1-week Postoperation Research Articles

Risk factors of bone loss after Prestige-LP cervical disc arthroplasty.

Cervical disc arthroplasty (CDA) is widely employed for patients diagnosed with cervical degenerative disc disease (CDDD). Postoperative bone loss (BL) represents a radiological alteration that is a relatively novel consideration in the realm of CDA. This study endeavors to examine the risk factors associated with BL following CDA, aiming to elucidate the underlying mechanisms and the impact of BL on surgical outcomes. A retrospective study was undertaken, encompassing consecutive patients subjected to one-level CDA, two-level CDA, or two-level hybrid surgery (HS) for the treatment of CDDD at our institution. Patient demographic and perioperative data were systematically recorded. Radiological images obtained preoperatively, at 1-week post-operation, and during the last follow-up were collected and evaluated, following with statistical analyses. A total of 295 patients and 351 arthroplasty segments were involved in this study. Univariate logistic regressions indicated that age ≥ 45years and two-level HS was associated with lower risk of BL; and a greater ΔDA (change of disc angle before and after surgery) was correlated with an increased risk of BL. Multivariate logistic regression determined that two-level HS and greater ΔDA were independent preventative and risk factors for BL, respectively. Further analysis revealed that severe BL significantly elevated the risk of implant subsidence compared to non-BL and mild BL. This study posited bone remodeling and micromotion as potential underlying mechanisms of BL. Subsequent research endeavors should delve into the divergent mechanisms and progression observed between lower- and higher-grade BL, aiming to prevent potential adverse outcomes associated with severe BL.

Macular Toxicity of Low-Concentration Cefuroxime during Cataract Surgery in Vitrectomized Eyes

Introduction: The objective of this study was to determine the toxic effect and clinical characteristics of 1 mg/mL cefuroxime sodium on retinas after phacoemulsification in vitrectomized eyes. Methods: Cataract patients with vitrectomized eyes were studied retrospectively. Phacoemulsification combined with intraocular lens implantation was performed uneventfully. Best-corrected visual acuity, intraocular pressure, fundus photography, macular central thickness, and angiography were collected and analyzed. They were studied in patients with macular edema to evaluate macular toxicity. Results: Ninety two cases (92 eyes) were enrolled, including 44 eyes of males and 48 eyes of females with an average age of 55.35 ± 12.32 years. Univariate analysis showed that the intraoperative use of balanced salt solution containing 1 mg/mL cefuroxime sodium compound electrolyte and macular involvement in primary vitrectomy were important risk factors for macular edema on the first day after cataract surgery (p < 0.05). In addition, the characteristics of this kind of macular edema were studied; the thickness of macular fovea was significantly high at 1-day follow-up (p < 0.05), but there was no difference between pre-operation and 1-week post-operation (p > 0.05). Conclusion: Low-concentration cefuroxime sodium can cause acute macular edema in vitrectomized eyes, which can heal within 1 week after surgery.

Mild Cognitive impairment Occurs in Rats During the Early Remodeling Phase of Myocardial Infarction

Cognitive impairment is a common health problem among people with heart failure (HF). Increases in oxidative stress, brain inflammation, and microglial hyperactivity have been reported in preclinical models of myocardial infarction (MI)-induced HF. We tested the hypothesis that oxidative stress, brain inflammation, mitochondrial dysfunction, and cell death participate in cognitive impairment in the early remodeling phase of MI. Rats underwent either a sham or permanent left anterior descending coronary ligation to induce MI. 1-week post-operation, MI rats with % left ventricular ejection fraction (%LVEF) ≥50 were assigned as a HF with preserved ejection fraction (HFpEF) group and MI rats with %LVEF <50 were assigned as a HF with reduced ejection fraction (HFrEF) group. Cognitive function and biochemical markers were assessed at week 5. The mean value of %LVEF in HFpEF and HFrEF were 63.62 ± 8.33 and 42.83 ± 3.93 respectively, which were lower than in the sham group, suggesting that these rats developed MI with cardiac dysfunction. Hippocampal dependent cognitive impairment was observed in MI rats. Serum, brain, and mitochondrial oxidative stress were all increased in MI rats, along with apoptosis, resulting in dendritic spine loss. However, brain inflammation and AD proteins did not change. In conclusion, during the early remodeling phase of MI, a high level of oxidative stress appears to be a major contributor of cellular damage which is associated with mild cognitive impairment. However, the severity of MI, as evidenced by the %LVEF, was not associated with the degree of cognitive impairment.

