Aortic injuries during laparoscopic gastric bypass for morbid obesity in Sweden 2009–2010: A nationwide survey

BackgroundIn Sweden, bariatric surgery has increased more than tenfold in the past decade, from 700 to 8,600 procedures annually, and laparoscopic gastric bypass (LRYGB) dominates (92% of all procedures). This expansion makes safety issues crucial. The aim of this nationwide survey was to identify aortic injuries in LRYGB.MethodsAll 41 centers performing LRYGB in Sweden were asked if an aortic injury had occurred during the years 2009–2010. Techniques for entering the first trocar and way of establishing pneumoperitoneum were evaluated. The total number of procedures was collected from the national quality registry, Scandinavian Obesity Surgery Registry (SOReg), and the National Patient Register.ResultsDuring the study period, 11,744 LRYGBs were performed. The analysis revealed 5 aortic injuries, all occurring in patients in whom an optical trocar had been placed before establishing pneumoperitoneum. Outcomes varied from no major sequelae to bilateral lower limb amputation and death. Based on the total number of LRYGBs, the risk for an aortic injury was .043% overall and .091% when an optical trocar was used.ConclusionAortic injury is a rare but serious complication in laparoscopic gastric bypass. In this survey, optical trocars constructed to reduce the risk of intraabdominal damage had been used in all 5 cases.     

A novel technique to measure severity of pediatric pectus excavatum using white light scanning.

Background/purpose

Computed tomography (CT) derived Haller Index (HI) remains the standard for quantifying severity in patient with pectus excavatum (PE). Optical scanning described in literature reports optimistic results and new indices that correlate with HI. This study assessed the feasibility of a handheld White Light Scanner (WLS) to obtain 3D measurements and indices of PE deformity.

光学相干断层扫描技术在激光治疗糖尿病性黄斑水肿的临床应用

目的探讨光学相干断层扫描（optical coherence tomography,OCT）技术在激光治疗糖尿病性黄斑水肿的临床应用。方法糖尿病性黄斑水肿（diabetic macular edema,DME）患者48例96只眼,采用波长532 nm激光格栅状光凝治疗,术前和术后2~3个月应用OCT检查,测量以黄斑中心凹为中心1 mm范围内视网膜厚度和相关视力变化情况。结果激光光凝后2~3个月,视力提高2行者65只眼（占67.7%）。术后3个月,患者黄斑中心凹1 mm内平均视网膜神经上皮层厚度（213.4±48.5）μm与术前比较差异有显著意义（P〈0.05）。经OCT检测发现,激光能量2.1~4.1 m J时,糖尿病性黄斑水肿患者的角膜内皮细胞没有明显损伤。结论 OCT检测可用于激光治疗糖尿病性黄斑水肿的临床疗效评价,值得临床推广应用。     

微孔塑料连续挤出成型研究进展

综述了微孔塑料的性能特点和应用前景，从微孔塑料的单一相溶液的形成、微孔的成核和气泡的长大控制三个方面详细论述了微孔塑料的连续挤出成型的研究进展，并指出了当前的研究方向。     

Structure–function relationship in ocular hypertension and glaucoma: interindividual and interocular analysis by OCT and pattern ERG

