Objective quantification of the impact of blepharoplasty on the superior visual field.

BACKGROUND: Blepharoplasty has both aesthetic and functional benefits in patients with pseudoptosis; however, previous studies could not demonstrate its beneficial effects quantitatively and objectively. The authors objectively analyzed the visual field before and after surgery and investigated whether measurements of the visual field can be applied as a suitable predictor of surgical outcomes. METHODS: In total, 18 eyelids in nine patients with pseudoptosis who had undergone simple skin excision blepharoplasty were evaluated prospectively from February to May 2016. The visual fields were analyzed preoperatively and 3 months postoperatively using the Goldmann kinetic perimetry test. The visual field test area was assessed using Adobe Photoshop. RESULTS: Blepharoplasty had an average 4.99-fold beneficial effect on the superior visual field. In particular, more improvement was seen in the superior temporal quadrant than in the nasal quadrant. No correlation was found between the preoperative margin-to-reflex distance 1 (MRD1) and the surgical outcome (P=0.119). However, there was a strong correlation between the preoperative superior visual field and the surgical outcome (P=0.001). CONCLUSIONS: Using the Goldmann kinetic perimetry test, we objectively and quantitatively proved the beneficial effect of blepharoplasty on patients with pseudoptosis. Furthermore, we demonstrated that the preoperative visual field is a better preoperative surgical outcome predictive factor than the preoperative MRD1.

Vessel Remodeling after Intima-to-Intima Contact Anastomosis.

BACKGROUND: Intima-to-intima microanastomotic vascular remodeling was explored, utilizing a polylactide-caprolactone absorbable vein coupler model (PAVCM), which was designed to simulate a non-absorbable counterpart system with the sole exception of being absorbable. METHODS: Six New Zealand white rabbits were used. After transection of the jugular vein, 2 PAVCMs were placed, 1 at each transected end. The stumps were slipped through the PAVCMs, and the venous wall was everted 90° to achieve intima-to-intima contact. Reanastomosis of the transected jugular vein was performed bilaterally in 3 rabbits. In the other 3 rabbits, the jugular vein (20 mm) harvested from one side was interpositionally grafted to the jugular vein on the opposite side to ease the anastomotic tension. Patency testing, ultrasonography, and histologic assessments were conducted postoperatively at weeks 2, 4, 12, 16, 22, and 26. RESULTS: All anastomotic sites were patent, without stenosis, occlusion, or dilatation. In the histologic sections, immature endothelial regeneration was observed at week 2, which was completed by week 4. Regeneration of the tunica media was noted at week 12. Between week 22 and week 26, the tunica media fully regenerated and the coupler dissipated entirely. CONCLUSIONS: Despite the absence of a coupler to act as an anastomotic buttress, the structure and function of all the vessels appeared normal, even histologically. These outcomes are true milestones in the development of an absorbable vein coupler.

Sorption and toxicity reduction of pharmaceutically active compounds and endocrine disrupting chemicals in the presence of colloidal humic acid.

This study investigated the toxicity changes and sorption of pharmaceuticals and endocrine disrupters in the presence of humic acid (HA). For the sorption experiment, a dead end filtration (DEF) system was used to separate bound and free-form target compounds. An algae growth inhibition test and E-screen assay were conducted to estimate the toxic effect of pharmaceutically active compounds (PhACs) and endocrine disrupting chemicals (EDCs), respectively. The permeate concentration was confirmed using liquid chromatography-mass spectrometry. In the sorption test, we observed significant sorption of PhACs and EDCs on colloidal HA, except for sulfamethoxazole (SMX). The values of log KCOC derived from DEF determinations ranged from 4.40 to 5.03. The removal efficiency varied with the HA concentration and the target chemical properties. Tetracycline and 4-octylphenol showed the highest sorption or removal efficiency (≈50%), even at 5 mg C/L HA. The algal growth inhibition of PhACs and the estrogenic effects of EDCs were significantly decreased in proportion to HA concentrations, except for SMX. In addition, the chemical analysis results showed a positive relationship with the bioassay results. Consequently, the sorption of PhACs and EDCs onto colloidal HA should be emphasized in natural environments because it significantly reduces bioavailable concentrations and toxicity to aquatic organisms.