Gluteal and Posterior Thigh Pain From a Suture Compared With an Anchor-Based Device in Patients Undergoing Sacrospinous Ligament Fixation: A Randomized Controlled Trial.

To compare postoperative gluteal and posterior thigh pain, device performance, and perioperative complications in women undergoing sacrospinous ligament fixation with an anchor-based compared with a suture-capturing device. This was a single-center, patient-blinded, parallel, superiority trial of patients undergoing native-tissue pelvic organ prolapse repair through sacrospinous ligament fixation with an anchor-based compared with suture-capturing device using randomized-block randomization. The primary outcome was the increase in gluteal and posterior thigh pain from baseline to 1-week postoperation using the numerical rating scale. Pain was also assessed at postoperative day 1, week 6, and a summarized assessment for the first postoperative week. Intraoperative device performance, home opioid pain medication use, and changes in prolapse symptom scores were also analyzed. To provide 80% power to detect a pain difference of 2.5 points between the groups with an SD of 2.8 and a 15% dropout estimate using a two-sided 5% significance level, 24 patients were required per group. Analysis with Student's t test, Wilcoxon rank-sum tests, and Fisher exact tests were performed as well as an analysis of covariance for the primary outcome. Between September 2018 and June 2020, 47 patients (24 anchor-based and 23 suture-capturing) were included in the study. There was no significant difference between the anchor-based and suture-capture groups in mean change in gluteal and posterior thigh pain from baseline to 1-week postoperation (-0.4, 95% CI -1.6 to 2.3). The highest pain increase from baseline during the first postoperative week was also similar between the two groups (up 4.00 and up 4.74, respectively) with no significant difference between the anchor-based and suture-capture groups (-0.7, 95% CI -1.4 to 2.8). There were no differences in changes in pain at any of the other timepoints, in opioid pain medication utilization, device performance, or in prolapse symptom scores. An anchor-based device did not reduce postoperative gluteal and posterior thigh pain compared with a suture-based device after sacrospinous ligament fixation. ClinicalTrials.gov, NCT03565640. Supported by Neomedic via Adler Instruments. Neomedic provided funding for this principal investigator-initiated study. Funding went to providing small value gift cards to patients for study completion, office supplies for the study, and funding the data analysis collaboration with the Wake Forest Baptist Health CTSI Biostatistics Department. Neomedic did not have any direct role in study design, patient recruitment, study execution, data analysis, or manuscript writing or editing.

Efficacy of modified levator-muscle resection using Putterman ptosis clamp versus traditional levator-muscle resection for aponeurotic ptosis: A retrospective analysis

Background/ObjectivesIn recent years, a modified levator muscle resection using Putterman ptosis clamp was developed. We used a retrospective case–control study to compare the effects of the modified and traditional levator muscle resection methods. MethodsPatients with moderate-to-severe ptosis who underwent the traditional or modified method for levator muscle resection were divided into two groups: Group I received the traditional method in 2013 and Group II received the modified method using Putterman clamp in 2015. During each postoperative visit, in addition to imaging, changes in the margin reflex distance 1 (MRD 1), and adverse events were recorded. Surgical time and final result in the last follow-up were recorded. ResultsGroup I had 35 patients (54 eyes) and Group II had 33 patients (59 eyes). After the surgery, the MRD 1 in both groups was significantly improved at 1 week and at the final visit compared to baseline. Significant differences were observed in MRD 1 change at 1-week post-operation and the change at the final visit and the surgical time between Groups I and II (P < 0.05). Group II had a shorter surgical time than Group I. Compared with Group I (20.37%), the revision rate was lower in Group II (10.16%). ConclusionsThe modified levator muscle resection using Putterman ptosis clamp and traditional levator muscle resection can both improve ptosis. Comparison results showed that using Putterman ptosis clamp assisted in levator muscle surgery had shorter operation time, faster postoperative recovery, and lower revision rate than the traditional method. Level of evidence IIIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Transient Alteration of Retinal Microvasculature after Refractive Surgery

