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Introduction: Posterior capsule opacification (PCO) is the most frequent late sequelae after successful cataract surgery. Neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy is considered the gold standard and a well-accepted, safe, and effective measure in treating PCO. However, iatrogenic damage of the intraocular lens (IOL) due to inappropriate focusing is a quite common side effect. These permanent defects (YAG pits) can critically affect overall optical quality. Methods: In this laboratory study, we used the micro-computed tomography (µCT) technique to obtain high-resolution 3D images of the lens and the YAG pits. Results: To the best of our knowledge, this is the first description of a detailed analysis of IOLs with µCT technology. This non-destructive technique seems to be ideal for comparative studies, measuring dimensions of the damage, and visualizing shooting channels within the material. Conclusion: µCT is excellently suited to examine an IOL in detail, analyze optics and haptics in three dimensions, and to describe all kinds of changes within the IOL without damaging it. [ABSTRACT FROM AUTHOR]

Aims: To describe the efficacy of a new pinhole amniotic membrane placement technique in cases of peripheral epithelial defects in patients with a single eye or low vision in the contrye. Methods: This technique is based on a small central hole done with a dermatological 3 to 4 mm punch (according to pupillary diameter in mesoscopic conditions) and a continuous suture in the perilimbal cornea to fix the amniotic membrane. We performed this technique in 6 patients. Patients were followed clinical and photographically. Results: No changes in the visual acuity before and after the surgery were observed. During follow-up, a complete re-epithelialization was observed with no need for reinterventions. Conclusions: Amniotic membrane transplantation is a very useful option in patients with persistent epithelial defects; however, its use is limited by the subsequent visual acuity. The use of the pinhole amniotic membrane technique allows us to treat peripheral persistent corneal lesions without modifying patients' visual acuity. This new technique may become especially useful in patients with functional single eye of low vision in the contralateral eye. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study is to analyze the outcomes of laparoscopic and open liver resections for (Intrahepatic CholangioCarcinoma) ICC in the modern era of laparoscopic liver surgery. Methods: Patients undergoing laparoscopic and open liver resections for ICC in two European referral centers were included. Finally, 104 patients from the open group and 104 patients from the laparoscopic group were compared after propensity scores matching according to seven covariates representative of patients and disease characteristics. Indications to surgery and short- and long-term outcomes were compared. Results: Operative time, number of retrieved nodes, rate, and depth of negative resection margins were comparable between the two groups. Blood loss was lower in the MILS (150 ± 100 mL, mean ± SD) compared with the Open group (350 ± 250 mL, p = 0.030). Postoperative complications occurred in 14.4% of patients in the MILS and in the 24% of patients in the Open group (p = 0.02). There were no significant differences in long-term outcomes between groups. Conclusions: Our results confirm feasibility, safety, and oncological efficiency of the laparoscopic approach in the management of ICC. However, this surgery is often complex and should be only considered in centers with large experience in laparoscopic liver surgery. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Psychodrama und Soziometrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The primary endpoint of this study is to evaluate the feasibility and safety of the laparoscopic approach in selected types of PeriHilar Cholangiocarcinoma (PHC). Secondary endpoint is to evaluate the potential advantages of laparoscopic approach over the open counterpart. From 2018, an MILS program for PHC was undertaken in selected patients: 16 patients constituted the study group (out of 261 operated between 2004 and 2019) and was compared with a group of patients operated by open technique (control group) in the previous period through a propensity score matching with a 1:2 ratio. Intraoperative and postoperative outcomes were evaluated and compared, focusing on blood loss, length of surgery, conversion to open approach, and complications. Laparoscopic resections resulted in statistically significant longer procedures (360 vs 275 min, p = 0.048). Conversion rate was 18.8%, being oncological concerns the most frequent reason for conversion (3/3 cases). A lower blood loss (380 vs 470, p = 0.048) and minor intraoperative blood transfusions (12.5% vs 21.9%, p = 0.032) were recorded in the study group. A number of retrieved nodes and rate of R0 resections were similar between the two groups. Patients in the MILS group had shorter length of stay (median 10) compared with open group (median 14), p = 0.048. The laparoscopic approach in PHC, so far maintained in an exploratory phase with the biliary-enteric anastomosis performed through the service incision, demonstrates adequate feasibility and safety standards when conducted in carefully selected patients and in centers with expertise. [ABSTRACT FROM AUTHOR]

