Validation of a New Instrument for Measurement of Flexible Contact Lenses

ABSTRACT: A newly developed instrument for the measurement of flexible contact lens parameters incorporating an autostigmatic microscope and optimised light collection techniques, is evaluated. The instrument measures back and front central optic radii and centre thickness of the contact lens, and these measurements can be used to determine back vertex powers. The instrument is shown to provide reliable and repeatable measures of lens parameters.     

Langzeitergebnisse nach endonasaler Stirnhöhlenchirurgie

Zusammenfassung Die endonasale Stirnh?hlendrainage etabliert sich zunehmend in der chirurgischen Therapie entzündlicher Nasennebenh?hlenerkrankungen. Eine Standortbestimmung ist erst nach Jahren m?glich und verlangt endoskopische und computertomographische (CT)-Untersuchungen. In dieser retrospektiven Studie werden Langzeitergebnisse nach breiter Er?ffnung der Stirnh?hle (Typ-II- und Typ-III-Drainage nach Draf) mittels endoskopischer und CT-Untersuchung pr?sentiert. 12–98 Monate nach Typ-II-Drainage waren von 83 per Endoskopie oder CT beurteilbaren Stirnh?hlen 58% belüftet und reizlos, 12% belüftet mit verdickter Schleimhaut und 14% narbig stenosiert mit Totalverschattung im CT. Weitere 16% waren aufgrund eines ausgepr?gteren Polyposisrezidivs total verschattet; 12–89 Monate nach Typ-III-Drainage waren von 81 Stirnh?hlen 59% belüftet und reizlos, 17% belüftet mit verdickter Schleimhaut, 7% narbig stenosiert. In 16% bestand ein ausgepr?gtes Polyposisrezidiv. Subjektiv gaben die Patienten in 79% nach Typ-II- und in 95% nach Typ-III-Drainage eine Beschwerdefreiheit oder deutliche Besserung an. Aus den eigenen Ergebnissen und Mitteilungen der Literatur in Verbindung mit der Physiologie der Wundheilung wurde ein Schema der Differentialindikation zur endonasalen Stirnh?hlendrainage erstellt. Eingegangen am 14. Februar 1996 Angenommen am 7. Juni 1996     

Selective insufflation of collapsed lung with fiberoptic bronchoscope and Swan-Ganz catheter

With its potential to initiate more serious pulmonary complications, atelectasis requires prompt, effective therapy. We present three cases of patients who, when conventional measures failed, were treated with a technique we devised using a flexible fiberoptic bronchoscope and Swan-Ganz catheter to selectively insufflate the collapsed area. The technique effectively re-expanded the patients' lung.     

输尿管镜致医源性输尿管损伤19例分析

目的：探讨输尿管镜在临床操作中所导致的医源性输尿管损伤的原因和预防方法。方法：总结分析2001年1月-2005年7月我院开展输尿管镜治疗310例患者中所导致的医源性输尿管损伤19例的临床资料。结果：本组19例中，输尿管开口穿孔3例，输尿管开口撕裂4例，输尿管穿孔4例，输尿管开口黏膜脱套2例，输尿管黏膜下隧道5例，输尿管取石钳臂断裂1例。除1例输尿管取石钳臂断裂因断臂嵌入输尿管壁内无法取出改开放性手术外，其余18例均经捅入双J管治疗后治愈。结论：进行输尿管镜操作过程中保持视野的清晰，操作要轻柔，避免动作的粗暴，熟悉输尿管解剖及走向，正确进镜碎石是手术成功的关键，术后留置支架管能减少输尿管狭窄的并发症发生。     

Endoscopically-assisted laparoscopic partial gastric resection for treatment of a large benign gastric adenoma

Gastric adenomas are benign tumors that are treated by fiberendoscopic removal, but large tumors need a surgical approach for resection. Laparoscopic approach fails to localize the exact placement of the lesion due to lack of sensitivity and fiberoptic control is advisable. We present a case of a large gastric adenoma that was resected by laparoscopy assisted with flexible gastric peroperative endoscopy because the lesion could not be palpated. A lateral gastric resection including the adenoma and wide margins was performed with an endostapler under fiberoptic control. Minimally invasive ancillary techniques enhance the efficacy of laparoscopic surgical procedures, especially in situations in which the lack of tactile feeling limits this approach.     

