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Descemet stripping automated endothelial keratoplasty in phakic eyes:incision modification reducing cataract formation

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International Journal of Ophthalmology(English edition) 2018年第1期11卷 53-57页

作者： Jacqueline Beltz Silvana Madi Yoav Nahum Paolo Santorum Massimo Busin Department of Ophthalmology Villa Igea Private HospitalForli 47122Italy Istituto Internazionale per la Ricerca e Formazione in Of talmologia(IRFO) Forli 47122Italy Department of Morphology Surgery and ExperimentalSurgeryUniversity of FerraraFerrara 44100Italy Centre for Eye Research Australia Royal Victorian Eye and Ear HospitalMelbourne 3002Australia Department of Ophthalmology Alexandria University HospitalAlexandria 21527Egypt Department of Ophthalmology Rabin Medical CenterPetahTikva 49100Israel Sackler Faculty of Medicine Tel Aviv UniversityTel Aviv 69978Israel Department of Ophthalmology San Maurizio Regional HospitalBolzano 39100Italy

AIM： To evaluate the efficacy of a technical modification to reduce the incidence of traumatic cataract induced by Descemet stripping automated endothelial keratoplasty（DSAEK） performed in phakic eyes. METHODS： A retrospective cohort study. The records of all patients with a clear crystalline lens and endothelial failure that underwent modified DSAEK at our insitution were reviewed. In this modification, in order to avoid inadvertent touch of the insertion forceps against the exposed crystalline lens while passing across the anterior chamber, the incision sites were shifted from the standard 9 and 3 o＇clock positions, superiorly to the 10 and 2 o＇clock position respectively. Formation of typically traumatic, anterior subcapsular cataract in these patients was compared to that observed in a cohort including all the patients with a clear crystalline lens and endothelial failure that underwent conventional DSAEK at our ***： The study group included 49 eyes following modified DSAEK and the control group included 35 eyes following DSAEK with conventional incision sites. Anterior subcapsular cataract occurring 4 mo or less postoperatively was identified in 2 of 49（4%） eyes in the study group and 7 of 35（20%） eyes in the control group. The rates of traumatic cataract were significantly higher in the control group in comparison to the study group（P=0.03, RR=4.9, 95%CI 1.08-22.1）.CONCLUSION： Traumatic cataract formation following phakic DSAEK may be avoided with a simple modification to the position of the incision sites.

关键词： cornea Descemet stripping automated endothelial keratoplasty cataract lamellar keratoplasty

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Treatment of Atherosclerotic Disease of the Femoral Artery: Randomized Controlled Trials and Meta-Analyses. Should You Be Sceptical?

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Surgical Science 2019年第7期10卷 235-254页

作者： Raymond Englund St George private hospital Kogarah Sydney

A narrative review of the data provided by Randomised Controlled clinical trials and meta-analyses was undertaken to assess how much reliance a clinician could place on these in selecting a treatment for patients with disease of the Femoral artery. An attempt was made to detect and review every clinical trial and meta-analysis published on treatments relating to disease of the femoral artery but not relating to drug treatment. Disease of the femoral artery in >65 years age group occurs in approximately 20% of the population but symptomatology was present in 40%. In almost all trials the predominant (>90%) indication for treatment was intermittent claudication. In this setting, clinical benefit was limited and did not extend beyond 12 months. Mortality, from co-morbidities was high. The Basil Trial was the only one to examine intervention for critical limb ischemia. The results for Bypass surgery and Percutaneous transarterial balloon angioplasty (PTA) were equivalent. There is little evidence to support the use of PTA or stenting other than in the treatment of patients with critical limb ischemia.

关键词： Femoral Artery Stent (Nitinol Drug-Eluting Covered) Percutaneous Balloon Angioplasty Drug Eluting Balloons Randomised Controlled Trials Meta-Analyses Intermittent Claudication Critical Limb Ischemia Patency Clinical Benefit

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Urinary incontinence following obstetric fistula repair

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World Journal of Obstetrics and Gynecology 2016年第2期5卷 182-186页

