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At least 73 records · Page 4Linked to original sources
PubMed1987

Surgical success rates in acquired, comitant, partially accommodative and nonaccommodative esotropia.

An extensive literature search covering the last 35 years was undertaken to retrieve all English language articles reporting results of surgical management of acquired, comitant, nonaccommodative and partially accommodative esotropia. Thirty-nine studies were found, but only 15 met the minimum criteria which we established for inclusion in our analysis. The functional success rate was 15% in 1170 patients, while the overall cosmetic success rate was 43% in 1473 patients. Direct comparison to optometric studies is not possible since the criteria for success used in surgical studies are considerably different. The most prevalent complication is the need for reoperation as a result of consecutive exotropia. The data indicate that an end result of consecutive exotropia is almost as likely as a functional cure.

Accommodation, Ocular↗
PubMed1979

[The functional result of surgery of hiatus hernia (author's transl)].

The authors study 50 case records of hiatus hernia operated according to the modified technic of Nissen or Toupet. There was no anatomical relapse, but they observed in five cases an imperfect functional result. In three cases, this imperfect result with dysphagia and esophageal dilatation, is transient and is due to restoration of the sphincter. In two other cases, the dysphagia persisted for years after the operation. The latter cases were in young subjects with digestive dystonia. From these cases, the authors distinguish hernias due to ageing and those due to deterioration of the meso-esophagus, easily curable surgically, and hernias in young subjects due to a neuro-hormonal disturbance where surgical reconstruction of the sphincter does not produce the expected functional cure.

Adult↗
PubMed1981

Intermittent exotropia: is surgery necessary?

Sixty cases of intermittent exotropia were studied to compare the outcome of those patients treated medically with the outcome of those patients treated surgically. Below 30 prism diopters of intermittent exotropia, there is a high functional cure rate in both groups. Preoperative orthoptics did not lead to a surgical overcorrection. And finally, central fusion is not essential for a clinical cure.

Adolescent↗
PubMed1978

Orthoptic treatment of strabismus.

The purpose of this paper will be to carefully examine the effectiveness of orthoptics as a viable treatment modality for strabismus. It will be necessary to first examine the scope of this problem and the significance of functional cure. A short discussion of perceptual and psychological effects will be included. A review of pertinent literature and an analysis of the data will be presented. Any commonalities or generalizations which can be identified will then be discussed and analyzed. Finally, the training of the optometrist in orthoptics and associated subjects will be examined to demonstrate the qualification of the optometrist to administer orthoptics in the treatment of visual anomalies.

Adolescent↗
PubMed1996

[Personal experience in the treatment of war injuries of the jaw and face at the Clinical Hospital Center in Rijeka].

In this paper we have presented 38 cases of wounded persons who had sustained war injuries in maxillo-facial and neck region. All of them were injured in Croatia during the war period of 1991 and 1992, and treated at the Maxillo-Facial Surgery Department of the Clinical Hospital of Rijeka. The wounded persons were observed and monitored from the moment of their injury through the first aid on the spot, up to the surgical treatment of the wounds, subsequent primary and secondary reconstruction, and the final medical treatment. This paper describes for wounded persons with injuries of bones and soft tissue of the face. In two thirds of the wounded persons with the primary medical treatment and reconstruction, the cure terminated, while in one third it was necessary to provide for a secondary reconstructive operation. At the end of the treatment, all the wounded persons were successfully cured, functionally and aesthetically restored, so they were able to leave the Clinic to return to their everyday life and work. Such result has been particularly gratifying because they were mostly young men.

Adult↗
PubMed1996

[Role of surgery in the treatment of Pott's disease in adults. Apropos of 29 cases].

