Major upper limb replantation

Major upper extremity amputations are those at or proximal to the level of the wrist. Between 1995 and 2002, twelve major upper limb replantations were performed for complete amputations at or above the level of the wrist in eleven males and one female. Incomplete amputations or transmetacarpal amputations were not included in this study. Average age of all patients was 25.6 years [range 7 to 40 years]. The average ischemic time was 4.3 hours. One patient died on the third postoperative day because of disseminated intravascular coagulopathy related to massive blood transfusion. One case had failed replantation because of severe infection on the eighth postoperative day. Follow up for successful cases averaged 3.5 years [range 10 months to seven years] after surgery. All patients stated that they benefited from replantation. None wished for a secondary amputation irrespective of the functional outcome. Range of finger motion was excellent in three cases, good in four cases and limited in the remaining cases. In two patients, two point discrimination ranged from 5 to 7 mm, and in four patients, two point discrimination rangedfrom 8 to 13 mm. The remaining four patients only had protective sensations. Pinch and grip strengths averaged 40% of the contralateral hand. Five secondary procedures were required; one free functioning gracilis transfer, one pedicle latissimus transfer, one tendon transfer and two tenolysis. According to Tamai scoring system, the functional outcome was excellent or good in six cases, fair in one, and poor in two cases. The present series demonstrates that major upper limb replantation, when performed in selected patients, yields acceptable functional results

value of ultrasonography and fluorescein fundus angiography in the differential diagnosis of optic nerve head oedema

Fifty six eyes with optic nerve head oedema were studied. Since all cases had clear media, fluorescein fundus angiography and coloured fundus pictures were taken; ultrasonography as well as performed. Cases included pleuro-cephalic oedema, acute anterior ischemic optic neuropathy, acute hypotony due to trauma or uveitis, acute papilHtis and giant drusen. Ultrasonography could only confirm the clinical differential diagnosis in cases with giant drusen while could not differentiate between other cases which gave same pictures. On the other hand, fluorescein fundus angiography differentiated only acute anterior ischaemic optic neuropathy from other lesions

Retinal vascular occlusions [fluorescein angiography study]

Fluorescein angiography can be used very effectively to study a variety of vascular disorders of the eye. Sixty cases with different clinical types of retinal vascular occlusions were investigated by fluorescein fundus angiography, in addition to full ophthalmic examination, in order to evaluate the role of fluorescein angiography in the management and recovery of these cases

Central serious retinopathy in Behcet's disease

A Male patient with long history of Behcet's disease presented by central serous retinopathy and the leaking point was treated by argon laser photocoagulation. Central serous retinopathy can be added to the ocular manifestation of Behcet's disease

Yag laser anterior capsulotomy

Planned extracapslar cataract extraction was done for different types of senile cataract, to study the role of Nd-YAG laser in anterior capsulotomy. As a result of this work is proved that YAG laser is a safe and satisfactory method for anterior capsulotomy