Comparative evaluation of povidone-iodine aerosol foam solution and silver sulphadiazine cream as prophylactic topical antibacterial agents for treatment of the burn wound

Nine patients with fresh burns were treated with povidone-iodine aerosol foam solution and matched with 9 patients with fresh burns of similar extent and distribution treated with silver sulphadiazine cream. Severe pain at the time of application of povidoneiodine was a constant complaint. The wounds of 7 patients treated with povidone-iodine had been colonized by bacteria by day 11 post burn, whereas the wounds of only 2 patients treated with silver sulpha-diazine had been colonized at the corresponding time. Gram-negative organisms appeared more frequently, earlier and in higher concentrations in the povidoneiodine treated patients (Pseudomonas aeruginosa, 4 patients), whereas Staphylococcus aureus was more frequent with silver sulphadiazine (4 patients). Five of the povidone-iodine treated patients had developed burn wound sepsis by day 11 post burn, whereas no silver sulphadiazine treated patient developed burn wound sepsis. For this reason, further evaluation of povidone-iodine foam as a prophylactic topical antibacterial for burns was abandoned.     

Phenoxybenzamine blockade in surgery of pheochromocytoma

A combination of oral and intravenous phenoxybenzamine block has been used at the University of Manitoba since 1958 in all elective operations on sympathetic amine-secreting tumors. A review of the last decade's (1965 to 1974, inclusive) experience reveals operations on 10 such patients. A preoperative diagnosis was made in eight cases, and the use of phenoxybenzamine in these eight cases is reviewed.Major fluctuations in hemodynamics during operative manipulation of tumor or following tumor removal were not observed in individuals receiving phenoxybenzamine in a dose of 1–3 mg/kg given 12 to 18 hr before operation. In those patients with high levels of catecholamine secretion, plasma volume expansion was sometimes required to sustain stable blood pressure during induction of the adrenergic blockade. However, no increased intraoperative requirements for transfusion occurred and no significant arrhythmias were detected on continuous monitoring.     

Supraclavicular thoracotomy for diagnosis of apical lung and superior mediastinal lesions.

Despite the use of mediastinoscopy, anterior mediastinotomy, transcarinal biopsy, needle biopsy, and transbronchial fluoroscopic brushing, thoracotomy is necessary to obtain tissue for diagnosis in patients suspected of having carcinoma of the lung. A technique we have employed is exploratory thoracotomy, as described for the approach to cervical and upper dorsal sympathetic ganglion, with entrance into the pleural space through a supraclavicular incision. Five patients, 3 with marginal pulmonary function and 2 with brachial plexus and upper mediastinal or vertebral involvement, had tissue diagnosis of lung carcinoma by this method without postoperative complication. Supraclavicular thoracotomy offers a safe, easy, and definitive method of tissue diagnosis of apical lung and superior mediastinal lesions.     

Effect of proximal selective vagotomy on the canine lower esophageal sphincter

The effect of proximal selective vagotomy on the lower esophageal sphincter was studied in 13 dogs by manometry and cinefluorography. The studies, done under resting conditions and during abdominal compression, were repeated 8 weeks after proximal selective vagotomy in seven animals and after truncal vagotomy in six animals. Proximal selective vagotomy had no significant effect on the pressures in the lower esophageal sphincter; the resting pressures were 32.1 ± 4.1 cm H₂O before and 28.9 ± 3.7 after operation, and the pressures on abdominal compression were 50.6 ± 6.5 and 41.6 ± 3.8 cm H₂O, respectively (p > 0.05). Truncal vagotomy decreased the lower esophageal sphincter pressures at rest from 28.2 ± 4.0 to 18.0 ± 2.2 cm H₂O (p = 0.1) and those during abdominal compression from 44.7 ± 5.6 to 15.5 ± 2.6 cm H₂O (p < 0.01). Gastroesophageal reflux was not seen after proximal selective vagotomy but was seen in one animal in the truncal vagotomy group. Since proximal selective vagotomy does not decrease lower esophageal sphincter function, it offers an advantage over truncal vagotomy in the treatment of duodenal ulcer. The data also indicate that vagal afferents from the proximal stomach are not important in reflex control of lower esophageal sphincter activity.     