PURPOSE: The management of tuberculous spondylitis remains much debated in countries with great tuberculous prevalence; the attitude in front of vertebral focus is divided between exclusive conservative treatment versus surgical treatment. The authors report their experience about surgical treatment of tuberculous spondylitis. MATERIAL AND METHODS: Twenty nine out of thirty one adults underwent surgery for tuberculous spondylitis, between january 1988 and july 1994. The average age was 29 years (range 18 to 65 years). Five patients presented radicular syndrome. The operative indications were mechanical in 20 cases, neurologic and mechanical in 5 cases, etiological and mechanical in 4 cases. Anterior approach was performed in 26 cases, posterior approach in 3 cases. A disc sequestrectomy and/or resection associated to pus evacuation and skeletal graft was performed in 24 cases. Fixation of the graft by screwed plate was used in 3 cases. Antituberculous treatment was instituted in all cases. RESULTS: The average duration of time spent in hospital was 29 days. The average follow-up was 15.61 months (range: 8 months to 5 years). Short and mean-term outcome was marked by a fistula in 3 cases. These patients underwent a second procedure; they had a good evolution. The long term outcome showed that all patients were considered as cured (functional and neurological results were satisfactory); all patients obtained fusion. Stability was achieved after 3 to 5 months. DISCUSSION: In our context, we prefer surgical treatment. Spine tuberculous is usually seen at an advanced anatomical and clinical stage with major destruction of several vertebras. CONCLUSION: Surgery allows to assert the diagnosis, to treat a compression, to evacuate pus, to treat or at less to avoid worsening of a deformation, and to reduce treatment duration.

Adolescent↗
PubMed1993

Long-term follow-up of pulmonary function in patients cured from testicular cancer with combination chemotherapy including bleomycin.

A follow-up study of pulmonary function in two groups of patients with testicular cancer was performed 6-12 years after treatment. Both groups, 47 patients in each, had undergone retroperitoneal lymph node dissection (RPLND). Patients with pathological stage (ps) II had also received bleomycin (median 270 mg) and cisplatin (median 540 mg) in three or four courses which included vinblastine or etoposide. Patients in ps I and II were similar with respect to age, general health, observation period, inspired oxygen fraction (FiO2) and maximal arterial oxygen pressure (pO2) at RPLND, but four (8.2%) with psII disease developed densities on chest X-ray during chemotherapy. At the long-term follow-up the groups were similar with respect to physical exercise, smoking pattern, present drug treatment and history of cardiopulmonary disease. In both groups forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and single breath transfer factor for carbon monoxide (TLCO) were within normal limits, and no difference was found between the groups. The combined data for both groups showed that smoking was highly associated with impairment in TLCO (P = 0.005), and smoking frequency was negatively correlated to TLCO (P = 0.002). We conclude that 3-4 courses with bleomycin, cisplatin and etoposide/vinblastine in testicular cancer patients do not lead to long-term impairment of pulmonary function.

Adolescent↗
PubMed1998

Changes in renal hemodynamics and tubular function of surgically cured primary hyperparathyroid patients are probably due to chronic hypercalcemic nephropathy.

To understand the mechanisms responsible for the persistent hypercalciuria and reduced glomerular filtration rate (GFR) previously found in 6 of 10 patients surgically cured of primary hyperparathyroidism (PHPx), the tubular handling of lithium, sodium, calcium, and phosphate as well as the renal hemodynamics were evaluated in these 10 PHPx patients, in 10 control subjects, and in 5 patients with renal hypercalciuria (RH), during fasting and after an oral calcium load. A positive correlation between the fractional excretions of calcium and sodium was found in all groups, but the PHPx patients excreted more calcium for the same amount of sodium than control subjects. The fractional proximal sodium reabsorption (FPRNa), distal delivery, and fractional phosphate reabsorption were similar in all groups; a significant positive correlation was found between the fractional calcium reabsorption and the FPRNa, indicating that proximal tubular function was preserved and that the urinary calcium losses in RH and in the hypercalciuric PHPx patients (h-PHPx) occurred in the distal nephron. However, only h-PHPx patients had reduced renal plasma flow, renal blood flow, and GFR, as well as a high renal vascular resistance, which was even more evident after the calcium challenge. These findings lead us to conclude that RH and h-PHPx patients are very different, as far as kidney dysfunction is concerned, and that a hypercalcemic nephropathy is the most probable cause of the alterations in distal calcium reabsorption and renal hemodynamics found in the h-PHPx patients.

Adenoma↗
PubMed2006

Middle phalangectomy: a functional and aesthetic cure for macrodactyly.

Macrodactyly is a rare congenital anomaly of the extremities. Some treatments such as debulking, epiphysiodesis, stripping or resection of the digital nerve, shortening of the fingers, amputation, and angulation osteotomy have been tried. We describe a patient with a giant digit in the hand, and present middle phalangectomy as a suitable treatment.

Child↗
PubMedDate not supplied

Growth and growth hormone secretion in paediatric Cushing's disease.

