952 (average = 0.736).     

Supplement Timing of Cranberry Extract Plays a Key Role in Promoting Caenorhabditis elegans Healthspan

Consumption of nutraceuticals is a major and potent dietary intervention for delaying aging. As the timing of administration is critical for the efficacy of bioactive compounds in medicine, the effectiveness of nutraceuticals may also be dramatically affected by the timing of supplementation. Cranberry exact (CBE), rich in polyphenols, is consumed as a nutraceutical, and possesses anti-aging properties. Here, we examined the influence of timing on the beneficial effects of CBE supplementation in C. elegans. The prolongevity effect of CBE in different aged worms, young adults, middle-age adults, and aged adults, was determined. Early-start intervention with CBE prolonged the remaining lifespan of worms of different ages more robustly than late-start intervention. The effectiveness of CBE on stress responses and physiological behaviors in different aged worms was also investigated. The early-start intervention prominently promoted motility and resistance to heat shocks and V. cholera infection, especially in aged worms. Together, these findings suggest that the timing of CBE supplementation critically influences its beneficial effects on C. elegans lifespan and healthspan. It is of interest to further investigate whether the similar results would occur in humans.     

Nitric oxide signaling in the brain: A new target for inhaled nitric oxide?

Nitric oxide (NO) is a powerful vasodilator, involved in both physiological functions and pathophysiological alterations of various regulatory processes, for example, the maintenance of vascular tone and inflammation. The recently demonstrated impact of exogenous NO on the central nervous system extends its role under normal and pathological conditions. At times neuroprotective, at times neurotoxic, NO is capable of different effects depending upon the extent of cerebral damage, the cellular redox state, and the spatiotemporal coordinates and concentration at which it is synthesized. This review provides new insights into the short‐ and long‐term effects of endogenous and exogenous NO in brain injury. ANN NEUROL 2013;73:442–448     

Brachial vessel injuries: high morbidity and low mortality injuries

Introduction  

Reports of arterial injuries from both the civilian and military arenas report the brachial artery as the most frequently injured vessel, accounting for approximately 25–33% of all peripheral arterial injuries. The brachial artery is surrounded by important peripheral nerves —the median, ulnar and radial, and also parallels the humerus and associated veins. Due to its close proximity to these structures, associated nerve and osseous injuries are frequent with residual neuropathy from such nerve injuries, often the main sources of permanent disability.     

A case series of symptomatic intraluminal duodenal duplication cysts: presentation, endoscopic therapy, and long-term outcome (with video)

BACKGROUND: Duodenal duplication cysts are rare congenital anomalies. Symptomatic cases have classically been treated by surgical resection, which can be complex because of the close proximity of the cysts to the papilla. OBJECTIVE: To describe a series of 8 patients with symptomatic duodenal duplication cysts who were treated endoscopically, with a special focus on the long-term outcome. DESIGN: Retrospective case series. SETTING: Three tertiary-care European academic hospitals. PATIENTS: Eight patients, age 8 to 72 years, were treated endoscopically for symptomatic intraluminal duodenal duplication cysts between 1981 and 2006. Seven patients presented with acute pancreatitis, and one patient presented with jaundice. INTERVENTION: Endoscopic incision and marsupialization of the cysts was performed by using a variety of endoscopic tools (needle-knife and regular sphincterotomes, cystotomes, and polypectomy snares). MAIN OUTCOME MEASUREMENTS: Technical success of endoscopic intervention and long-term clinical recurrence of symptoms. RESULTS: No major complications occurred. All patients remained asymptomatic at a median follow-up of 7.3 years. LIMITATIONS: Retrospective study; the small number of patients. CONCLUSIONS: The endoscopic treatment of symptomatic intraluminal duodenal duplication cysts is a safe and effective technique, with excellent long-term results. It represents a minimally invasive alternative to surgical resection and might be considered the preferred therapeutic modality for these cases.