Purpose: To describe a green-laser marking technique to assist partial cystectomy, which allows accurate identification of tumour margins, and provide our initial experience with ten patients. Methods: Between January 2014 and February 2018, ten patients suspected with muscle-invasive bladder cancer and request of bladder-preserving treatment were selected. In each case, bilateral pelvic lymphadenectomy was performed before green-laser assisted laparoscopic partial cystectomy. Under the direct view of cystoscope, the front-firing green-laser incision was performed 0.5–1 cm away from the exterior margin of lesion with adequate depth into the fat tissue. Tumours were then en bloc removed via laparoscope under the tracing of laser beam. Results: The location of 12 tumours in 10 patients was superior wall in 7 cases, lateral wall in 3 cases, anterior wall in 1 case, and posterior wall in 1 case. All procedures were completed without serious complications. The median operating time was 270 (210–360) min with a median haemoglobin decrease of 11 (3–38) g/L. Nine patients were high-grade transitional cell carcinoma and one patient was urachal carcinoma, and the clinical stage was pT1 in 1 case, pT2 in 4 cases, and pT3 in 5 cases. The pathological evaluation of tumour margins was negative in 10 patients. During the follow-up, no recurrence or metastasis were detected in 8 patients, but 2 patients presented regional recurrence. Conclusion: The use of green-laser marking technique during laparoscopic partial cystectomy is a feasible manoeuvre in assisting the accurate incision and minimizing injury to the remaining bladder. [ABSTRACT FROM AUTHOR]

Although foreign body aspiration is common in children and the elderly, it is very rare in young people. However, headscarf needle aspiration is common in Muslim societies, especially in young people. In needle aspirations that cannot be removed by bronchoscopic methods, thoracotomy is frequently essential method due to the sliding of the needle to the distal part of the lung. A 21-year-old female patient was referred from our emergency department to our clinic with the preliminary diagnosis of needle aspiration. Needle was not visualized by fiberoptic bronchoscopy. Video-assisted thoracoscopic surgery (VATS) was performed and the needle was removed successfully by a maneuver which we encountered for the first time in the literature. Our patient was discharged on the second postoperative day. [ABSTRACT FROM AUTHOR]

Percutaneous nephrolithotomy (PCNL) is a commonly used type of minimally invasive treatment in kidney stone surgeries. Surgical success is assessed according to residual stone amount after surgery. The purpose of this study is to compare the two methods’ success and practicality that are applied after the fracture of the stone in the patients who applied PCNL and which enable the removal of the residual stones. Among 102 patients who underwent a single-session of PCNL at our department between June 2015 and November 2016 were evaluated. Previously identified irrigation method and our aspiration method which described used in post-operative patients divided into two groups of residual fragments was assessed by computed tomography. The results were evaluated in statistical analyses. Significant p was accepted as p < 0.05. The age and gender distribution of patients in the irrigation and aspiration groups did not differ significantly (p > 0.05). In irrigation and aspiration groups, stone size did not differ significantly (p > 0.05). The amount of residue stones and dust remaining in the irrigation group was significantly higher (p < 0.05) than the aspiration group. Although many methods have been tried before, we think that the aspiration method we have described is a cheaper, more effective and feasible option. [ABSTRACT FROM AUTHOR]

Background: Hernia repair represents about 25% of all pediatric surgeries. Repair can be done using an open or laparoscopic technique. The open approach has a reported recurrence rate of 1.2% but requires an additional incision to repair for a contralateral hernia. With the laparoscopic approach, no additional incision is needed but the recurrence rate has been reported to be as high as 4%. The objective of this study was to assess the safety and efficacy of a novel sutureless laparoscopic inguinal hernia repair that has the advantages of both approaches.Methods: Since April 2014 up to March 2017, 26 children (12 girls and 14 boys) aged 3 months to 13 years underwent sutureless laparoscopic inguinal hernia repair. The peritoneum around the internal inguinal ring was severed and folded into the inguinal canal. Regeneration of the peritoneum around the inguinal ring creates a scar that effectively closes the internal orifice.Results: No recurrences or complications were observed in any of the 26 cases after a follow-up of 1-35 months (median, 14 months).Conclusions: Sutureless laparoscopic inguinal hernia repair provides a new option for the management of patients with a pediatric inguinal hernia. The procedure does not require advanced laparoscopic skills, is easily reproducible, and is safe.Therapeutic Study: Level of Evidence IV. [ABSTRACT FROM AUTHOR]

