ABSTRACT
To determine globe and patient survival in children with retinoblastoma at a major referral center in Iran. Hospital records of 156 eyes of 105 patients with retinoblastoma referred to the Ocular Oncology Center at Rasoul Akram Hospital, Tehran, Iran from 2001 to 2007 were reviewed. Demographic data, family history, presenting symptoms, duration of symptoms, ocular findings and treatment modalities were evaluated. Main outcome measures included patient survival with the event of death, and globe survival with the event of enucleation. Mean age at the time of diagnosis was 28.5 +/- 23.0 [range 3-120] months. Mean follow-up was 30.9 +/- 29.0 [range 3-72] months. Male to female ratio was 47/58. Five patients had positive family history. Involvement was unilateral in 52% and bilateral in 48% of patients. Enucleation was performed as primary treatment in 76 eyes [48.7%] and as secondary treatment for recurrence in 11 eyes [7.1%]. Sixty nine eyes [44.2%] were salvaged by different globe preserving modalities. Kaplan-Meier 5-year survival estimate for globe preservation according to the International Classification of Retinoblastoma [ICRB] was 100% for group A, 93.5% for group B, 86.7% for group C, 57.1% for group D and 0% for group E. Kaplan-Meier estimates for 5-year patient survival was 100% for ICRB groups A and B, 92.3% for group C, 73.3% for group D and 79.9% for group E. Five year patient survival rate was better in ICRB groups A to D than in group E [P=0.004]. Advances in treatment, early diagnosis and prompt referral have improved the prognosis of patients with retinoblastoma in terms of globe and patient survival
ABSTRACT
Despite the tremendous investigation in the areas of flexor tendon anatomy, biomedhanics, nutrition, healing and adhesion formation return of satisfactory digital performance following for the hand surgeons. This is a descriptive cross sectional study which investigates the results of primary repair of acute trauma [less than 10 days] to flexor tendons of zone II. After initial exam, the operation was done by an experienced hand surgeon. The operation was done mostly in first 24 hours [primary repair] and in some cases in 10 days [delayed primary repair]. All FDP lacerations were repaired with 4/0 nylon modified Kessler core suture and 6/0 nylon circumferential running suture. Post operation mobilization was done by using a dorsal splint in 40 degree wrist flexion and 60 degree metacarpophalengeal flexion and interphalengeal extent ion from finger tips to elbow. Early motion was begun one or two days after operation with modified Kleinert regimen, in children who could not cooperate in motion, long cast was used all patens completed follow up every two weeks for 6 weeks and every three weeks for another 6 weeks. The results were evaluated to buck-gramcko classification system at least 3 months after treatment. The results analyze was done using SPSS software and Kruskal-Wallis and man Whitney tests. The study was done on 37 patients with injured flexor tendons,%67 male and%33 female with average age of 26. The results were excellent 22 [%37.3] and good in 21 [%35.6 and fair in%20.3 and bad in 4 [%6.8]. The most common complications were mild to moderate adhesion [%45] and cold intolerance [%36]. Results of tendons repair were better in females than those in males [p value =%0.399]. The best result was repair of isolated FDS. Results of repairing both FDP and FDS were the same as repairing FDP and resecting FDS [P value =%0.0006] final results were better in non dominant had [p value =%0.0025]. The repair of flexor tendons of zone II has various side effects and demands more and more primary repair measures on the part of an experienced surgeon