作者： Judith TW Goh Hannah Krause Greenslopes private hospital Griffith University

Prolonged and/or obstructed labour is the most common cause of genital tract fistula world-wide, in particular, sub-Saharan Africa and parts of Asia where emergency obstetric services are unavailable or suboptimal to afford timely delivery of the baby. This results in pressure necrosis by the fetal presenting part at the level of the obstruction in the maternal pelvis. Other reasons for obstetric fstula include trauma from vaginal deliveries （spontaneous or instrumental） and iatrogenic from cesarean section/hysterectomy. The majority of women develop the fistula during their first labour and most babies are stillborn. Women with a fistula suffer from leakage of urine and/or faeces from the vagina and surgery is the treatment for an established fstula. Long-term complications of fstulas include recurrent fstula, urinary incontinence, reproductive dysfunction, sexual dysfunction, mental health dysfunction, social isola-tion and orthopaedic complications such as footdrop. Ongoing urinary symptoms are not uncommon after successful fistula closure. There are various reasons for residual urinary incontinence following obstetric fstula repair including urinary stress incontinence, overa-ctive bladder, mixed urinary incontinence and voiding dysfunction. Urinary incontinence after fistula repair requires careful evaluation prior to further surgery, as in some diagnoses, continence surgery is unlikely to treat and may worsen the condition. Initial results from educational and physiotherapy programs demonstrated a positive impact on post-fstula incontinence.

关键词： Urinary incontinence Obstetric fstula

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Heart failure with preserved ejection fraction

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Journal of Geriatric Cardiology 2013年第4期10卷 369-376页

作者： Marzia Rigollil Gillian A Whalley Awhina Health Campus Waitakere Hospital Waitemata District Health Board Private Bag93-503 Auckland New Zealand Division of Cardiology University of Verona Ospedale Maggiore Pie Stefani 1 37126 Verona Italy Faculty of Social and Health Sciences Unitec Institute of Technology Private Bag92025 Auckland NewZealand

Progressive aging of the population and prolonga tion of life expect ancy have led to the ris ng prevalence of heart failure (HF)。Despitethe improvements in medical therapy，the mortality rate of this condition has remained unaccept ably high，becoming t heprimary cause ofdeath in the elderly popul at ion。Almost half of patient swith signs and symptoms of HF are f ound to have a nearly normal ejection fraction，which delineates a distinctclinical syndrome 。known as HF with preserved ejection fraction(HF-PEF) 。While early research focused on the importance of diastolicdys function，more recent studies reported the pathophysological compl exity of the disease with multiple cardiovas 。cular abnormalities contributing to its development and progression。HF-PEF is a challenging maj or health problem with yet no solution as there is no evidence。Based treatment which improves clinical out comes。This review summarizes the state of current knowledge on diagnosis，prognosis and treatment of HF。PEF，with particul ar insights on the pathological characteristics in the elderly population。

关键词： Diastole Echocardiography Heart failure Mortality Preserved ejection fraction

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3D additive-manufactured nanocomposite magnetic scaffolds: Effect of the application mode of a time-dependent magnetic field on hMSCs behavior

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Bioactive Materials 2017年第3期2卷 138-145页

作者： Ugo D'Amora Teresa Russo Antonio Gloria Virginia Rivieccio Vincenzo D'Anto Giacomo Negri Luigi Ambrosio Roberto De Santis Institute of Polymers Composites and BiomaterialsNational Research CouncilNaplesItaly villa Betania Evangelical hospital NaplesItaly Department of Neuroscience Reproductive Sciences and Oral SciencesUniversity of Naples Federico IINaplesItaly Unit of Dentistry Bambino GesùChildren's HospitalIRCCSRomeItaly

Over the past few years,the influence of static or dynamic magnetic fields on biological systems has become a topic of considerable *** has recently been implicated to play significant roles in the regulation of cell responses and,for this reason,it is revolutionizing many aspects of healthcare,also suggesting new opportunities in tissue *** aim of the present study was to analyze the effect of the application mode of a time-dependent magnetic field on the behavior of human mesenchymal stem cells(hMSCs)seeded on 3D additivemanufactured poly(3-caprolactone)/iron-doped hydroxyapatite(PCL/FeHA)nanocomposite scaffolds.

关键词： Additive manufacturing Scaffold Magnetic field Cell-material interaction

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Murine hepatocellular carcinoma derived stem cells reveal epithelial-to-mesenchymal plasticity

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World Journal of Stem Cells 2017年第9期9卷 159-168页

作者： Aparna Jayachandran Ritu Shrestha Bijay Dhungel I-Tao Huang Marianna Yumi Kawashima Vasconcelos Brian J Morrison Charmaine A Ramlogan-Steel Jason C Steel the University of Queensland School of Medicine and the Gallipoli Medical Research Institute Greenslopes Private Hospital Viral and Rickettsial Diseases Department Infectious Diseases DirectorateNaval Medical Research Center