Butterfly graft inlay tympanoplasty is a well-established technique for the repair of small- and medium-sized perforations. There are some difficulties with application of conventional butterfly technique and it affects our success rate of graft healing. With some modifications of graft preparation we can make better success rates. The aim of this study was to present the new renovation of conventional method, describe about what kind of changes we made and its technical facilities about the procedure. The study design is a prospective case series. This study was carried out on 18 patients who underwent inlay butterfly cartilage tympanoplasty with the new technique for anterior and inferior perforations at an otolaryngology department of a tertiary medical center between November 2015 and August 2016. Patients were followed with otoscopy and audiometry, and graft healing's success. Anatomic closure at 6th month after tympanoplasty was found in all 18 patients. There was no incidence of cartilage graft rejection or displacement. Preoperative mean PTA was 27.7 dB, which improved 6 months after surgery to 10.5 dB (the average value of hearing thresholds at 0.5, 1, 2 and 4 kHz). Butterfly cartilage tympanoplasty technique is safe and efficient in terms of both anatomical closure of the defect and improvement in hearing. We believe with this new technique, we facilitate this procedure in addition to the improvement of patients' comfort and decrease the morbidity of the procedure. [ABSTRACT FROM AUTHOR]

China has ranked first in the coal fly ash emission in the world. The multipurpose use of the fly ash from power plant waste is always an important topic for the Chinese environmental protection, which has drawn the concern of the government, scientific research departments, manufacturing enterprises and industry experts. This paper introduces an experimental research on how to recycle fly ash effectively, a kind of new technology of making bricks by which fly ash content could be amounted to 50-80 %. The article introduces raw materials of fly ash brick, production process and key control points. It introduces how to change the technical parameters of the existing brick-making mechanical device, optimize the parameters combination and improve the device performance. High-content fly ash bricks are manufactured, which selects wet fly ash from power plants, adding aggregate with reasonable ratio and additives with reasonable dosage, and do the experimental research on manufactured products for properties, production technology and selection about technology parameters of production equipment. All indexes of strength grade, freezing-thawing resisting, and other standards of the studied bricks reached the national standards for building materials industry. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the efficacy and safety of a new and modified canaloplasty technique with suprachoroidal drainage in a large patient cohort, and to compare its IOP-lowering and topical drug-sparing effect to that of conventional canaloplasty. Methods: This retrospective clinical trial included patients with open-angle glaucoma or secondary forms of glaucoma who underwent either conventional canaloplasty or canaloplasty with suprachoroidal drainage. Primary endpoint was the IOP reduction after 12 months as well as the number of IOP-lowering medications. Secondary endpoints were intra- and postoperative complications and the occurrence of secondary surgical interventions. Results: Four hundred and seventeen eyes were included in the study; 180 of them were treated with conventional canaloplasty, and 237 eyes underwent canaloplasty with suprachoroidal drainage. In both groups, a significant IOP reduction could be observed after 12 months. Mean IOP reduction was stronger after canaloplasty with suprachoroidal drainage (35.9 %) (from baseline 20.9 ± 3.5 mmHg to 13.1 ± 2.5 mmHg) than after conventional canaloplasty (31.2 %) (from baseline 20.8 ± 3.6 mmHg to 14.0 ± 2.6 mmHg) ( p < 0.01). The number of IOP-lowering medications decreased significantly in both groups: after canaloplasty with suprachoroidal drainage from 3.5 ± 0.9 to 0.7 ± 1.0, and after conventional canaloplasty from 3.4 ± 0.9 to 0.8 ± 0.9 with different drugs. The percentage of patients who were free of IOP-lowering agents after 1 year was significantly higher in the combined group (56.9 %) than in the group of conventional canaloplasty (45.4 %) ( p = 0.0383). No serious complications were observed. Conclusions: The modified surgery technique of canaloplasty with suprachoroidal drainage yields the opportunity to optimize the IOP-lowering effect of canaloplasty as a non-penetrating surgical procedure while still offering a more favourable safety profile than trabeculectomy. The suprachoroidal access facilitates the most complicated step of the canaloplasty surgery: the localization of Schlemm's canal. [ABSTRACT FROM AUTHOR]