Although paediatric Cushing's disease is rare, it is associated with severe morbidity in childhood and presents a major diagnostic and therapeutic challenge for the paediatric endocrinologist. Growth failure remains an important feature of paediatric Cushing's disease, both at diagnosis and after successful treatment. However, the development of specific diagnostic tests and important therapeutic advances has contributed significantly to the current management. Transsphenoidal pituitary surgery (TSS) is now accepted as first-line therapy for both adult and paediatric Cushing's disease, offering the best opportunity for cure while preserving normal pituitary function. The cure rate following TSS in our centre is currently 62%; therefore, a significant proportion of children following TSS will remain uncured. Our favoured second-line therapy is pituitary radiotherapy, which is effective, rapid and appears to spare anterior pituitary function, with the exception of GH secretion. Growth failure was a symptom at diagnosis in 74% of patients; mean height SDS -1.81 (-0.28 to -4.17) compared with mean BMI SDS 2.29 (1.72-5.06). Height velocity (HV) was also subnormal; range 0.9-3.8 cm/yr. Chronic hypercortisolaemia suppresses linear growth and a history of symptoms for >2 years was obtained in 72% of our paediatric patients with Cushing's disease. In our series, 9 out of 10 patients did not demonstrate catch-up growth 0.64 years after TSS or pituitary radiotherapy and peak serum GH level to glucagon/ITT stimulation was 0.5-20.9 mU/l. Assessment of GH secretion over a period of 6 to 108 months after cure of paediatric Cushing's disease suggests that impaired GH secretion may persist into adult life. Investigation of possible GHD is performed in our unit in all post-cure patients who do not show optimal catch-up growth. If GH secretion is subnormal, GH replacement is started early and continued until final height, when GH secretion is reassessed. In our series of 10 patients, 9 received GH therapy, combined in 3 with a GnRH analogue to arrest puberty. The results of this treatment were satisfactory with mean height deficit compared with target height improving significantly from mean -1.72 +/- 1.26 SDS at diagnosis to -0.93 +/- 1.13 SDS (p=0.005) at final height or latest assessment, indicating that a favourable final height can be achieved.

Journal Article↗
PubMed1994

Flexural behavior of visible light-cured composites as a function of temperature under water immersion test conditions.

OBJECTIVES: The purpose of this study was to investigate the effect of temperature of the flexural behavior for four visible light-cured hybrid composite materials. METHODS: Light-cured samples were post-cured for 24 h at 37 degrees C in 100% relative humidity prior to testing. Flexural tests were performed at the following water immersion temperatures: 5, 15, 25, 37, 45 and 55 degrees C, as well as in the dry condition which served as control. The following flexural property parameters were obtained as a function of test temperature: flexural strength, sigma fs, flexural modulus, Efs, flexural stress at 0.06% total offset strain, 0.06% (yield stress), and the total displacement at fracture, delta fs. Statistically significant differences (p < 0.01) in flexural parameters were noted for all the materials as a function of test temperature. RESULTS: The yield stress, sigma 0.06% was found to be most sensitive to thermomechanical changes. The results of this study indicate significant softening due to temperature under wet immersion test conditions for all materials. The temperature range at which two of the materials show significant reduction in yield stress compare well with "Wet Tg" values obtained by dynamic thermal mechanical analysis (Culbertson et al., 1990; 1991). SIGNIFICANCE: The effect of damage accumulation on surface or subsurface microstructure due to transient thermomechanical loads needs to be taken into account in the correlation of in vitro and in vivo wear or creep behavior.

Absorption↗
PubMed2003

Why does surgery fail to cure limbic epilepsy? Seizure functional anatomy may hold the answer.

Surgery for the mesial temporal lobe epilepsy syndrome is highly effective in controlling seizures in as many as 80% of the patients who undergo this procedure. However, the majority of the patients with successful operations still require medications to control their seizures. Only a small minority are able to stop medications and remain seizure free, patients who would be considered cured. Why are so few patients cured by this procedure? The answer may lie in the relation of the critical seizure circuits to the tissue that is actually resected. In this paper we will discuss two hypotheses for the functional anatomy of limbic epilepsy in light of what is known about the pathology and physiology of limbic epilepsy. Combining the clinical and scientific observations with these constructs for seizure initiation may lead us to a better understanding of this particular epilepsy syndrome as well as to more effective surgical approaches.

Epilepsy↗