Purpose: The purpose of this study was to determine the retinal microvasculature in myopic patients after refractive surgery. Methods: Thirty-six right eyes of 36 patients who undertook femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) were imaged using optical coherence tomography angiography preoperatively, 1-week, 1-month, and 3-month postoperation, respectively. Vessel density was analyzed after the correction of magnification, and results were correlated with clinical manifestations, including spherical equivalent (SE), amplitude of accommodation, intraocular pressure, and axial length. Results: There was a significant decrease in microvascular density 1-week postoperation compared to preoperative measurement (p < 0.05), and it recovered 1-month postoperation. Microvascular densities in superficial vascular plexus (r = 0.528, p < 0.01), deep vascular plexus (r = 0.500, p < 0.01), and retinal vascular network (r = 0.390, p < 0.05) were all positively correlated with the decrease of the SE 1-week postoperation. Conclusion: The transient alteration of the retinal microvasculature after refractive surgery appeared to recover quickly, which may not impact the visual function after FS-LASIK.

Surgical treatment outcome of obstructive sleep apnea patient with nasal cavity and oropharyngeal airway abnormality

Background: The purpose of this study was to evaluate the result of the multilevel single-stage procedure for obstructive sleep apnea (OSA) with a narrow nasal cavity and oropharyngeal, velopharyngeal airspace. A retrospective study was performed in OSA patients who underwent surgery in Khon Kaen hospital, Thailand. Methods: A retrospective study was conducted and medical records were reviewed between 2015 May and 2019 November in patients with loud snoring and having symptoms and signs of OSA, 43 patients included for evaluation history taking and physical examination by fiberoptic laryngoscope and performed multilevel single-stage procedure and evaluated clinical postoperative. Results: All patients were evaluated preoperatively by a history taking and physical examination for clinical assessment including fiberoptic laryngoscope examination. There were 3 surgical procedure, Procedure 1: 12 patients underwent Tonsillectomy with uvulopalatopharyngoplasty (27.9%), Procedure 2: 22 patients underwent Tonsillectomy with uvulopalatopharyngoplasty and inferior turbinoplasty (51.2%), Procedure 3: 9 patients underwent Tonsillectomy with uvulopalatopharyngoplasty and inferior turbinoplasty, and septoplasty (20.9%). After a 1-week post-operation 41 patients (95.3%), all (100.0%) no symptoms of OSA, and 60.9% improved their loud snoring more than 80.0%. After 3-week post-operation, 32 patients (74.4%) followed up and all (100.0%) no symptoms of OSA, 27 patients (84.4%) improved their loud snoring by more than 80.0%. Conclusion: Clinical assessment in patient with OSA is important before treatment. The Multilevel single-stage procedure is alternative choice for first treatment of OSA patients who reject continuous positive airway pressure (CPAP) or failure using CPAP. The results outcome is good for both obesity and non-obesity patients and improve clinical in OSA.

Comparison of surgical outcome between conventional open thyroidectomy and endoscopic thyroidectomy through axillo-breast approach.