Background: Intrahepatic cholangiocarcinoma (ICC) is still a relatively uncommon indication for laparoscopic surgery because of technical challenges related to the frequent need for major hepatectomies and the necessity to perform formal regional lymphadenectomy. The aim of the present case-matched study was to compare laparoscopic and open resections for ICC.Methods: In a case-matched retrospective analysis, 20 consecutive patients who had undergone laparoscopic resection for ICC (LPS group) were compared with 60 of 83 patients who had undergone open surgery (open group) in the same institution. The groups were matched in a ratio of 1:3 using propensity scores based on covariates representing relevant patient characteristics and severity of disease. The main endpoints were short- and long-term outcomes and impact and adequacy of laparoscopic lymphadenectomy.Results: The groups were well matched in terms of patient and disease characteristics. The laparoscopic approach resulted in less blood loss (200 vs. 350 mL, p = 0.040) despite less extensive use of the Pringle maneuver. There was no difference in perioperative morbidity and mortality rates; however, the laparoscopic approach was associated with faster functional recovery (median 3 vs. 4 days, p = 0.050). After a mean follow-up of 39 months, disease-free and overall survivals were 33 and 51 months, respectively, for the LPS and 36 and 63, respectively, for the open group (p ns). The number of harvested nodes was comparable between groups.Conclusions: Compared with open surgery, laparoscopic resection of ICC is feasible and safe, providing short-term benefits without negatively affecting oncologic adequacy in terms of rate of R0 resections, depth of margins, and long-term overall and disease-free survivals. Laparoscopic regional lymphadenectomy is technically possible but should be the object of future focused studies. [ABSTRACT FROM AUTHOR]

Purpose: This study was conducted to analyse the intraocular pressure (IOP)-lowering and drug-sparing effect of micro-invasive 360-degree suture trabeculotomy after successfully performed canaloplasty. Methods: This retrospective interventional study included patients with open angle glaucoma or secondary forms of glaucoma, suffering from insufficient IOP level after previously conducted canaloplasty. To enhance the IOP-lowering canaloplasty effect, all patients underwent micro-invasive 360-degree suture trabeculotomy as a conjunctiva-sparing ab interno approach for circumferential trabeculotomy. This was achieved by introducing end-gripping forceps into the anterior chamber with topical anaesthesia, and grasping and extracting the canaloplasty suture through the trabecular meshwork under gonioscopic visualisation. Main outcome measures were IOP reduction and the number of IOP-lowering medications after 3 and 12 moths. Intraoperative and postoperative complications were documented systematically. Results: In total, 88 eyes of 88 patients were included. Mean IOP reduction after micro-invasive 360-degree suture trabeculotomy at month 3 was 37.5 % (from baseline 22.8 ± 6.7 mmHg to 14.3 ± 3.1 mmHg, p < 0.01) and 41.2 % after 12 months (from 22.8 ± 6.7 mmHg to 13.4 ± 2.3 mmHg, p < 0.01). The number of IOP-lowering medications decreased significantly from a mean of 2.7 ± 1.4 to 1.3 ± 1.4 after 3 months, and 1.6 ± 1.2 after 12 months. No serious complications were observed. However, mild or moderate retrograde bleeding from the collector channels was present in 25 % of eyes that resorbed spontaneously in all cases. Conclusions: Micro-invasive 360-degree suture trabeculotomy represents a simple and safe minimal invasive ab interno technique to postoperatively enhance the IOP-lowering and drug-sparing effect of canaloplasty. [ABSTRACT FROM AUTHOR]

To describe the newly designed technique of applying topical oxygen therapy for large wounds. C arm sterile disposable cover is used for covering the wound. For abdominal and pelvis wounds, two artificial holes are created at one end of the cover for the inclusion of the limb. Free end of the cover is secured with adhesive, and a hole is created for the insertion of the suction catheter. Oxygen cylinder is connected to the suction catheter, and oxygen is supplied at the rate of 10 L/min. Three patients were treated with topical oxygen therapy. These patients were cases of necrotizing soft tissue infections and large post traumatic wounds. There were less requirements of debridement and granulation tissue appeared earlier. The cost of one cycle of the therapy is less than 500 INR. Topical oxygen therapy is the recent modality for improved wound healing. The novel method of applying topical oxygen devised by us is effective, feasible, and cost-effective as compared to standard devices. [ABSTRACT FROM AUTHOR]

Background: Anterior shoulder dislocation (ASD) is a common sports injury. The goal of this study was to evaluate a new procedure for reduction after ASD with respect to success rate, the need for medication for muscle relaxation, sedation, and application of pain medication and put it into context to a systematic literature review.Patients and Methods: We retrospectively evaluated the new method in 263 patients in an Austrian skiing area from December 2005 till April 2009. We included patients with unilateral ASD and excluded those with a combined trauma and consecutive admission to hospital.Results: The new procedure is performed in a supine position, the therapist takes the patients hand of the injured limb with his one hand and with his other hand counter holds against the acromion. Then he enhances the traction on the upper limp by using his trunk as a kind of fulcrum. With eye contact and instructions to relax, the therapist is able to detect the muscular tension, so that he can adjust the amount of traction accordingly. The presented procedure was successful in all reported cases. For 196 patients (74.5 %) no medication for muscle relaxation, sedation, or pain medication were needed.Conclusion: The new method is a promising option to popular techniques for reduction of anterior shoulder dislocations. The benefits of this protocol are a gentle and simple application of the procedure as well as an easy acquisition. [ABSTRACT FROM AUTHOR]

