PURPOSE: Analysis of the femtosecond laser refractive lens surgery corneal incision confi guration and corneal higher-order aberration (HOA) effect from the fi rst postoperative day. METHODS: High-resolution anterior segment optical coherence tomography was used to assess 20 eyes undergoing femtosecond laser refractive lens surgery with 2.2-mm minimal incision. The primary incision (triplanar) actual length, cord length, surface angle, surface irregularity, and regional pachymetry values and the secondary incision (uni-planar) length, angle, surface irregularity, and pachymetry values were analyzed. Hartmann-Shack aberrometer was used to assess corneal HOAs to correlate the effect. Assessment was done preoperatively and 1 month postoperatively. RESULTS: The actual length, cord length, and surface angle means for the primary incision in the fi rst postoperative day and month were 1.50 ± 0.1 and 1.47 ± 0.2 mm (P = .5), 1.41 ± 0.1 and 1.42 ± 0.2 mm (P = .8), and 27° ± 4° and 23° ± 5° (P = .07), respectively. The length and surface angle for the secondary incision in the fi rst postoperative day and month were 1.17 ± 0.01 and 1.04 ± 0.1 mm (P = .05) and 52° ± 3° and 42° ± 5° (P = .007). The regional pachymetry values for the primary and secondary incisions were signifi cantly increased in the fi rst postoperative day and then signifi cantly decreased after 1 month. All irregularities occurred in the posterior surface (endothelium): 2 cases of posterior gap (fi rst day) and 1 case of posterior retraction (fi rst month). The HOAs had not signifi cantly changed preoperatively and after 1 month. CONCLUSIONS: The femtosecond laser refractive lens surgery incision is stable and does not signifi cantly change the HOA.

إن التثبيت الداخلي المحدود لكسور عظمة حق مفصل الحوض قد أصبح طريقة علاجية للكسور الغير منقولة مع تثبيت الكسور باستخدام مسامير من خلال فتحات صغيرة الجلد. هذه الدراسة تصف طريقة علاجية مستحدثة جديدة لكسور عظمة حق مفصل الحوض باستخدام الشق المحدود جار العضلة المستقيمة بجدار البطن لتصليح الكسور المنقولة وتثبيتها داخلياً باستخدام مسامير من خلال فتحات صغيرة الجلد.

إن التثبيت الداخلي المحدود لكسور عظمة حق مفصل الحوض قد أصبح طريقة علاجية للكسور الغير منقولة مع تثبيت الكسور باستخدام مسامير من خلال فتحات صغيرة الجلد. هذه الدراسة تصف طريقة علاجية مستحدثة جديدة لكسور عظمة حق مفصل الحوض باستخدام الشق المحدود جار العضلة المستقيمة بجدار البطن لتصليح الكسور المنقولة وتثبيتها داخلياً باستخدام مسامير من خلال فتحات صغيرة الجلد.

إن التثبيت الداخلي المحدود لكسور عظمة حق مفصل الحوض قد أصبح طريقة علاجية للكسور الغير منقولة مع تثبيت الكسور باستخدام مسامير من خلال فتحات صغيرة الجلد. هذه الدراسة تصف طريقة علاجية مستحدثة جديدة لكسور عظمة حق مفصل الحوض باستخدام الشق المحدود جار العضلة المستقيمة بجدار البطن لتصليح الكسور المنقولة وتثبيتها داخلياً باستخدام مسامير من خلال فتحات صغيرة الجلد.

إن التثبيت الداخلي المحدود لكسور عظمة حق مفصل الحوض قد أصبح طريقة علاجية للكسور الغير منقولة مع تثبيت الكسور باستخدام مسامير من خلال فتحات صغيرة الجلد. هذه الدراسة تصف طريقة علاجية مستحدثة جديدة لكسور عظمة حق مفصل الحوض باستخدام الشق المحدود جار العضلة المستقيمة بجدار البطن لتصليح الكسور المنقولة وتثبيتها داخلياً باستخدام مسامير من خلال فتحات صغيرة الجلد.

Many non-fusion instrumentation techniques were shown to be effective in controlling the progression of spinal deformity in young children, and maintaining the growth potential of the immature spine. Of these, the Vertical Expandable Prosthetic Titanium Rib (VEPTR) has been approved by the FDA in the treatment of Thoracic Insufficincy Syndrome (TIS) in skeletally immature patients. The aim of this presentation is to demonstrate the effect of expansion thoracoplasty and implantation of a VEPTR in three children with progressive spinal deformity despite previous convex- sided hemiepiphysiodesis. Three patients with progressive congenital thoracic scoliosis, who had previously undergone anterior and posterior convex hemiepiphysiodesis of the thoracic spine at the age of 17 to 36 months, were treated with expansion thoracoplasty of the concavity using the VEPTR device at the age of 5 to 9 years. They were evaluated after a minimum of two years in order to assess the effect of the procedure on the spinal deformity, spinal growth, and chest wall expansion. At the latest follow-up, the Cobb angle of the fused segments, the length of the thoracic spine from T1 o T12, and the Space Availabel for the Lungs (SAL) improved in all three patients. Detailed results are listed in the next table. Thoracic spinal height increased from 11.25 to 15.68 cm in patient 1, from 15.40 to 17.15 cm in patient 2, and from 16.35 to 18.25 cm in patient 3. Sagittal Balance improved from +4.5 cm to neurtral in patient 1, and from +6 cm to +1 cm in patient 2, but deteriorated from -0.5 cm to -1.5 cm in patient 3. Expansion Thoracoplasty and VEPTR implantation seem to be effective in rigid congenital scoliosis even after prior convex-sided hemipepiphysiodesis.

