Epikeratoplasty without sutures using collagen IV lens in monkeys: description of the surgical technic

The authors describe their original epikeratoplasty technic without sutures which is compatible with the use of collagen IV lens. They describe the first four observations of primates operated on using this technic. At first the epithelium is removed at the cornea center and a trepanation is made of 4 mm diameter and 0.1 mm depth. The bottom of the trepanation is then cut horizontally, and the periphery of the lens is put in the cornea stroma. Later the epithelium will recover the collagen lens. The lens is perfectly set in the cornea. We don't use any suture and so we avoid astigmatism and neovascularisation. The follow-up consisted of biomicroscopic examination photography, specular microscopy, pachymetry, photokeratoscopy (Nidek System) tonometry and histology. Clinical observance showed a perfect lens tolerance. The cornea is immediately transparent and within a week epithelial cells recovered the lens of three animals out of four. The photokeratoscopy study proved the important cornea refraction modification. This technic is reversible and the lens can be exchanged. A study of histology has begun and already shows a pluristratified epithelium. Further studies will test the biomaterial stability and ultra structural relations between the collagen IV lens and epithelial cells.     

Epidemiologic study of the mortality among the employees of a coal tar distillery

A mortality study was carried out, throughout the period 1970-1984, in a cohort of 963 men who had worked for at least one year in a coal tar distillery. The observed number of deaths, 109, did not significantly differ from the expected number. Using the death rates of the local population as a reference, no excess was observed for lung cancer and for cancers of the larynx, while there was an excess for cancers of the oesophagus but non significant and for cancers of the buccal cavity and pharynx (SMR = 2.17 - p less than 0.05). A nested case-control study was carried out. From within the cohort, 5 deaths from lung cancer and 10 deaths from cancers of the buccal cavity and pharynx were defined as "cases". For each case, all the available dead controls with the same sex, year of birth, tobacco and alcohol consumption were selected from within the cohort. The odds ratios for lung cancer did not reveal any occupational risk. With regard to buccal cavity and pharyngeal cancers, the odds ratios were neither significant for a duration of exposure greater than or equal to 1 year nor for a duration greater than or equal to 5 years along with a latent period greater than or equal to 10 years. Nevertheless there is a significant OR for exposure less than or equal to 10 years (OR = 7.56) but it is near one for exposures greater than 10 years.     

Adverse events and mortality: comparative analysis between diagnostic and interventional endoscopic ultrasound

Abstract

Background and aims

Escalating an indication of EUS for diagnosis and treatment justifies the evaluation of the conditions associated with the adverse events (AE) and related deaths. The aim is to evaluate and compare the incidence of AE and deaths after diagnostic-EUS (D-EUS) and interventional-EUS (I-EUS).     

Variceal ligation plus nadolol compared with ligation for prophylaxis of variceal rebleeding: a multicenter trial

beta-Blockers and endoscopic variceal ligation (EVL) have proven to be valuable methods in the prevention of variceal rebleeding. The aim of this study was to compare the efficacy of EVL combined with nadolol versus EVL alone as secondary prophylaxis for variceal bleeding. Patients admitted for acute variceal bleeding were treated during emergency endoscopy with EVL or sclerotherapy and received somatostatin for 5 days. At that point, patients were randomized to receive EVL plus nadolol or EVL alone. EVL sessions were repeated every 10 to 12 days until the varices were eradicated. Eighty patients with cirrhosis (alcoholic origin in 66%) were included (Child-Turcotte-Pugh A, 15%; B, 56%; C, 29%). The median follow-up period was 16 months (range, 1-24 months). The variceal bleeding recurrence rate was 14% in the EVL plus nadolol group and 38% in the EVL group (P = .006). Mortality was similar in both groups: five patients (11.6%) died in the combined therapy group and four patients (10.8%) died in the EVL group. There were no significant differences in the number of EVL sessions to eradicate varices: 3.2 +/- 1.3 in the combined therapy group versus 3.5 +/- 1.3 in the EVL alone group. The actuarial probability of variceal recurrence at 1 year was lower in the EVL plus nadolol group (54%) than in the EVL group (77%; P = .06). Adverse effects resulting from nadolol were observed in 11% of the patients. In conclusion, nadolol plus EVL reduces the incidence of variceal rebleeding compared with EVL alone. A combined treatment could lower the probability of variceal recurrence after eradication.