Optimal time joint-trajectory planning for an industrial manipulator using linear interpolation

The path of an industrial manipulator in a crowded workspace generally consists of a set of Cartesian straight-line segments connecting a set of two adjacent points. To achieve the Cartesian straight-line path (segment) is, however, a non-trivial task, and an alternative approach is to place enough intermediate points along a desired path and linearly interpolate between these points in the joint space. A method is developed that determines the subtravelling and transition times such that the total travelling time for this path is minimized subject to the maximum joint velocity and acceleration constraints. These results are simulated on a digital computer using a six-joint revolute manipulator to show their applications.     

气管支气管镜检查术在儿童气道异物诊治中的价值

气道异物吸入是导致3岁以下儿童急性死亡的重要原因之一.异物吸入种类多样,嵌顿在气道不同部位引起临床表现轻重不一,极易引起误诊误治.气管支气管镜检查术既是气道异物的确诊手段,同时又能够取出异物,及时治疗.临床上无论是明确或是疑似异物吸入,均需行气管支气管镜检查以帮助诊治.     

Comparison of different methods of internal fixation of symphyseal disruptions under multidirectional dynamic conditions: an experimental analysis simulating gait conditions

Summary For the stabilization of the ruptured pubic symphysis, rigid forms of fixation such as plate osteosynthesis and flexible fixations such as wire loops or PDS banding have been recommended. All methods have only been tested by static unidirectional loading until failure of the system. By this experimental arrangement Ecke and Hofmann found comparable results for flexible and rigid methods of internal stabilization of the pubic symphysis. They preferred flexible methods to maintain mobility of the symphysis and to prevent symphyseal fusion. We tested dynamic compression plate osteosynthesis, reconstruction plate osteosynthesis, wire loops and PDS banding for internal fixation of injured pubic symphysis in a dynamic multidirectional experimental arrangement simulating gait conditions. The specimens were loaded with 85 N in vertical (y -) direction and 34 N in sagittal (z -) direction, which represent 50 % of the forces acting at the pubic symphysis during walking and with a frequency of 1.5 Hz over 55 500 loads simulating the conditions over a 6-week mobilization period. Loading with 100 % of the acting forces (corresponding to full weight bearing mobilization) led to early failure of the system. Our experimental analysis showed that neither wire loops nor PDS banding is able to stabilize the ruptured pubic symphysis, even immediately after fixation before loading. During the tests instability increased until failure of the system due to cutting of the bone or breaking of the wires or PDS banding. Success of plate osteosynthesis was dependent on the initial stability of the fixation. Overwinding of the screws, as in osteoporotic bone, lead to increasing loosening during repeated loading, whereas primary stable fixation of the screws was almost completely maintained during the test. In consequence, neither wire loops nor PDS banding should be used for stabilization of injured pubic symphysis if early mobilization with partial weight bearing is desired. Plate osteosynthesis (DC or reconstruction plate) tolerates early half weight bearing in patients with „open-book“ injury only if safe screw fixation is guaranteed.      

Office based trans nasal esophagoscopy, and its role

Trans Nasal Esophagoscopy (TME) - a new concept to visualize the esophagus in office practice has obviated the conventional rigid esophagoscope, which is a cumbersome, time consuming procedure and sometimes associated with complications like perforation. Many surgeons in the West using flexible endoscope after air insufflation have tried this procedure. We fabricated a new gadget far the purpose of air insufflation in collaboration with the department of biomedical engineering, Apollo hospitals, Chennai which substitute oxygen insufflation through central supply or through the flow meter connected to an O₂ cylinder. In this article we have discussed various uses of the procedure in diagnosis A therapeutic application in an E.N.T office practice and also the unique technique of air insufflation with the new gadget.     