Perampanel is a novel drug recently approved as adjunctive therapy in epileptic patients aged 12 years and older who have drug-resistant partial epilepsy with and without secondary generalization. Pharmacological researches revealed that perampanel reduces neuronal excitability by a non-competitive antagonistic activity against the ionotropic alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors causing modulation of glutamatergic neurotransmission. The pharmacological profile of the drug showed complete absorption following oral administration, and extensive metabolism in the liver by oxidation followed by glucuronidation with an elimination half-life of approximately 53–165 h (average: 105 h), allowing once-daily administration. Randomized placebo-controlled trials demonstrated an effective dose range of the drug, between 4 and 12 mg/day, to significantly reduce seizure frequency in patients with partial-onset seizure that are pharmacoresistant with a favorable tolerability profile. The most frequent adverse events of the drug reported in phase III clinical trials were dizziness, somnolence, fatigue, and headache. However, the data raised from the studies can give a hope that perampanel offers a valuable option as an adjuvant therapy for pharmacoresistant partial-onset and secondarily generalized seizures.

Many non-fusion instrumentation techniques were shown to be effective in controlling the progression of spinal deformity in young children, and maintaining the growth potential of the immature spine. Of these, the Vertical Expandable Prosthetic Titanium Rib (VEPTR) has been approved by the FDA in the treatment of Thoracic Insufficincy Syndrome (TIS) in skeletally immature patients. The aim of this presentation is to demonstrate the effect of expansion thoracoplasty and implantation of a VEPTR in three children with progressive spinal deformity despite previous convex- sided hemiepiphysiodesis. Three patients with progressive congenital thoracic scoliosis, who had previously undergone anterior and posterior convex hemiepiphysiodesis of the thoracic spine at the age of 17 to 36 months, were treated with expansion thoracoplasty of the concavity using the VEPTR device at the age of 5 to 9 years. They were evaluated after a minimum of two years in order to assess the effect of the procedure on the spinal deformity, spinal growth, and chest wall expansion. At the latest follow-up, the Cobb angle of the fused segments, the length of the thoracic spine from T1 o T12, and the Space Availabel for the Lungs (SAL) improved in all three patients. Detailed results are listed in the next table. Thoracic spinal height increased from 11.25 to 15.68 cm in patient 1, from 15.40 to 17.15 cm in patient 2, and from 16.35 to 18.25 cm in patient 3. Sagittal Balance improved from +4.5 cm to neurtral in patient 1, and from +6 cm to +1 cm in patient 2, but deteriorated from -0.5 cm to -1.5 cm in patient 3. Expansion Thoracoplasty and VEPTR implantation seem to be effective in rigid congenital scoliosis even after prior convex-sided hemipepiphysiodesis.

Carbon tetrachloride (CCl4) induces testicular damage, through formation of free-radical metabolites. Molecular chaperone heat shock protein of 70kDa (HSP 70) protects cells from various stresses. This study was designed to investigate the potential role of induction of HSP70 using geranylgeranylacetone (GGA) on testicular damage caused by CCl4. Rats were divided into group I (control group), Group II (CCl4 group) received CCl4 s.c. for 4 weeks, group III received CCl4 s.c. for 4 weeks simultaneously with daily single oral dose of GGA (GGA - treated CCl4 group). Serum testosterone, testicular lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), testicular malondialdehyde (MDA), total nitrite and total antioxidant capacity (T-AOC) were measured. Evaluation of histopathological changes and immunohistochemical HSP70 expression for testicular biopsies were performed. Group II showed lower values of gonado-somatic index, serum testosterone, testicular LDH, ALP, T-AOC and greater values of testicular MDA and total nitrite than in control. Testicular morphology showed widening of seminiferous lumen, less spermatogenesis, vacuolization of germinative epithelium. Group III had higher values of gonado-somatic index, serum testosterone, testicular LDH, ALP, T-AOC with less testicular MDA and total nitrite than in group II. They have less damage and restored the altered testicular morphology. Immunohistochemical HSP70 expression was increased in the testicular spermatogenic and sertoli cells in group II that was significantly accentuated in group III. These findings suggest that GGA-induced activation of HSP 70 significantly alleviate CCl4 inflicting testicular damage by HSP 70 mediated cytoprotection and antioxidant effects.