AIM To establish a model to enrich and characterize stemlike cells from murine normal liver and hepatocellular carcinoma(HCC) cell lines and to further investigate stem-like cell association with epithelial-to-mesenchymal transition(EMT).METHODS In this study,we utilized a stem cell conditioned serumfree medium to enrich stem-like cells from mouse HCC and normal liver cell lines,Hepa 1-6 and AML12,*** isolated the 3-dimensional spheres and assessed their stemness characteristics by evaluating theRNA levels of stemness genes and a cell surface stem cell marker by quantitative reverse transcriptase-PCR(q RTPCR).Next,we examined the relationship between stem cells and EMT using q *** Three-dimensional spheres were enriched by culturing murine HCC and normal hepatocyte cell lines in stem cell conditioned serum-free medium supplemented with epidermal growth factor,basic fibroblast growth factor and heparin *** 3-dimensional spheres had enhanced stemness markers such as Klf4 and Bmi1 and hepatic cancer stem cell(CSC) marker Cd44 compared to parental cells grown as adherent *** report that epithelial markers E-cadherin and ZO-1 were downregulated,while mesenchymal markers Vimentin and Fibronectin were upregulated in 3-dimensional *** 3-dimensional spheres also exhibited changes in expression of Snai,Zeb and Twist family of EMT transcription *** Our novel method successfully enriched stem-like cells which possessed an EMT *** isolation and characterization of murine hepatic CSCs could establish a precise target for the development of more effective therapies for HCC.

关键词： Hepatocellular carcinoma Hepa 1-6 Cancer stem cells Cancer initiating cells Epithelial-to-mesenchymal transition Cellular plasticity Epithelial-to-mesenchymal transition transcription factors AML12

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Awake robotic liver surgery:A case report

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2954-2961页

作者： Antonella Delvecchio Gaetano Pavone Maria Conticchio Claudia Piacente Miriam Varvara Valentina Ferraro Matteo Stasi Annachiara Casella Rosalinda Filippo Michele Tedeschi Carmine Pullano Riccardo Inchingolo Vito Delmonte Riccardo Memeo Unit of Hepato-Pancreatic-Biliary Surgery “F.Miulli”Regional General HospitalBari 70021Italy Unit of Anesthesia and Perioperative Medicine “F.Miulli”Regional General HospitalBari 70021Italy villa Pia hospital Rome 00151Italy Unit of Interventional Radiology “F.Miulli”Regional General HospitalBari 70021Italy

BACKGROUND In recent years,minimally invasive liver resection has become a standard of care for liver *** the need to treat increasingly fragile patients,general anesthesia is sometimes avoided due to respiratory ***,surgical treatment with curative intent is abandoned in favor of a less invasive and less radical *** anesthesia has been shown to reduce respiratory complications,especially in elderly patients with pre-existing lung *** SUMMARY A 77-year-old man with hepatitis-C-virus-related chronic liver disease underwent robotic liver resection for hepatocellular *** patient was suffering from hypertension,diabetes and chronic obstructive pulmonary *** National Surgical Quality Improvement Program score for developing pneumonia was 9.2%.We planned a combined spinal–epidural anesthesia with conscious sedation to avoid general *** modification of the standard surgical technique was *** were stable and bleeding was *** postoperative course was *** Robotic surgery in locoregional anesthesia with conscious sedation could be considered a safe and suitable approach in specialized centers and in selected patients.

关键词： Robotic surgery Awake surgery Liver resection Frail patient Locoregional anesthesia Conscious sedation Case report

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Secondary endoresection for previously treated choroidal melanomas with a non-responsive course and persistent exudative retinal detachment

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International Journal of Ophthalmology(English edition) 2022年第2期15卷 276-283页

作者： Ahmet Kaan Gündüz Ibadulla Mirzayev Department of Ophthalmology Ankara University Faculty of MedicineAnkara 06590Turkey private Eye Clinic Ankara 06590Turkey Department of Ophthalmology Dünyagoz HospitalAnkara 06540Turkey

AIM:To evaluate the results and complications of secondary endoresection via pars plana vitrectomy for choroidal melanoma and review the previously reported endoresection studies on the treatment of choroidal ***:The medical records of 6 patients with choroidal melanoma who underwent secondary endoresection between March 2012 and March 2020 were retrospectively *** indications for secondary endoresection were progressive or recurrent tumor and severe exudative retinal detachment after previous treatment with plaque radiotherapy/Cyberknife radiosurgery/transpupillary thermotherapy(TTT).RESULTS:Before endoresection,2 eyes had Iodine-125 plaque radiotherapy and TTT,1 eye had Ruthenium-106 plaque radiotherapy and TTT,1 eye had Cyberknife radiosurgery and TTT,1 eye had Cyberknife radiosurgery,and 1 eye had TTT *** visual acuity ranged from 20/63 to 20/1600(Snellen) and from 0.5 to 1.9(mean:1.1) on the log MAR *** mean tumor base diameters were 9.5×8.7 mm and the mean tumor thickness was 5.4 *** secondary endoresection,transient vitreous hemorrhage developed in 2(33.3%) eyes and retinal detachment in 1(16.7%) *** examination revealed epithelioid cell melanoma in 4(66.7%) eyes and mixed cell melanoma in 1(16.7%).Melanoma cell type was not specified in 1(16.7%) *** a mean follow-up of 49.6 mo(range:16-90 mo),mean visual acuity did not improve and 1 eye was enucleated due to tumor *** visual acuity ranged from 20/63 to 20/1600(Snellen) and from 0.5 to 1.9(mean:1.2) on the log MAR *** patients with choroidal melanoma developed metastasis and eventually ***:Secondary endoresection seems to be an effective treatment option for globe salvage in choroidal melanoma not responsive to conventional treatment and displaying persistent exudative retinal *** was no visual acuity increase among the treated eyes but globe salvage was possible in most cases in this study.