Assessment of precision of astigmatism measurements taken by a swept-source optical coherence tomography biometer - IOLMaster 700

Purpose:To assess the repeatability of ocular measurements, particularly astigmatism, taken using the latest version of an swept-source optical coherence tomography (SS-OCT) device, IOLMaster 700.Methods:This prospective observational study done in a private eye care centre. Study included 213 eyes of 152 patients diagnosed with cataract. Axial length (AL), Anterior corneal astigmatism (ΔK), Total corneal astigmatism (ΔTK), Aqueous depth (AD), Lens thickness (LT), Iris barycentre distance (IBD) and White to white distance (WTW) were analysed; three measurements were taken for each patient in the same sitting by the same examiner in an undilated state using the SS-OCT device. Repeatability was analysed using intraclass coefficient (ICC) and coefficient of variation (CV) measures, and astigmatism values were transformed into vector components (J0/J45) and categorised based on magnitude.Results:Astigmatism vector components (J0/J45) showed poor repeatability (ICC < 0.5 and CV > 0), while iris coordinates (IBD) and astigmatism magnitude had good correlation (ICC > 0.9) but more variations between the readings which was least for magnitude ≥ 1.5D; however, rest of the parameters demonstrated excellent repeatability (ICC > 0.9 with P value < 0.05).Conclusion:IOLMaster 700 demonstrated good reliability for the parameters measured, although, for astigmatism and iris barycentre distance, more number of readings and cross reference with other devices may be required to get clinically accurate results.     

Testicular seminoma: Scattered radiation dose to the contralateral testis in the modern era

Purpose

Limited data exist on testicular dose measurements using modern radiation treatment techniques and volumes for testicular seminoma. The aim of this study was to report the testicular dose using in vivo measurements in men with testicular seminoma receiving abdominopelvic radiation therapy (APRT) and a modified dog-leg field with and without gonadal shielding.

A giraffe neck sign of the medial meniscus: A characteristic finding of the medial meniscus posterior root tear on magnetic resonance imaging

Background

The posterior root ligament of the medial meniscus (MM) has a critical role in regulating the MM movement. An accurate diagnosis of the MM posterior root tear (MMPRT) using magnetic resonance imaging (MRI) is important for preventing sequential osteoarthritis following the MMPRT. However, diagnosis of the MMPRT is relatively difficult even after using several characteristic MRI findings. The aim of this study was to identify a useful meniscal body sign of the MMPRT for improving diagnostic MRI reading.

四种人工晶状体屈光度计算公式预测高度近视白内障人工晶状体屈光度的准确性

目的:评估Haigis、SRK/T、Holladay 1和Holladay 2公式预测高度近视白内障患者拟植入人工晶状体屈光度的准确性。方法:前瞻性研究。选取2017-08/2021-11于我院就诊的眼轴长度(AL)≥26 mm的年龄相关性白内障患者168例168眼,根据术前IOL Master 700测得眼轴长度将纳入患者分为5组,其中A组患者37例37眼,26mm≤AL<27 mm; B组患者34例34眼,27 mm≤AL<28 mm; C组患者42例42眼,28 mm≤AL<29 mm; D组患者28例28眼,29 mm≤AL<30 mm; E组患者27例27眼,AL≥30 mm。术后3 mo进行主觉验光,计算各公式预测屈光度的平均算术误差(MNE)和平均绝对误差(MAE)。结果:各组中Haigis与Holladay 2公式的MNE与MAE相对较小,且随着眼轴的增长MNE与MAE并未明显增加,而SRK/T、Holladay 1公式随着眼轴的增长MAE与MNE则明显增大,其中C、D、E组中Holladay 1公式的MNE与MAE增大更为明显。结论:对于眼轴长...