Application of minimally invasive 23G vitrectomy via corneal approach for the treatment of pediatric cataract.

OBJECTIVES: To determine the curative effect and complications of 23G vitrectomy via corneal approach for the treatment of pediatric cataract. MATERIALS AND METHODS: We performed anterior circular capsulotomy, lentectomy and aspiration, posterior circular capsulotomy, and anterior vitrectomy via corneal approach in 40 eyes from 25 children with congenital cataract. In patients aged > 2 years, foldable intraocular lens (IOL) was implanted and frame glasses were prescribed at younger age. The intraoperative/postoperative complications, comfort level, and inflammatory reaction after surgery were observed. RESULTS: No intraoperative complications occurred and 9 eyes were simultaneously implanted IOL. All patients could blink normally except one child who suffered from corneal epithelial abrasion for one day. All corneas were clear and only mild postoperative inflammation was observed. There was no hyphema, effusion, hypotony, and hypertension. A week later, the mild congestion also disappeared. All parents reported good vision of their babies allowing them free play during 3-50 months follow-up. This surgical technique provided a clear 4-6 mm diameter visual axis and circular pupil in all cases. The IOL positions were centered at the pupil area. No secondary cataract developed. CONCLUSIONS: The 23-gauge vitrectomy via corneal approach for the treatment of pediatric cataract involves only mild discomfort and fewer complications.

Influences of pH and hydraulic retention time on anaerobes converting beer processing wastes into hydrogen.

To convert high-solids organic wastes (3% w./w.) to high-value hydrogen, a full factorial experimental design was employed in planning the experiments for learning the effects of pH and hydraulic retention time (HRT) on the hydrogen production in a chemostat reactor using waste yeast obtained from beer processing wastes. For determining which experimental variable settings affect hydrogen production, predictive polynomial quadratic equation and response surface methodology were employed to determine and explain the conditions required for high-value hydrogen production. Experimental results indicate that a maximum hydrogen production rate of 460 mL/gVSS/d was obtained at pH = 5.8 and HRT = 32 hours. Moreover, hydrogenase targeted RT-PCR results indicate that Clostridium thermocellum and Klebsiella pneumoniae predominated.

Pontine myelinolysis following correction of hyponatraemia.

A patient with severe hyponatreamia secondary to chronic renal failure was treated with peritoneal dialysis (PD). On the third day of admission, she developed progressive obtundation. Neurological examination showed bilateral brisk reflexes with intact brain stem reflexes. Magnetic resonance imaging demonstrated patchy demyelination of the pontine area indicating central pontine myelinolysis (CPM). Despite supportive measures, the patient died on the fifteenth day of admission. The rate of correction of hyponatraemia with peritoneal dialysis can be rapid and detrimental to hyponatraemic chronic renal failure patients and careful monitoring of serum sodium level is advocated.

Long-term outcome of the use of OKT3 to treat steroid-resistant acute renal allograft rejection.

OKT3 was used to treat steroid-resistant acute renal allograft rejection in 30 of 496 adult patients transplanted over a 6-year period. Rejection was reversed (defined as a fall in serum creatinine by 50% or more within 30 days of treatment with OKT3) in 40% of cases. Successful reversal was significantly more likely when rejection occurred shortly after transplantation (t ratio -2.53; P = 0.019). The long-term outcome was disappointing; the actuarial graft survival at 1 year from the start of treatment with OKT3 was 42%, and no grafts have thus far survived longer than 3 years. Graft survival was shorter in older patients (coefficient/standard error 2.226; P < 0.05), and no other predictor of long-term outcome was identified. Patient survival at 3 years was 88%. Serious infection occurred in 33% of patients, with two deaths. Our experience suggests that treatment with OKT3 is unlikely to reverse acute renal allograft rejection in more than half of patients where rejection is resistant to steroids. Although long-term graft survival occurred in a few cases, the overall long-term outcome was disappointing, particularly in older patients. Finally, our analysis indicates the difficulty of predicting which patients will derive long-term benefit when OKT3 is used to treat steroid-resistant rejection.

[Potentiation by Rabdosia rubescens on chemotherapy of advanced esophageal carcinoma].

One hundred and fifteen patients with inoperable esophageal carcinoma were treated by either chemotherapy alone or chemotherapy plus Rabdosia rubescens. In group A, out of 31 patients treated with pingyangmycin (P) and nitrocaphane (N), 10 (32.3%) responded to the treatment. Among them, 2 showed partial response (greater than 50% tumor regression) and 8 minimal response (greater than 50% tumor regression). In group B, out of 84 patients treated with PN plus Rabdosia rubescens, 59 (70.2%) responded. Of them, 10 showed complete response (100% tumor regression), 16 partial response and 33 minimal response. the one-year survival rates of group A and B were 13.6% and 41.3%. Statistical significance was present in these two groups both in the response rate and one-year survival rate. As regards the drug toxicity, there was no significant difference between these two groups. Alopecia, anorexia, nausea and hyperpyrexia occurred in more than 30% of patients. Mild leukopenia and thrombocytopenia and interstitial pneumonia were noted in some patients, and two patients died of toxicity in the lungs.