Objective:Minimally invasive thyroidectomy can be categorized into either video-assisted method or remote access thyroidectomy (RAT). Although RAT provided excellent cosmetic results, some debate about the advantages and disadvantages remains in different countries. Thus, this study aimed to compare the surgical results between endoscopic thyroid surgery and conventional thyroidectomy.Materials and Methods:The study retrospectively reviewed the conventional and endoscopic thyroidectomy performed at our institution from September 2011 to July 2012. Overall, 30 patients were recruited for this study. The patients were divided into two groups: Group O (open group, n = 15) and Group E (endoscopic group, n = 15). Postoperative outcomes (including wound pain, swallowing disturbance, and chest wall paresthesia) and complications were analyzed and assessed.Results:The endoscopic group was associated with longer operation time and hospital stay. The visual analog scale (VAS) score of surgical wound pain was significantly higher in the open group in 1-week postoperation. However, the VAS score of swallowing disturbance was significantly higher in the endoscopic group in 1-week postoperation. More than half of the patients (53%) had chest wall paresthesia within 1-month postoperation in the endoscopic group. No surgical complications occurred in both groups.Conclusion:Although endoscopic thyroidectomy provides excellent cosmetic results in thyroid surgery, higher immediate postoperative pain, and prolonged chest wall paresthesia compared with those in conventional surgery are a concern and warrant careful patient selection.

Early and midterm outcomes of a modified single-patch technique for repairing complete atrioventricular septal defect in children and adults.

The "modified single-patch" technique (Nunn's technique) has become more widely adopted, especially in small infants with common atrioventricular septal defect (CAVSD). In this study, we retrospectively reviewed our surgical experiences of the "modified single-patch" technique with CAVSD patients, including newborns and adults, to reveal the early and midterm clinical results. There were 233 cases diagnosed with CAVSD undergoing biventricular repair in our hospital from June 2009 to 2016. A total of 197 cases (84.5%) with the "modified single-patch" technique were enrolled in the final analysis, including type A in 106 cases (53.8%), type B in 13 cases (6.6%), type C in 15 cases (7.6%), and intermediate type in 63 cases (32%). Major associated cardiovascular malformations included five cases of unroofed coronary sinus syndrome with LSVC (UCS), five cases of coarctation of the aorta and one case of translocation of the great artery. The median age at operation of the studied 197 cases was 44.3 ± 103.3 months (ranging from 18 days to 58 years old), including two newborns. Detailed information on the "modified single-patch" procedure was described previously, and the other cardiac malformations were repaired simultaneously with surgical repair. There were 14 (7.1%) early deaths and 3 (1.5%) late deaths at 3 months and 1 year after the initial operation, respectively. The total mortality rate was 8.1%, and there was no significant difference in mortality among the different age groups (P = .291). Five patients (2.5%) underwent reoperation because of severe mitral insufficiency (MI), and another patient was reoperated for left ventricular outflow tract obstruction 3 years after the initial surgery. Long-term survival in the <3 months group was significantly lower than that in the group of older children (1-18 years old). Of the 180 survivors who were followed up for at least 1 year, the proportion of severe MI began to drop from 26.2% before the operation to 13.8% just 1-week postoperation and continued to decline to the lowest level, 3.4%, at 3 months postoperation. However, MI began to rebound at 3 months and reached 20.8% at 1-year postoperation. The rebound of MI was evident in the (3 months, 6 months) age group and the >18 years age group. However, compared to the preoperation situation, the proportion of severe tricuspid insufficiencies decreased each month from 24.8% to 0.0% until 3 months after the operation and remained at a relatively low level within 1 year after surgery. In our experience, age is not a limitation of the modified single-patch technique, and patients even in adults with surgical indications can apply this technique. In older children and adults, we should pay more attention to atrioventricular valve annuloplasty. Infants may suffer from severe residual left atrioventricular valve regurgitation, especially in the <3 months age group, so we should improve postoperative follow-up work during infancy.

Increased resting-state functional connectivity in suprasellar tumor patients with postoperative visual improvement.