Background: Delivery of hydatid cysts, especially large ones, without rupture is very important and there is still no 100 % successful method. Methods: After the hydatid cyst was reached, starting near the surface working around the cyst toward the base, a Foley probe was advanced and, in the region of desired dissection, the balloon of the Foley probe was inflated, and adhesion bands were freed to allow dissection. Conclusions: We believe our balloon-aided dissection technique is a method that increases the chances of delivering hydatid cysts, with no calcification and secondary infection, without rupture. [ABSTRACT FROM AUTHOR]

We are introducing a new continuous hydrostatic pressure system for identification and catheterization of epidural space in adults. One hundred and eight patients scheduled for elective endoscopic urological procedures were enrolled in this prospective randomized study. They were assigned to perform loss of resistance epidural technique by either the conventional saline-filled syringe (group C) or the new pressure technique (group P). The latter depends on observing passage of free flow of pressurized normal saline (50 mmHg) connected to epidural needle during its advancement, and then the epidural catheter was inserted to 'float' easily while saline was flowing. Ten ml of bupivacaine 0.5 % with 50 μg fentanyl were injected. Time to identify epidural space, number of attempts, ease of catheterization, sensory and motor block by Bromage scale after 20 min, quality of anesthesia and any side effects were recorded. Significant reduction was found in group P versus group C concerning time to identify epidural space [20 (6-40) vs. 60.5 (23-75) s with p = 0.001], number of attempts [1 (1-2) vs. 1 (1-4) with p = 0.02] and motor block [1 (0-3) vs. 2 (0-2) with p = 0.02], respectively. No significant difference in epidural catheterization, sensory block, quality of anesthesia and incidence of side effects. We concluded that this new technique is an easy way to identify epidural space using available tools in the operating room. [ABSTRACT FROM AUTHOR]

Background: Incisional hernia is a frequent complication after abdominal surgery. Today open sublay mesh repair and the laparoscopic intraperitoneal onlay mesh repair are the most widely used techniques for its cure. We developed a laparoscopic transperitoneal sublay mesh repair for the treatment of small- and medium-size ventral and incisional hernias. Outcomes of the new technique and the Rives-Stoppa repair were compared. Methods: This prospective cohort study with a control group involved 93 patients. Between 2008 and 2010, 43 patients underwent the laparoscopic transperitoneal sublay mesh repair. During the same period of time, a control group of 50 patients underwent an open sublay repair after Rives and Stoppa. In 2011, all patients were invited for follow-up. This included pain assessments and physical examinations with use of ultrasound. Results: The two groups were comparable in terms of patient characteristics and hernia data. The operating time was slightly longer for the laparoscopic technique. The hospital stay was shorter in the laparoscopy group. There was less chronic pain in the laparoscopy group, but this difference was not statistically significant. There was no significant difference in postoperative complications, use of analgetics, foreign body sensation, and paresthesia between the two groups. We found one long-term hematoma in the laparoscopy group and one seroma in the open group. In this series, there were no recurrences and no wound infections. Conclusions: Our initial results indicate that the new laparoscopic transperitoneal sublay mesh repair is a safe and effective method for the treatment of small- and medium-size ventral and incisional hernias. [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Laparoscopy is considered the 'gold standard' to perform left-lateral sectionectomy with results identical to those of open surgery, yielding decreased postoperative pain and disability, reduced hospital stay, and shortened patient recovery time. As the emphasis on minimizing the invasiveness of surgical techniques continues, laparoendoscopic single site (LESS) surgery is quickly evolving. The purpose of this study was to compare the results of laparoscopic left-lateral sectionectomy performed using the traditional approach or LESS approach with a case-matched analysis for tumor size, type of resection, and surgical indications. Methods: Thirteen patients who underwent LESS left-lateral sectionectomy are considered the study group (LESS group) and compared with 13 patients who underwent left-lateral sectionectomy with traditional laparoscopic approach (conventional group). Results: There were no significant differences between groups for length of surgery (165 min in conventional group vs. 195 min in LESS group), blood loss (150 mL in conventional group vs. 175 mL in LESS group), conversion to open surgery, histological tumor exposure, and requirements of postoperative analgesics. One patient in the LESS group died of cardiac failure due to an unknown severe aortic valve stenosis. No differences were recorded for postoperative complications (23.1% in both groups) and median length of postoperative stay (4 days in both groups). Conclusions: For left-lateral hepatic sectionectomy, LESS surgery is technically feasible and as safe as traditional laparoscopic surgery in terms of intraoperative and postoperative results, even though requiring both hepatobiliary and laparoscopic technique experience. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate sleeve gastrectomy with jejunal bypass (SGJB) as a surgical treatment for type 2 diabetes mellitus (T2DM) in patients with a body mass index (BMI) <35 kg/m. This is a prospective cohort study. Patients with T2DM and BMI <35 kg/m who underwent SGJB between January 2009 and June 2011 at DIPRECA Hospital, in Santiago, and Hospital Base, Osorno, Chile were included. SGJB consists of creating a gastric tube, which preserves the pylorus, and performing a jejunoileal anastomosis 300 cm distal to the angle of Treitz. Excess weight loss (EWL) and complete or partial remission of T2DM were reported. Forty-nine patients met the inclusion criteria. The mean age was 49 years (36-62), and 53 % of patients were female. Mean preoperative BMI was 31.6 kg/m (25-34.9 kg/m). Operation time was 123 ± 14 min, with 94.7 % of operations performed laparoscopically. Mean postoperative hospital stay was 2 days. Mean postoperative follow-up was 12 months. Median EWL at 1, 3, 6, 12, and 18 months postoperatively was 31.9 %, 56.9 %, 76.1 %, 81.5 %, and 76.1 %, respectively. Complete T2DM remission was achieved in 81.6 % of patients (40/49) and partial remission in 18.4 % (9/49). Forty of 41 patients (97.6 %) on oral hypoglycemic agents achieved complete T2DM remission, and 100 % of insulin-dependent patients stopped using insulin but were still being treated for T2DM. One patient experienced postoperative gastrointestinal bleeding. There were no deaths. SGJB is an effective treatment for T2DM in patients with BMI <35 kg/m. [ABSTRACT FROM AUTHOR]

