Evaluation of a prototype Minified Augmented-View device for patients with impaired night vision.

An evaluation was carried out of the first prototype (LV-3) of a new night vision device, which incorporates visual field expansion through minification (Minified Augmented-View), to provide feedback for continuing development. Six subjects with night blindness completed visual function measurements and indoor mobility assessments without a device, with the LV-3 and with a commercially available comparison device (the Multi-Vision) at light levels representative of well lit and poorly lit streets. Device performance and potential benefits in real-world situations were evaluated at four outdoor locations (well lit to very dark). Results indicate that the see-through nature and spectacle-frame mounting of the LV-3 address some of the cosmetic and ergonomic disadvantages of currently available devices; however insufficient light sensitivity of the prototype camera limited LV-3 performance. With improved camera sensitivity and full implementation of the Minified-Contours Augmented-View concept in the next prototype, patients might be able to make better use of the novel field expansion and vision multiplexing features to aid outdoor night mobility.     

应用多处头皮扩张器修复瘢痕性秃发

目的:探讨头部多处皮肤扩张器修复瘢痕性秃发有效的方法.方法:采用多个皮肤扩张器进行头皮扩张,利用扩张皮瓣修复瘢痕性脱发.结果:修复瘢痕性秃发2 3例,扩张皮瓣全部成活,头皮瓣毛发分布均匀,随访半年至2年,效果满意.结论:该手术方法并发症发生率低,皮瓣张力小,毛发分布均匀,应为同类病例治疗的首选方法,值得推广.     

Tissue expanders; review of indications,results and outcome during 15 years’ experience

BackgroundTissue expanders (TE) are frequently used worldwide.In this study we surveyed outcome of our patients retrospectively during 15 years.Materials and MethodsWe had 1105 patients for whom 3059 TEs have been used. Demographic data, age, sex, indications, type of tissue expander devices, volume of devices, site of scar and site TE insertion, our technique for tissue expander insertion and flap design, complications and outcome were gathered. A complete and through technical points and tips will be discussed.ResultsIn 91% of patients overexpansion was done. (Expansion ratio = 2.1–4.5). Re-expansion has been done in about 12% of patients. Complications were perforation of skin of pocket (11%) or exposure, infection (6%), dehiscence of the wound (1.5%), perforation of the port or disconnection of the tubes (2.1%), expansion of the scar itself (1%), saggy flap (3%), dog ear (5%), lack of adhesions of flap to its new site (4%).OutcomeIn 93% of the patients we could totally remove the scar. Around 9.1% of our patients had two sessions of expansion in the same area and 2.9% had three sessions of expansion. 51% of our patients were highly satisfied and 42% were satisfied of the results of expansion.ConclusionOur patients were satisfied with the results. In 12% cases we have done re-expansion. Re-expansion is possible as long as you have enough thickness of dermis in the skin. More than 50% of our patients were optimistic for 2nd or 3rd session of re-expansion.     

上颌骨性扩弓器对成年女性眼眶容积的评价

评价上颌骨性扩弓器（MSE）治疗成年女性上颌骨宽度不足（MTD）对眼眶容积及眶周骨骼间宽度的影响。     

皮肤软组织扩张器水囊内液体污染状况与皮瓣质量相关性研究

通过对33个水囊内液体进行细菌培养和对33个皮瓣进行临床血循环观察对比，发现皮肤软组织扩张器水囊内液体污染状况与皮瓣血循环有显相关性。提示用水囊时要严格灭菌，每次注水要无菌操作，同时提出了甲硝唑注射液可作为一种新的、可行性水囊内介质。     

Utility of tissue expansion in pediatric phallic reconstruction: a 10-year experience

ObjectiveBoys with complex penile anomalies often undergo multiple operations, leaving a paucity of unscarred skin for further reconstructive procedures. Our objective was to evaluate the ability of tissue expansion to provide local skin for successful phallic reconstruction.Materials and methodsEighty boys (mean age of 11.9 years) with hypospadias (n = 42) or epispadias (n = 38) formed the study cohort. All patients had undergone at least one failed reconstructive operation. Indications for tissue expansion included scarcity of penile skin with urethral stenosis, urethrocutaneous fistula, chordee, and/or residual defect. One or two expanders were placed under the skin of the penile shaft and removed at the time of reconstruction.ResultsAverage time between expander placement and reconstruction was 10.9 weeks. Mean follow-up time was 25.3 months. Complications during expansion occurred in 33 patients (41.3%). Twenty-two patients (27.5%) had at least one expander removed prematurely and 46.9% were replaced. Expansion yielded adequate tissue for reconstruction in 76 patients (95.0%). Successful outcomes were achieved in 39 patients after initial reconstruction and 25 patients after further intervention, yielding an overall success rate of 80.0%.ConclusionTissue expansion is a useful tool with an acceptable rate of complications for phallic reconstruction in patients who have failed prior surgical reconstruction.     

