A simplified xeroscope for the noninvasive measurement of tear break-up time

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To develop and validate a noninvasive method for measuring tear break-up time (NIBUT) using readily available materials and comparing it to the standard fluorescein tear break-up time (TBUT) assessment.</p> <p style="text-align: justify;"><strong>METHODS:</strong> A prototype xeroscope was made from an ordinary round plastic lid. At its inner lining, a fluorescent green sticker paper printed with black circular concentric grid pattern was fixed to simulate modified placido rings on the precorneal reflection. A central rectangular cut-out measuring 2 cm x 1 cm was made into the base frame serving as the viewfinder for the device through which the precorneal grid reflection was observed. A 30-LED blue light strip was fixed in the inner rim of the lid using a double-sided adhesive tape and was powered by a multi-voltage AC-DC power adapter set at 6-volts at 350mA (2 watts). The prototype device was tested on fifty (50) patients (100 eyes), aged 21 to 65 years old, with no apparent ocular surface disorders and eyelid abnormalities. Measurement of NIBUT was done on both eyes using the prototype xeroscope followed by fluorescein TBUT measurement. The two values were compared and their correlation determined by linear-regression.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> Fifty (50) patients (100 eyes) were enrolled into the study. The mean age was 48.52 years (range 21 to 62 years). The mean NIBUT for both eyes was 20.10 secs, ranging from 11.56 to 36.17 secs, and the mean TBUT was 18.70 secs, ranging from 10.20 to 30.40 secs. The mean difference between NIBUT and TBUT was 1.40 sec. Regression analysis revealed a strong positive linear correlation between the 2 measurements with a computed R-squared value of 0.9697.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> The noninvasive technique using the prototype device provided a good alternative approach for measuring tear film stability without disturbing normal tear physiology and dynamics at at fraction of the cost of current commercially-available xeroscopes and tearscopes.</p>

Primary Closure of the Bile Duct without a T-tube for Treating Biliary Stone Disease

PURPOSE: The aim of this study is to examine whether conventional primary closure of the bile duct without routinely inserting a T-tube could be performed after all the surgeries used to treat choldocholithiasis. METHODS: From April 2002 to July 2005, we retrospectively analyzed 125 bile duct stone disease patients who underwent primary closure of the bile duct. RESULTS: Wound infection was the most frequent surgical complications, and it showed a higher trend in the patients who had a history of previous biliary operation, and it showed a trend to be slightly higher in the recurrent biliary stone cases than that in the de novo cases. However, these findings were not statistically significant. In addition, surgical complications developed in 16 of 100 patients who were older that 60 years, whereas there was only 1 of 25 patients who developed complications for the patients younger than 60 years. The development of complications has a tendency to be higher for the older patients, yet the level was not statistically significant. In regard to postsurgical hyperamylasemia, although a statistically significant difference could not be detected, this malady developed in 3 of 12 cases in whom endoscopic nasobiliary drainage (ENBD) tubes were inserted. This showed a trend to be higher than that for 13 cases of 113 patients for whom endoscopic nasobiliary drainage tubes were not inserted. Concerning the postsurgical hospitalization period, it was significantly longer in the cases who developed complications (p=0.018), and there was a tendency for a prolonged hospitalization period for the patients who were older than 60 years, for women, recurrent cases and the cases with a history of the bile duct surgery. Yet these had no statistical significance CONCLUSION: It appears that the primary closure of bile duct is a technique that could be performed safely for all choledocolithotomy patients , and this is regardless of the size of bile duct diameter, history of surgery on the bile duct system, gender, emergency operation, age, recurrent biliary stones, the presence of presurgical nasobiliary drainage tube and the presence of concomitant diseases.

Septic Shock Caused by Acinetobacter Baumannii in Postoperative Patient

Acinetobacter baumannii is the most abundunt species of the Acinetobacter genus. The incidence of bacteremia caused by Acinetobacter baumannii among bloodstream infection has been increasing since 1986, when the taxonomy of the genus was first described. The mortality rate of bacteremia due to Acinetobacter baumannii is high, with reported ranging from 17 to 52%. We report a case of septic shock due to Acinetobacter baumannii in a 54-year-old man who underwent subtotal gastrectomy, with Billroth II reconstruction, for stomach cancer.

Suturas manuales y mecanicas en cirugia colonica. Estudio experimental comparativo. / Manual and mechanic sutures in colon surgery. Experimental comparative study

Con el objeto de estudiar los resultados histopatologicos comparativos en cirugia colonica utilizando suturas manuales y mecanicas fueron operados 18 perros. Se evaluaron las caracteristicas macro y microscopicas de ambas suturas, hallandose diferencias significativas en los procesos de necrosis y neoformacion

Correlacion clinica y de los metodos de diagnostico con los hallazgos operatorios en pacientes con presuncion de hipertension biliar. / Correlation of clinics and diagnostic methods with the operative findings in patients with presumptive biliary hypertension

Se seleccionaron 162 pacientes que ingresaron con diagnostico presuntivo de sindrome de hipertension biliar de origen benigno, destacandose la discordancia hallada entre la clinica, el laboratorio y los hallazgos operatorios. Se considera la conveniencia de complementar su estudio con otros procedimientos de diagnostico entre los que merece destacarse la colangiografia retrograda, la colangiografia transparietohepatica y la ecografia

Determinacion temprana del compromiso canalicular de la pancreatitis aguda mediante la utilizacion de la colangiografia transparietohepatica con aguja ultrafina. / Early determination of canalicular involvement of the acute pancreatitis using the percutaneous transhepatic cholangiography

Se presenta una serie de 35 enfermos con diagnostico presuntivo de pancreatitis aguda, a quienes se practico una colangiografia transparietohepatica con el fin de reconocer una probable etiologia litiasica del proceso

Colangiografia intraoperatoria con placa de contacto. / Intraoperative cholangiography with contact plaque

Se analizan las ventajas observadas mediante la aplicacion de la colangiografia de contacto, oclusal o regional; se aconseja su incorporacion como metodo de estudio intraoperatorio del coledoco terminal, fundamentado en la mayor nitidez de sus imagenes y en la exactitud de sus rasgos anatomicos