Background: Conventionally described standard techniques of forequarter amputation may not be suitable for patients presenting with neglected or maltreated very large tumors of the proximal humerus. Patients and methods: Eleven patients with unsalvageable malignant tumors of proximal humerus, who underwent forequarter amputation using a new technique between Jan 2008 to March 2010, were retrospectively analysed. This new single incision anterior approach involves supine positioning of patients, ligation of axillary vessels in the axilla followed by resection of muscles from lateral border and inferior angle of scapula, resection of lateral one-third of clavicle; resection of muscles from vertebral border and superior angle of scapula by applying superolateral traction without any incision over acromioclavicular axis or posterior scapular skin. Results: The average age was 16.27 year and minimum follow-up was 6 months (range 6-24 months). There were seven males and four females. Average duration of surgery was 62 min (range 55-90). Blood loss ranged from 400 to 750 ml. One patient had superficial infection and one patient with metastatic lesion died at 6 months follow-up. Conclusions: This technique is safe, easy, less time consuming, involves small single incision in supine position, has better wound healing and can be used for both small and large tumors of proximal humerus with or without involvement of axillary vessels. Although there was no local recurrence for last 24 months but a long term follow-up is required to comment on its actual rate. [ABSTRACT FROM AUTHOR]

Caudal block is one of the most popular and effective techniques of regional anesthesia in pediatric surgery. Good anatomic knowledge and accurate adherence to guidelines pertaining to the technique and to drug administration is necessary to perform this block safely. The usual approach is well-known and has been extensively described, but failure is seen in some cases. Another approach is the 'no turn' technique, which is a new method developed in the Ain-Shams University, Pediatric Surgical Unit by the author. It has a high success rate and can be easily learned and implemented even by junior staff. [ABSTRACT FROM AUTHOR]

This paper presents a new surgical technique of inguinal hernia repair in which both crura of the aponeurosis of the external oblique abdominal muscle and transverse fascia were used for complex reconstruction of the entire musculopectineal hiatus. Between 2nd December 2003 and 29th April 2005, 250 patients (233 male and 17 female) underwent inguinal hernia repairs using our own technique. The inguinal canal was opened together with the posterior wall, dividing the transverse fascia into two flaps. The lower flap was inserted into the femoral opening and sewn to the pectineal ligament, whereas the upper flap with both crura of the aponeurosis of the external oblique abdominal muscle were used for three-fascia reconstruction of the posterior wall of the inguinal canal. The study group was randomly chosen from patients undergoing surgery due to inguinal hernias in our hospital. Procedures were carried out under subarachnoid anaesthesia; postoperative pain was treated with methamizol or ketoprofen. Patients were discharged 48 h after surgery. The postoperative complications included one hernia recurrence and one testicular atrophy. The remaining complications were transient and included prolonged wound healing, transient skin hypoaesthesia around the wound or testis oedema. The technique used strengthens the musculopectineal hiatus, effectively preventing recurrences of inguinal as well as femoral hernias. [ABSTRACT FROM AUTHOR]