Background and Objective: Large suprasellar tumors often compress the optic chiasm and give rise to visual impairment. Most patients have significantly improved visual function at 1 to 4 months after chiasmal decompression surgery, and only a few individuals regain normal vision at 1 week after surgery. How the recovery of visual function in these patients affects the visual cortex is not fully understood. In this study, we aimed to investigate alterations in brain functional connectivity (FC) in suprasellar tumor patients with visual improvement using resting-state functional magnetic resonance imaging (rs-fMRI).Methods: This longitudinal study was conducted on 13 suprasellar tumor patients who had ophthalmological examinations and rs-fMRI at the following time points: within 1-week preoperation (Pre-op), 1-week postoperation (Post-1w) and 1-month postoperation (Post-1m). The visual impairment score (VIS), local functional correlation (LCOR) and FC values were subjected to one-way ANOVA. Pearson correlation coefficients between changes in the LCOR and clinical factors were calculated.Results: The VIS was significantly decreased at both Post-1w and Post-1m compared to that at Pre-op. Whole-brain analysis of LCOR values showed that the left V1 (primary occipital cortex) was increased significantly at Post-1m compared to that at Pre-op (p < 0.05, FDR corrected). ROI analysis exhibited a significant negative correlation between the LCOR and VIS changes at Post-1m compared to those at Pre-op (p < 0.05, r = - 0.60). FC analysis within the visual network showed that the FC strengths were significantly increased between the left V5 and the left V4, right V3a, left V3, left V2d, and right V5 at Post-1m compared to those at Pre-op (p < 0.05, FDR corrected). Additionally, the FC strengths were significantly increased between the left V5 and the left V1, right orbital-frontal gyrus and left posterior supramarginal gyrus at the whole-brain network level at Post-1m compared to those at Pre-op (p < 0.05, FDR corrected).Conclusions: Postoperative visual improvement can be reflected by the increased FC of the visual cortex at Post-1w and Post-1m, especially at Post-1m. The LCOR value of the left V1 was associated with improved visual outcomes and may be used to objectively assess early visual recovery after chiasmal decompression at Post-1m.

Dose-dependent Nerve Inflammatory Response to rhBMP-2 in a Rodent Spinal Nerve Model.

We developed a spinal nerve root wrapping rodent model to evaluate the relationship between recombinant human bone morphogenetic protein 2 (rhBMP-2) dosage and the degree of inflammation. To investigate the direct effects of recombinant human bone morphogenetic protein 2 (rhBMP-2) dosage and the degree of inflammation in rodent spinal nerve roots. rhBMP-2 is commonly used in clinical practice to augment spinal fusion. However, complications such as postoperative leg pain, and a higher rate of postoperative neurologic deficits have been reported. These may be attributable to the exposure of adjacent nerve roots to high doses of rhBMP-2. Eighteen rats were randomized into three groups as follows: Group 1: absorbable collagen sponge (ACS) + 10 μg rhBMP-2, Group 2: ACS + 1 μg rhBMP-2, and Group 3 ACS with 20 μL saline. The ACS containing rhBMP-2 or saline were then wrapped around the L5 nerve root and secured loosely with nonabsorbable sutures. At 1-week postoperation, the rats were sacrificed, and the L5 nerve root and dorsal root ganglion harvested for reverse transcription polymerase chain reaction (RT-PCR), histology and immunohistochemical staining. In our study, 10 μg rhBMP-2 induced a 10-fold increase in seroma compared with 1 μg group. Using RT-PCR, macrophage markers MIP3-α, and CD-68 were upregulated by 8- and 2-fold respectively in comparison with the saline group. Haematoxylin and eosin (H&E) images demonstrated disruption of nerve structures in the high dose 10 μg rhBMP-2, but not at 1 μg rhBMP-2 and with saline. High doses of rhBMP-2 induced neuroinflammation in a dose dependent manner, resulting in higher seroma volume, macrophage marker gene expressions, and higher proportions of immunohistochemically stained TNF-alpha and more macrophage infiltration. 2.