关键词： endoresection choroidal melanoma metastasis pars plana vitrectomy recurrence

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Effect of fibrin glue on corneal lamellar healing and how it correlates to biomechanical properties: biomechanical wavefront analysis and confocal study

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Eye and Vision 2016年第1期3卷 114-120页

作者： Almamoun Abdelkader Department of Ophthalmology Faculty of MedicineAl-Azhar UniversityCairoEgypt Ophthalmology Department Abha Private HospitalP.O Box 1794AbhaKingdom of Saudi Arabia

Background:To evaluate,using a rabbit model,the influence of the wound healing process at the flap edge on corneal biomechanics after sutured,glued,and non-augmented microkeratome ***:Unilateral 160μm thick laser in situ keratomileusis(LASIK)flaps using a mechanical microkeratome were performed on the corneas of the left eyes of 36 *** were then divided into 3 groups of 12 rabbits each:A:the flaps were glued with human fibrin tissue adhesive(Tisseel);B:the flaps were sutured;and C:the flaps were allowed to heal without the use of sutures or glue(non-augmented).The contralateral eyes served as *** ocular response analyzer(ORA)was used to measure corneal hysteresis(CH),corneal resistance factor(CRF),Goldmann-correlated intraocular pressure(IOPg)and cornea-compensated IOP(IOPcc)at 6 weeks and 3 months *** vivo confocal microscopy(IVCM)was also used to study the corneal wound healing process in all ***:Both mean CH and mean CRF were significantly higher in sutured and glued groups compared with the non-augmented group at 6 weeks and 3 months postoperatively(P<0.0001).No statistically significant difference in corneal biomechanics was found between controls and groups A and B at any time *** keratocytes were detected at the wound edge and peripheral flap interface in sutured and glued ***:The healing process at the wound edge is critical for optimal corneal *** glue may serve as a safe and effective substitute to sutures in enhancing the corneal flap edge healing response and in increasing its mechanical strength.

关键词： Wound healing Corneal hysteresis Corneal resistance factor Ocular Response Analyzer(ORA) Confocal microscopy

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Towards a Classification of Left Common Iliac Vein Compression Based on Triplanar Phlebography

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Surgical Science 2017年第1期8卷 19-26页

作者： Raymond Englund St. George private hospital Kogarah Australia

Introduction: There is currently no consistent classification of the extent of left common iliac vein compression syndromes such that clinicians working in the area have a common terminology. Hypothesis: To create a classification of left common iliac vein compression based on the end point of triplanar pelvic phlebogrpahy. Methods: Based on 61 consecutive patients found to have left common iliac vein compression on triplanar phlebography in the course of treatment of venous disease, clinical presentation and symptomatology were retrospectively used to create a classification of left common iliac vein compression. Treatment of left common iliac vein compression was also retrospectively correlated with staging. Results: The following classification was arrived at: Stage 0, no compression and no intraluminal fibrous bands;Stage 1, evidence of compression by surrounding anatomical structures with or without the presence of fibrous bands;Stage 2: evidence of compression with or without fibrous bands as evidenced by cross-pelvic collaterals;Stage 3: compression of the left common iliac vein. Fibrous bands replaced by localised occlusion, with collateralisation and no involvement of adjacent venous segments;Stage 4a: as for Stage 3 but with the addition of thrombotic involvement of adjacent venous segments;Stage 4b: as for Stage 4a but with involvement of distal venous segments, femoral and popliteal. Stages 3, 4a or 4b correlated well with clinical presentations of DVT, PE, venous ulceration, vulval or cross-pelvic collaterals, ipsilateral limb swelling and claudication. The presence of varicose veins or recurrent varicose veins was a common finding amongst all groups. Conclusion: Acceptance of this classification system would provide a common terminology to allow more transparent assessment of modalities of treatment for this condition.

关键词： May Thurner Syndrome Left Common Iliac Vein Compression Venous Collaterals Venous Hypertensive Disease Cross-Pelvic Collaterals Varicose Veins

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