Gynecomastia is an extremely disturbing deformity affecting males, especially when it occurs in young subjects. Such subjects generally have no hormonal anomalies and thus either liposuction or surgical intervention, depending on the type and consistency of the breast, is required for treatment. If there is slight hypertrophy alone with no ptosis, then subcutaneous mastectomy is usually sufficient. However, when hypertrophy and/or ptosis are present, then corrective surgery on the skin and breast is mandatory to obtain a good cosmetic result. Most of the procedures suggested for reduction of the male breast are usually derived from reduction mammaplasty methods used for females. They have some disadvantages, mainly the multiple scars, which remain apparent in males, unusual shape, and the lack of symmetry with regard to the size of both breasts and/or the nipple position. The author presents a new, simple method that has proven superior to any previous method described so far. It consists of a horizontal excision ellipse of the breast’s redundant skin and deep excess tissue and a superior pedicle flap carrying the areola-nipple complex to its new site on the chest wall. The method described yields excellent shape, symmetry, and minimal scars. A new method for treating gynecomastis is described in detail, its early and late operative results are shown, and its advantages are discussed. [ABSTRACT FROM AUTHOR]

The article presents abstracts of several studies on environmental geochemistry. Some of the abstracts presented include "Biogeochemical Cycling of Nutrients in Karstic Catchments, Southwestern China: Linkages to Changes of Eco-Environments," by Congqiang Liu and "Emerging Organic Contamination in China," by Guibin Jiang and colleagues.

Objective: To develop a technique that would permit the identfication of dendritic cells (DC) in small volumes of preterm neonatal cord blood in order to investigate neonatal immune response in relation to infection and preterm labor.Methods: We used three-color flow cytometry and a fixed quantity of fluorospheres to determine absolute cell numbers. Four red cell lysis techniques, sample dilution, time delay experiments, and a comparison with traditional Ficoll cell separation techniques were performed. Absolute numbers of DC recovered using each technique were calculated and compared.Results: With increasing time delay, there was a statistically significant reduction in the numbers of leukocytes in adult blood. In contrast, there was a significant increase in leukocytes in umbilical cord blood. Sample dilution did not significantly affect the total number of leukocytes or DC. The use of the reagent Optilyse B (Immunotech, Oxford, UK) combined with an additional washing step produced the best discrimination of all populations based on light scatter properties. For the same blood sample, antibody labeling of whole blood resulted in a greater recovery of DC when compared to prior cell purfication using a Ficoll density gradient.Conclusion: Using traditional Ficoll cell separation, cell manipulation requires large volumes of blood and leads to cell loss and alteration in phenotype. We have validated a novel method using small volumes of whole blood, diluted if necessary, and using red cell lysis to enable analysis of small volumes of preterm neonatal cord blood. This may permit further analysis of the contribution of the fetal immune response in the development of spontaneous preterm labor and preterm birth due to infection. [ABSTRACT FROM PUBLISHER]

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A new technique of integral representations in ℂ n , which is different from the well-known Henkin technique, is given. By means of this new technique, a new integral formula for smooth functions and a new integral representation of solutions of the ∂-equations on strictly pseudoconvex domains in ℂ n are obtained. These new formulas are simpler than the classical ones, especially the solutions of the ∂-equations admit simple uniform estimates. Moreover, this new technique can be further applied to arbitrary bounded domains in ℂ n so that all corresponding formulas are simplified. [ABSTRACT FROM AUTHOR]

A new approach is described for a type of lower blepharoplasty to correct excess skin and subcutaneous adiposity localized on the malar eminences. This surgery removes skin and subcutaneous tissue leaving only a fine and invisible scar on the lower malar rim. [ABSTRACT FROM AUTHOR]

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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An improved method of epiphyseal lengthening operation and subsequent outer fixation are presented on the basis of experience in 30 cases. The operative technique is described in detail, including the different options of separative traction and osteotomy at subtrochanteric, distal part of the upper femur and lower tibial levels. The physiological and histological research concerning this method is discussed. The authors believe that this procedure is better than the other methods. [ABSTRACT FROM AUTHOR]