Comparison of recombinant human bone morphogenetic protein-2-infused absorbable collagen sponge, recombinant human bone morphogenetic protein-2-coated tricalcium phosphate, and platelet-rich fibrin-mixed tricalcium phosphate for sinus augmentation in rabbits

Background/purposeNumerous grafting materials have been used in the bone regeneration of maxillary sinus to obtain a sufficient amount of new bone in implant dentistry. The objective of this study was to compare the potentials of Type I absorbable collagen sponge (ACS) impregnated with recombinant human bone morphogenetic protein (rhBMP)-2, rhBMP-2-coated tricalcium phosphate (TCP), platelet-rich fibrin-mixed TCP for enhancing bone regeneration in sinus augmentation in rabbits. Materials and methodsThe sinus defects were grafted with rhBMP-2+ACS (Group A), rhBMP-2-coated TCP (Group B), and platelet-rich fibrin-mixed TCP (Group C). The specimens underwent decalcification, and were stained for histomorphometric analysis. ResultsThere were no significant differences in inflammatory features among the groups 1-week postoperation. In a histomorphometric analysis, the new bone formation ratio showed significant differences between groups at 2 weeks. rhBMP-2+ACS showed a larger and more rapid bone formation area at 2 weeks than those of Groups B and C. ConclusionOur histological evaluation demonstrates that Type I ACS can be used as a carrier of rhBMP-2, and rhBMP-2+ACS showed rapid bone formation, remodeling, and calcification at Week 2 in rabbit.

Clinical observation on femtosecond laser-assisted ultrasonic phacoemulsification

Objective To observe the clinical efficacy of femtosecond laser-assisted ultrasonic phacoemulsification. Methods In this prospective study, total of 131 eyes of 85 age related cataract patients with age 40-75 years were collected and divided into two groups. Femtosecondlaser group included 63 eyes of 42 cases, they received femtosecond laser-assisted ultrasonic phacoemulsifcation.Traditional group included 68 eyes of 43 cases, they reveived traditional phacoemulsifcation.Phacoemulsification power and time were recorded for each procedure.Endothelial cell density, central corneal thickness, visual acuity and complications were noted.Data were analyzed using independent t test , χ2 test and Mann-Whitney U test. Results The patient’s demographics parameters, such as age, gender, cataract grade, did not differ significantly between groups(P>0.05). The effective phacoemulsification time (EPT) of (4.81±2.14)s in the laser group were significantly lower than that of(10.34±2.31)s in the traditional group (t=3.025, P=0.003). The cumulative dissipated energy (CDE) of 5.78%±3.18% in the laser group were significantly lower than that of 8.92%±5.16% in the traditional group (z=2.598, P=0.009). The percentage of corneal endothelial cell loss was significantly lower in the laser group than in the traditional group(1week postoperation: χ2=7.273, P=0.007; 3 months postoperation: χ2=5.16, P=0.015). There was no significant difference in the UCVA or BCVA between two groups(t=0.550, P=0.583; t=0.498, P=0.619). There were no severe surgical complication in both groups. Conclusion Femtosecond laser-assisted ultrasonic phacoemulsification is safe and effictive the same as conventional ultrasonic phacoemulsification. The former can significantly lower effective phacoemulsification time and ultrasonic energy.Although femtosecond laser-assisted ultrasonic phacoemulsification still requires a certain learning curve. Key words: Ultrasonic phacoemulsification , femtosecond laser assised; Effective phacoemulsification time; Cumulative dissipated energy; Corneal endothelial cell density

Aerobic exercise can ameliorate heart function in patients with myocardial infarction through up-regulating M3 receptor