以ADSCs附着ADM植入促进扩张皮瓣真皮修复的实验研究

目的观察脂肪干细胞对扩张皮瓣的影响。方法将雌性SD大鼠制备成扩张器模型,皮肤下方与扩张器之间放置着附着大鼠脂肪干细胞(ADSCs)的脱细胞真皮基质(ADM)。培养3周后获取扩张皮瓣,免疫组化分析组织形态变化,使用western blot分析作用部位皮瓣内ColⅠ、ColⅢ和fibronectin蛋白表达情况,使用QPCR检测作用部位皮瓣内转化生长因子β1(TGF-β1)的表达量。结果三周后组织切片提示ADSCs促进扩张皮瓣真皮内TGF-β1表达升高;术后第一周及第二周,在ADSCs的作用下,扩张皮瓣中ColⅠ和fibronectin蛋白表达明显上升,第三周有一个明显衰减,而ColⅢ表达量平稳,无明显变化趋势;QPCR提示术后第一周TGF-β1高表达,之后其表达量随时间衰减。结论 ADSCs诱导皮肤组织中的TGF-β1增加,进而促进真皮层下层成纤维细胞分泌更多的胶原结构与蛋白,促进扩张皮瓣真皮层修复。     

Comparison of outcome in patients with cirrhosis and ascites following treatment with albumin or a synthetic colloid: a randomised controlled pilot trail.

BACKGROUND: The question of which colloid (albumin or synthetic colloids) used for plasma expansion following paracentesis or other complications requiring fluid loading in patients with cirrhosis remains controversial. AIMS: To compare outcome and hospital-related cost in patients with cirrhosis treated with 20% human albumin with those treated with a synthetic colloid (3.5% polygeline). METHODS: The primary end point was occurrence of a first liver-related complication. RESULTS: When the trial was prematurely discontinued because of safety concerns about bovine-derived products, 30 patients were assigned to receive albumin and 38 were assigned to receive a synthetic colloid. Sixty-three patients were included for ascites removal by paracentesis and five patients for ascites removal by paracentesis and renal impairment. The median time to first liver-related complication was not significantly longer in the albumin group (20 vs. 7 days). However, the total number of liver-related complications adjusted to a 100-day period was significantly lower in the albumin group. The median hospital cost for a 30-day period was significantly lower in the albumin group (1915 euros vs. 4612 euros). CONCLUSIONS: In patients with cirrhosis and ascites, human albumin appears to be more effective in preventing liver-related complications than synthetic colloid. This may be associated with decreased hospital costs.     

Class III malocclusion and bilateral cross-bite in an adult patient treated with miniscrew-assisted rapid palatal expander and aligners

This case report describes the use of a miniscrew-assisted rapid palatal expander and aligners to correct bilateral cross-bite and crowding in an adult patient with a Class III skeletal pattern. A digitally designed surgical guide was three-dimensionally printed and used to accurately insert four miniscrews into the palate; these were employed to anchor a novel miniscrew-assisted rapid palatal expander appliance without any dental anchorage. Cone-beam computed tomograms before and after miniscrew-assisted rapid palatal expander treatment demonstrated the orthopedic expansion of the maxilla without dental tipping. The patient was then fitted with aligners to correct crowding and malocclusion. This case report demonstrates the successful treatment of an adult patient with a narrow maxilla and bilateral cross-bite using a nonsurgical, conservative treatment.     

皮肤软组织扩张器置入术感染的病例对照研究

目的分析影响患者皮肤扩张器置入术后感染的危险因素,为制订干预措施提供科学依据。方法采用自行设计的调查问卷,通过查阅病历结合电话询问获取相关资料,采用病例对照研究方法进行统计分析。结果共调查532例扩张器置入患者,其中发生术后感染22例,感染率为4.14%,病例组共纳入14例感染患者。单因素条件logistic回归分析结果显示,扩张器置入个数(OR=1.58,95%CI:1.20~2.32)、埋置部位(OR=1.75,95%CI:1.30~2.32)、患者居住环境(OR=1.87,95%CI:1.84~2.65)、是否常规消毒(OR=2.66,95%CI:1.76~4.32)差异均有统计学意义(均P0.05)。多因素条件logistic回归分析结果显示患者居住环境(OR=1.55,95%CI:1.15~2.25)、是否常规消毒(OR=3.66,95%CI:2.86~3.22)是进入回归方程的2个主要因素,均P0.01。结论患者居住环境以及是否常规消毒是影响患者皮肤软组织扩张器置入术后感染的主要危险因素,临床上应重点加强对围手术期患者及主要照顾者预防感染知识教育,建立患者出院后延续护理体系。