Diplopia secondary to endoscopic sinus surgery

OBJECTIVE: Diplopia after endoscopic sinus surgery (ESS) is rare but very serious. In this study, we investigated the characteristics, prognosis and treatment of diplopia occurring after ESS. MATERIAL AND METHODS: A retrospective analysis was carried out to investigate three patients with diplopia after ESS referred to us from other hospitals. RESULTS: In one case, an improvement in ocular motility was seen after surgical treatment. In the other cases, no improvement was observed, despite surgical treatment. CONCLUSION: In order to prevent diplopia after ESS, the surgeon must possess a complete anatomical knowledge obtained by means of cadaveric dissection, the ability to carefully read preoperative CT scans and the necessary surgical experience.     

Necrotic cell death of ovarian adenocarcinoma caused by seminal plasma

Objective. From the knowledge of risk factors of epithelial ovarian cancer, we deduced a hypothesis that human seminal plasma (HSP) has a preventive role in the development of epithelial ovarian cancer. To examine whether HSP directly influences the growth of ovarian cancer, we have investigated the in vitro and in vivo effect of HSP on ovarian adenocarcinoma cell lines (SK-OV-3 and OVCAR-3) in comparison with its effects on normal ovarian surface epithelial cells (NOSE).Methods. Cell viability was determined by MTT assay. Cytotoxic effect was evaluated by flow cytometry analysis, by DNA laddering, and by morphological analysis. In vivo therapeutic effect of HSP was evaluated by the subcutaneous inoculation of SK-OV-3 cells in nude mice (BALB-c) model.Results. HSP at a final concentration of 1:50 induced a time- and dose-dependent inhibition of SK-OV-3 and OVCAR-3 growth, whereas NOSE was not affected. Flow cytometric analysis, DNA laddering, and morphological analysis indicated that HSP induced necrosis, rather than apoptosis, of both ovarian carcinoma cell lines. In in vivo experiment that used the nude mice (Balb-C) with tumor inoculation of SK-OV-3 cells, HSP induced necrosis of tumor with no detectable toxic effects on the major organs.Conclusion. These results show that HSP inhibits the growth and induces the necrosis of epithelial ovarian cancer cells and suggests that one or more components of HSP may provide a scientific basis for preventing epithelial ovarian cancer.     

Lymphangioma of the esophagus: surgical treatment

Lymphangioma of the esophagus is a very rare submucosal tumor, but it can usually be removed without complication by endoscopic resection because of its small size and benign nature. My colleagues and I report a case of an uncommonly large lymphangioma (5.1 x 2.3 x 1.7 cm) in the distal esophagus treated by distal esophagectomy and esophagogastrostomy for complete resection without narrowing the esophagus. The patient's immediate postoperative course was uneventful, and he remains well 6 months after the operation.     

The potential of gene therapy for the treatment of disc degeneration

Research in biologic methods of treating disc degeneration is still in its infancy. Many different strategies are being evaluated, but the gene therapy strategy stands out because of its potential for long-term efficacy. Choosing the correct gene for use in gene therapy is critically important. Of the many different classes of potentially therapeutic genes, the regulatory genes hold the most promise. Of the different gene therapy delivery methods, the most work has been performed with viral vectors, either ex vivo or in vivo. Current research now is turning toward in vivo experiments in rabbits. Efficacy and safety will be demonstrated first with smaller animal models. Beyond that, nonhuman primate experiments demonstrating efficacy and safety will be the penultimate step before initiation of human studies.     

Position of the superficial femoral artery in closed hip nailing

Introduction Adduction of the ipsilateral hip joint is necessary to facilitate closed hip nailing for trochanteric fracture. Even though positioning the patient supine with the perineal post against the ipsilateral medial thigh can change the course of the neurovascular structure in the proximal thigh, there have been no reports regarding the position of the femoral artery in the hip nailing position.Materials and methods We studied the position of the superficial femoral artery in 59 thighs using color-flow duplex scanning method in three hip nailing positions.Results The mean of the distance between the superficial femoral artery and the femur in 48 normal limbs was 20.28 mm in neutral position (D1), 11.85 mm in 20^o adduction (D2), and 9.53 mm in 20^o adduction plus 20^o internal rotation of the foot plate (D3). The distances D2 and D3 were always shorter than D1 (p<0.001). D3 was less than 10 mm in 30 of the normal limbs (62.5%) and less than 5 mm in 4 (8%). In 11 patients who sustained a trochanteric fracture, the mean of D1, D2, and D3 in the injured limbs was 25.28 mm, 17.98 mm, and 14.38 mm, respectively. The mid-thigh circumference and D3 of the injured limbs were always greater than those of the normal limbs (p<0.001). However, D3 of both sides was less than 10 mm in 3 patients.Conclusion To lessen the vascular injury during hip nailing, we recommend that the limb be placed in neutral position during preparation of the interlocking holes.