Objective cardioprotective effect and mechanism of exercise training up-regulating the expression of M3 receptor on myocardial infarction. Methods 48 male Sprague-Dawley rats were randomly assigned to three groups (n=16, per group):control group (C), myocardial infarction group (MI), moderate-intensity aerobic exercise with myocardial infarction group (ME). Rats in C group were breed normally. MI was induced by ligation of the left anterior descending (LAD) coronary artery in MI group. Rats in ME group took treadmill exercise for 8weeks. after 1week post-operation. ME group running began at the speed of 10m/min for 5min, then accelerated from 3m/min to 16m/min. The total time of ME is 60min, 5d/week, for 8weeks. LVSP, LVEDP, ±dp/dtmax and the cardiac function changes were measured after training. Myocardial collagen fibers were observed histological section and Masson staining. The expression of myocardial M3 R was observed and analyzed by immunofluorescence. The myocardial protein content of M3 R, MEK1/2,P-ERK1/2,ERK1/2 and apoptosis related Bcl-2 and Bax was assayed by Western blot. Results Compared with the C group, MI increased CVF and LVEDP (P˂0.01), but decreased LVSP and −dp/dtmax (P˂0.01). After MI myocardial M3 positive staining, after MI M3 protein expression significantly higher compared with the C group (P˂0.01), MEK1/2,P-ERK1/2/ERK1/2 protein expression were significantly increased compared with the C group (P˂0.01, P˂0.01), after the MI the Bcl-2/Bax expression significantly reduced compared with the C group (P˂0.01). ME group CVF%, LVEDP significantly reduced compared with the MI group (P˂0.01), but −dp/dtmax significantly increased (P˂0.01). ME group was identified myocardial M3, compared with the MI group, M3 protein expression significantly increased (P˂0.01), but Bcl-2/Bax expression significantly reduced (P˂0.01). Conclusions moderate-intensity aerobic exercise can up-regulated the M3 R-MEK1/2-ERK1/2 signaling pathway, thus inhibit the apoptosis of myocardial cells, reduced myocardial interstitial fibrosis and promote cardiac function after MI.

The clinical effect of Nd: YAG laser anterior capsulotomy for the treatment of capsular bag contraction syndrome

Objective To observe the clinical effect of Nd: YAG laser anterior capsulotomy for the treatment of capsular bag contraction syndrome(CCS) after intraocular lens implantation. Methods Eighty-five eyes of 85 cases of CCS were treated with Nd: YAG laser anterior capsulotomy. The minimum diameter of the anterior capsule opening, best corrected visual acuity(BCVA), corneal endothelial count and intraocular pressure (IOP) were observed 1 day preoperation and 1 week postoperation. The follow-up time was 6 months. Results The contractile ring of anterior capsule opening was opened and the contraction of capsule bag was released after Nd: YAG laser anterior capsulotomy. No serious complication was observed. The number of the eyes with BCVA≥0.3 was increased from preoperative 43 eyes to postoperative 52 eyes. The minimum diameter of the anterior capsule opening increased significantly, form (1.91±1.52)mm to (4.33±1.92)mm (t=7.45, P=0.00). No significant change in corneal endothelial cell counts after treatment was observed, (2304±202)/mm2vs (2281±234)/mm2 (t=1.03, P=0.15). IOP did not change significantly 1week postoperation compared to 1day preoperation, (15.53±4.34)mmHg vs (15.76±4.49) mmHg (t=0.62, P=0.27). No IOL shift was observed during 6 months follow-up. Conclusion Nd: YAG laser anterior capsulotomy is an effective treatment for CCS. No serious complication was observed after early surgical treatment. Key words: Cataract; Capsule contraction syndrome; Laser anterior capsulotomy; Intraocular pressure

Salvianolic acid A promotes the acceleration of neovascularization in the ischemic rat myocardium and the functions of endothelial progenitor cells

