Methods of preventing opacification in the posterior lens capsule after extracapsular cataract extraction]

The methods of extracapsular cataract extraction generated some problems connected with postoperative opacification of the posterior capsule. The authors present clinical and experimental methods applied nowadays, intended to prevent these opacifications from forming.     

Effects of lung volume on parasternal pressure-generating capacity in dogs

Previous studies have suggested that the optimum length for force generation of the parasternal intercostal (PS) muscles is well above functional residual capacity (FRC). We further explored this issue by examining the pressure-generating capacity of the PS muscles as a function of lung volume in anaesthetized dogs. Upper thoracic spinal cord stimulation (SCS) was used to electrically activate the PS muscles. Changes in airway pressure and parasternal resting length (LR) during airway occlusion were monitored over a wide range of lung volumes during SCS. To assess the effects of parasternal contraction alone, SCS was performed following phrenicotomy and section of the external intercostal, levator costae and triangularis sterni muscles. With increasing lung volume, there were progressive decrements in the capacity of the PS muscles to produce changes in airway pressure. The relationship between PS pressure generation and lung volume was similar to a previous comparable assessment of the external intercostal muscles. The PS muscles shortened during passive inflation and also shortened further (by > 20 % of LR) during SCS. Total shortening (passive plus active) increased progressively with increasing lung volume. Our results indicate that the capacity of the PS muscles to produce changes in airway pressure (a) falls progressively with increasing lung volume and (b) is similar to that of the external intercostal muscles. We speculate that the fall in PS pressure-generating capacity is related, in part, to progressive reductions in end-inspiratory length.     

Trans-sclerally fixated PC-IOLs: six year of investigations

PURPOSE: To present the results of PC IOLs transscleral fixation to the ciliary sulcus in six years follow-up. MATERIAL AND METHODS: 152 eyes in 3 groups: 15 eyes with primary fixations of PC IOLs, 92 eyes with secondary fixations of PC IOLs and 45 eyes with secondary fixations of PC IOLs combined with penetrating keratoplasty. RESULTS: Postoperative corrected visual acuity was 0.5 or better in 32.2% of cases, the most common complications in our material was CME (9.9%), lens tilt (4.6%) and increase of IOP (3.95%). CONCLUSION: Transscleral fixation of PC IOLs offers good visual outcome with relatively low rate of complications and is recommended in cases with inadequate posterior capsule support.     

The evaluation of the usefulness of phacotrabeculectomy as the only surgery for glaucoma and cataract patients

PURPOSE: To evaluate IOP changes after phacotrabeculectomy. MATERIAL AND METHODS: 24 glaucoma patients (27 eyes) with coexistence of cataract. Age: 56-79 years. Mean IOP level before surgery: 23.2 +/- 2.4 mm Hg. In all cases phacotrabeculectomy was performed. Follow-up ranged from 3 to 12 months. RESULTS: IOP decrease after surgery was achieved: mean decrease 7.1 +/- 2.3 mm Hg after 3 months and 5.5 +/- 2.4 mm Hg, and 4.1 +/- 2.1 mm Hg after 6 and 12 months, respectively. CONCLUSION: Phacotrabeculectomy combines all advantages of phacoemulsification and creates perspective for IOP normalization.     

Radical cystectomy with ileoneocystoplasty

There were examined 32 patients with cancer of bladder, to whom radical cystectomy with ileoneocystoplasty in the author's modification was performed. Operative intervention was done for the transitional cell carcinoma of bladder in T2-T4 stage. The method of the bladder formation using resection of the ileum segment 40-60 cm in length was adduced. The intestinal segment was transsected along the side opposite to mesentery, the transplant was placed in U-like fashion, the posterior wall of bladder was formed sewing together medial edges, anastomosis between bladder and ureter was performed. In 17 patients postoperative complications had occurred, mainly of septic-purulent character. Postoperative mortality was 9.4%. Radical cystectomy with ileoneocystoplasty is an effective method of medico-social rehabilitation of patients, which secures restoration of urodynamics of upper urinary ways and urination.     

一叶萩的化学成分

目的：对一叶萩枝叶的化学成分进行研究。方法：应用各种色谱技术从一叶萩总碱部位中分离化合物，根据理化常数和波谱（NMR及MS等）分析方法对化合物的结构进行鉴定。结果：自一叶萩枝叶的总碱部位中分离得到11个化合物。分别鉴定为：（-）-15β-ethoxy-14，15-dihvdroviroallosecurinine（1），一叶萩碱（securinine，2），二氢一叶萩碱（14，15-dihydrosecurinine，3），4-epiph），llanthine（4），securitinine（5），右旋别一叶萩碱（viroallosecurinine，6），一叶萩醇A（securinol A，7），secu’amamineA（8），ent-phyllanthidine（9），（＋）-aquilegiohde（10）和（＋）-menisdaurilide（11）。结论：1为新化合物，4，8，10和11为首次从一叶萩中分离得到。     

Intraperitoneal chemotherapy for patients with advanced ovarian cancer: a review of the evidence and standards for the delivery of care

OBJECTIVES: To evaluate the role of intraperitoneal (IP) chemotherapy as part of primary treatment in patients with advanced ovarian cancer and to develop standards of care within the context of current clinical practice. METHODS: A multidisciplinary expert panel, convened to develop standards on the use of IP chemotherapy, searched the MEDLINE, EMBASE, and Cochrane Library databases up to December 2006 for randomized trials or published standards on the efficacy and/or delivery of IP chemotherapy. RESULTS: Eight randomized trials comparing IP chemotherapy versus intravenous (IV) chemotherapy were identified. Three trials reported statistically significant improvements in median survival of 8.0, 11.0, and 15.9 months with cisplatin-based IP chemotherapy. In one trial, the 15.9-month improvement in median overall survival (RR=0.75, 95% CI=0.58-0.97) represented a 25% reduction in the risk of death with IP chemotherapy. Severe adverse events and catheter-related complications were often dose limiting with IP chemotherapy. Using a consensus-based approach with a nationally representative panel, multidisciplinary care standards were developed to review medical and surgical criteria, the practice setting, volume requirements, and the institutional criteria required to safely deliver IP chemotherapy. CONCLUSION: The survival benefits with cisplatin-based IP chemotherapy may represent a significant improvement in the outlook for select patients with advanced ovarian cancer. The delivery of IP chemotherapy is more challenging than the IV route; however, severe adverse events and catheter-related complications may be offset through research defining the optimum treatment regimen, and the standardization of care. System-wide standards for the delivery of IP chemotherapy in Canada for patients with optimally debulked stage III ovarian cancer are offered.