BACKGROUND: Pattern electroretinogram (PERG) and optical coherence tomography (OCT) represent objective probes to investigate respectively the function of retinal ganglion cells and their structure as retinal nerve fiber layer (RNFL) thickness. We examined interindividual (II) correlations of PERG amplitude and RNFL thickness, as well as correlations between interocular (IO) differences in both measures, in ocular hypertension (OHT) and early glaucoma (EG) patients. METHODS: Thirty-one OHT, 34 EG (mean deviation: -1 to -6 dB) and 16 age-matched controls were examined in both eyes. Participants had clear optical media, no or moderate refractive errors and no concomitant ocular or systemic diseases. PERGs were elicited by counterphased (16.28 reversals/second) gratings (1.6 cycles/degree spatial frequency). The Fourier isolated 2nd harmonic PERG amplitude and phase were measured. RNFL thickness was quantified by means of OCT Stratus according to a standard protocol. Average, superior and inferior RNFL thicknesses were considered. RESULTS: Mean PERG amplitude was decreased (p < 0.01) in both OHT and EG patients compared to controls. Mean RNFL thicknesses were reduced (p < 0.01) in EG patients compared to both OHT and controls. In OHT patients, PERG amplitude did not correlate significantly with RNFL thickness in both II and IO analysis. In EG patients, PERG amplitude was positively correlated with RNFL thickness in both II (p < 0.005) and IO (p < 0.001) analysis. The slope of the correlation predicted that PERG losses exceeded systematically RNFL losses when the latter were between 0 and -0.25 log units. CONCLUSIONS: Both II and IO analyses revealed a lack of structure-function relationship in OHT, suggesting that, at this disease stage, PERG losses appear to affect primarily retinal/optic nerve head function. In EG they reflect both dysfunction and RNFL loss.     

手术显微镜检验方法的研究

研究了手术显微镜的技术要求及性能检验方法，重点介绍了检验所需的设备、检验方法及检验结果的判定，这种检验方法适用于手术显微镜新品验收和在用设备的性能检测，对于保证手术显微镜的质量具有重要意义。     

Application of Computer Programs in the Management of Diabetic Children

Microcomputers have been used in our hospital for the past five years to summarize data from patients and to remind us to carry out routine tests. Recently, we have shown computer data on the screen to patients; this helps us to explain and discuss the monitoring of their condition with them. Unlike some other systems, general data as well as data on self-monitored blood glucose levels are recorded in our computer system. The data consist of five categories: personal profile, treatment, etiological research, indices of control and data for checking complications. The analysis and evaluation of our system are done by the modes of display, statistical calculations, early detection of complications and graphics. The system is compatible with input from a keyboard, optical character readers and interface to a glucose meter with a memory.     

Age-dependent emergence of oscillatory signal flow between the primary and secondary visual cortices in rat brain slices

Developmental changes in dynamics of signal propagation between the primary (Oc1) and secondary visual cortex (Oc2) were investigated by using optical recording methods with voltage-sensitive dyes. Propagating oscillatory optical responses were evoked by our previously reported procedure, and were recorded on stimulation to white matter of Oc1 in rat visual cortex slices. In immature slices, evoked signals spread out from the stimulation site by way of deep layers, but were restricted largely to Oc1. In mature slices, however, evoked signals spread upward from the stimulation site at first, and then spread out along layer II/III, finally to penetrate Oc2. More remarkably, after this initial signal was attenuated, oscillatory responses emerged and spread back from Oc2 to Oc1 by way of layer II/III, suggesting that the origin of backpropagating oscillation is located in Oc2. The initial forward component was dependent on both N-methyl-D-aspartate (NMDA) and non-NMDA receptors, and the subsequent backward components were dependent only on NMDA receptors. These results suggest that the extent of corticocoritcal signal propagation within the visual cortex grows wider horizontally during maturation, so that information interchange may become easier between the Oc1 and Oc2.     

白内障超声乳化术后黄斑部视网膜地形图的变化

目的观察手术顺利的白内障超声乳化术后黄斑部的变化。方法应用光学相干断层扫描仪视网膜地形图模式分析50眼白内障超声乳化吸出术后2周、4周、6周、8周、3个月的黄斑部变化及60只正常眼的黄斑部。结果术前黄斑部地形图呈现中心薄四周厚的山谷样外观。术后中心变厚，趋向穹隆样外观，尤以术后4～6周明显，术后8周起中心区渐回归原态，恢复山谷样外观。术后各期黄斑中心注视点厚度均与视力呈负相关(r=-0．6～-0．8)。结论白内障超声乳化吸出术后黄斑部呈现厚度增加的趋势，少数人会出现黄斑囊样水肿，但绝大多数人可自愈，预后良好。视网膜地形图更直观准确地反映了白内障术后黄斑部的变化，为临床诊断及治疗提供了重要依据。