Ethnopharmacological relevanceSalvia miltiorrhiza (SM, also known as DanShen) is one of the well-known widely used Chinese herbal medicines in clinical, containing phenolic compounds and potent antioxidant properties. Salvianolic acid A (SAA) is the most potent component of SM. A modern experimental strategy for treating myocardial ischemia is to induce neovascularization of the heart by the use of "angiogens", mediators that induce the formation of blood vessels, or angiogenesis. Studies demonstrated that coronary collateral vessels protect ischemic myocardium after coronary obstruction; therefore, we sought to examine whether SAA could stimulate myocardial angiogenesis. Materials and methodsMale Sprague–Dawley rats myocardial infarct (MI) induced by ligation of left anterior descending coronary artery (LAD) were randomly divided into five groups: sham-operated group; LAD occlusion + administration of physiological saline (vehicle treated group); LAD occlusion + administration of different concentrations of SAA (10, 5.0 and 2.5mg/kg/d). Infarct size and capillary density in the infarct region were measured with a previous experimental method. Immunohistological analysis was performed to measure vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR-2) expressions. The secretion of matrix metalloproteinase type X (MMP-9) was evaluated in serum of post-ischemic rats. We also performed the experiments of SAA on rat endothelial progenitor cells (EPCs) numbers and the capacity of migration and vasculargenesis. ResultsSAA potentiated the ischemia-induced neovascularization after 1week post-operation when compared to vehicle treated group. This effect could be attributed to an increased formation of VEGF, VEGFR-2, and MMP-9 as well as the promotion of numbers and functions of EPCs. ConclusionThese findings show that SAA has potent proangiogenic properties by promoting the expression of proangiogenic factors, and the functions of EPCs, indicating that SAA might contribute to the protective effect against coronary disease. Chemical compound studied in this paper is salvianolic acid A (PubChem CID: 5281793)

顎矯正手術における術中出血量および非輸血下での血液検査値の推移に関する検討

It is difficult to predict the necessity of transfusion during orthognathic surgery. In order to examine the propriety of orthognathic surgery without preparing for transfusion, we examined 62 patients who underwent orthognathic surgery in our hospital during 3 years from January 2000 to December 2002, and performed statistical analysis of the blood loss and pre- and postoperative values of blood examination for each surgical procedure.The results were as follows:1. It seemed that a greater amount of blood is lost in double-jaw surgeries compared to single-jaw surgeries. There was a significant difference between the sagittal split ramus osteotomy combined with Le Fort I osteotomy group and the intraoral vertical ramus osteotomy group (P< 0.05). However, no case was indicated for transfusion intraoperatively.2. The larger the amount of blood lost in each surgery, the greater the decrease in values of blood examination (red blood cells, hemoglobin, hematocrit) at 1-week post-operation. A significant difference was found between pre-operation and 1-week post-operation except in the intraoral vertical ramus osteotomy group (P<0.05). Although the values tended to decrease slightly until 2-weeks post-operation, no general complication occurred.These results indicate that there is little risk of remarkable bleeding in routine orthognathic surgery. Therefore, it seems appropriate to carry out the operation without preparing for transfusion.

Oral administration of a neuroprotective compound T‐588 prevents motoneuron degeneration after facial nerve avulsion in adult rats

R(-)-1-(benzo[b]thiophen-5-yl)-2-[2-(N,N-diethylamino) ethoxylethanol hydrochloride (T-588), a synthetic compound, has been shown to have neuroprotective potentials for neuronal cells. We investigated whether orally administered T-588 can rescue injured motoneurons after facial nerve avulsion in adult rats. The right facial nerves of adult Fischer 344 male rats were avulsed and the animals were freely administered solution of 0.05% (w/v) T-588 or received T-588 (3-30 mg/kg/day) through an oral tube for 1-4 weeks. Facial motoneurons on both sides of the facial nuclei were counted in Nissl-stained sections, and choline acetyltransferase (ChAT) immunoreactivity in injured motoneurons and ChAT enzyme activities in the ventral brain stem tissue containing the facial nuclei were examined. Both free oral administration of 0.05% T-588 solution and oral tube administration of T-588 (30mg/kg/day) improved the survival of facial motoneurons at 3 or 4 weeks after avulsion. These treatments ameliorated ChAT immunoreactivity in injured motoneurons and the tissue ChAT enzyme activities at 1-week postoperation examined. These results indicate that oral administration of T-588 ameliorates the survival of injured motoneurons and supports their neuronal function after facial nerve avulsion in adult rats. T-588 may have therapeutic potential in motoneuron injury or motor neuron diseases in humans.