A new and simple technique, zonal unit-gravity elutriation, has been devised for separating very large cells, multicellular complexes, or small organisms from suspensions consisting mainly of small cells. The separation vessel is a conical chamber with an entrance at the lower, narrower part of the cone and an exit at the upper, wider part of the cone via a dome-shaped lid. A baffle at the entrance prevents turbulence from incoming fluid. Chambers of differing widths and wall slopes are chosen depending on the sedimentation rate of the particles to be separated. A small volume of the cell suspension is placed in the chamber on the bench in a cold-room. Medium stabilized by a shallow density gradient is pumped into the base of the chamber and ascends, creating a decreasing velocity gradient. Cells sediment at unit-gravity against this ascending counterstream, and are separated into bands according to sedimentation velocity. By adjusting the flow rate of the medium, different sizes of cells can be separated. Tumor cells can be enriched, and larger blast cells can be separated from small cells in lymphoid cell suspensions. The procedure produces complete separation of thymic nurse cells (epithelial-lymphoid complexes) from free thymocytes in digested thymus suspensions and produces substantial enrichment of thymic rosettes (macrophage-lymphoid complexes). A very favorable situation for applying this technique is the isolation of Taenia taeniaformis larvae, which can be completely purified from infected liver suspensions, representing a 4×10-fold enrichment of the parasites, with high recovery, in a single 30 min operation. [ABSTRACT FROM AUTHOR]

Laparoscopic pancreaticoduodenectomy (PD) is challenging, and the performance of successful laparoscopic PD has been limited. The dissection of the pancreatic head from the right aspect of the portal vein and the superior mesenteric artery is one of the most difficult procedures in laparoscopic PD. For the safe dissection of the pancreatic head during laparoscopic PD, we developed a novel “pancreas-hanging maneuver” technique. Nine patients underwent this new surgical procedure between December 2008 and June 2009 during the course of laparoscopic pylorus-preserving PD. The pancreas-hanging maneuver can ensure suitable tension, surgical field, and laparoscopic view for the resection of the pancreatic head during PD. Mean intraoperative blood loss was 642 ml (range = 420–780 ml). This new surgical procedure can provide good tension and an appropriate laparoscopic view with a suitable surgical field for safely dissecting the pancreas head from the major mesenteric vessels during laparoscopic PD. [ABSTRACT FROM AUTHOR]

The traditional technique for correcting the hump on a deviated nose frequently results in redeviation. The main cause of redeviation is incomplete correction of the septal deviation, but complete septal correction is very difficult. The authors have therefore adopted a new technique to reduce the possibility of redeviation. The new technique is simple. It no longer requires complete septal correction and gives good results. [ABSTRACT FROM AUTHOR]

Background: There are several minimally invasive means of exposing the adrenal glands. Each of them has its own advantages and disadvantages. A new approach was introduced for laparoscopic adrenalectomy on the left side. Patients and methods: Between June 1997 and January 2000, 23 transperitoneal unilateral laparoscopic adrenalectomies on the left side were performed. In 4 of these cases, only enucleation of a well-circumscribed adenoma was done. In a semilateral position, the gland was approached through the splenophrenic ligament with partial mobilization of the spleen. The left adrenal gland was quickly and safely exposed, thus avoiding the complications of transmesocolic exposure. There was no need for extensive mobilization of the spleen or the pancreas. Results: In 20 cases the laparoscopic operation was successfully performed. In 3 cases conversion was necessary because of bleeding. The estimated blood loss was on average 150 ml. The mean operation time was 84 min, the mean postoperative stay 4.5 days. No other major complications were observed. Conclusion: This new method is a safe and quick technique for left-sided laparoscopic adrenalectomy, and it can be an alternative to the existing ones. [ABSTRACT FROM AUTHOR]

The authors present a new method for fixation of meniscus bucket-handle lesions. This technique is based on the development of a Biofix self-reinforced polylactic acid tack and an application system. The main goal of this technique has been to eliminate or at least reduce the risk of neurovascular injury during meniscus fixation and to simplify the fixation procedure. Additional skin incisions and exposure of the knee joint capsule are superfluous. The steps in the development of this technique are outlined and the surgical technique and preliminary results described. [ABSTRACT FROM AUTHOR]

We describe a new, simple technique for tunneling of reversed saphenous vein graft to prevent its kinking and twisting thereby avoiding early graft failure during peripheral vascular bypass procedures. The technique is based on the principle of a temporary rigid tube outside acting as tunnel for the delicate, compressible reversed saphenous vein grafts in getting the proper lie without twists and kinks. [ABSTRACT FROM AUTHOR]