Technik der laparoskopischen Ultraschalluntersuchung bei der diagnostischen Laparoskopie

Zusammenfassung Die laparoskopische Ultraschalluntersuchung (LUS) vergrößert den Informationsgewinn bei der diagnostischen Laparoskopie (DL) durch die Beurteilung der dritten Dimension, da des Organinnere und der Retroperitonealraum sichtbar gemacht werden. Die dazu notwendigen technischen Voraussetzungen sind mit der Einführung flexibler Ultraschallsonden, Bildmixingsystemen und dem Dopplermodus gegeben. Beim Magenkarzinom kann die LUS wertvolle Aufschlüsse fiber die retrogastrale Ausbreitung, die Vergrößerung von Lymphknoten im Bereich der kleinen Kurvatur oder Infiltrationen des Diaphragmas geben. Ebenso werden Lebermetastasen darstellbar, die für die klassischen bildgebenden Verfahren zu klein sind. In einer eigenen Untersuchungsserie wurde allein durch die sonographische Diagnostik eine Änderung des präoperativen Befundes in 8% der Fälle erzielt. Auch die bisher unbefriedigende preoperative Abklärung des frühen Pankreaskarzinoms könnte durch die Verwendung der LUS verbessert werden. Der Tumor kann exakt lokalisiert und die Invasion von Blutgefäßen oder eine lokale oder regionale Lymphknotenmetastasierung mittels LUS können beurteilt werden. Beim Speiseröhrenkarzinom bzw. Kardiakarzinom kann die LUS zum Ausschluß kleiner Lebermetastasen, einer Zwerchfellinfiltration oder eines abdominellen Lymphknotenbefalls hilfreich sein. Bei Leberprozessen ermöglicht die LUS eine gezielte Dignitätsabklärung durch Punktion. Unter zusdtzlicher Beurteilung des extrahepatischen Lymphknotenstatus ersetzt die LUS eine ansonsten erforderliche diagnostische Laparotomie vor Lebertransplantation. Die heutigen Erfahrungen bestätigen bereits die Rolle der LUS als wertvolle Erweiterung der diagnostischen Laparoskopie, die nicht nur den Informationsgewinn durch DL erweitert, sondern auch zusätzliche Informationen im Vergleich zu konventionellen bildgebenden Verfahren erbringt.

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Technique of laparoscopic ultrasound examination in diagnostic laparoscopy

In gastric cancer, retrogastric invasion or enlarged lymph nodes in the hilus of the spleen or at the celiac trunk can readily visualized with laparoscopic ultrasound examination (LUS). Invasion or metastases of the liver can be identified which are invisible with the classic imaging methods. In our series this led to revision of the TNM staging in 8% of 111 patients with advanced gastric carcinoma. In the staging of early pancreas cancer the standard methods of investigation, including ERCP, are unsatisfactory. Tumor localization, invasion of blood vessels and local or distal lymph node metastases cannot always be evaluated reliably. LUS promises to provide this valuable information. In carcinoma of the distal esophagus or the cardia, LUS can help to exclude small liver metastases, assess invasion of the diaphragm and evaluate the extent of enlarged intraabdominal lymph nodes, especially those at the celiac trunk. A frequent challenge/task for LUS is the exact determination of the benign or malignant nature of liver foci. Quite commonly they are inaccessible to percutaneous CT-guided puncture, but can be easily reached and biopsied under direct vision or LUS-guidance. By virtue of LUS and its information about extrahepatic lymph node infliction, diagnostic laparoscopy is now a less invasive but equally valid substitute for diagnostic laparotomy prior to liver transplantation in oncological diseases. LUS is now well established in diagnostic laparoscopy as a reliable tool for the preoperative staging of distal esophageal and abdominal tumors. It provides additional information which cannot be obtained with conventional imaging procedures.