To present our experience with pushed monocanalicular nasolacrimal intubation in the management of 90 consecutive cases of nasolacrimal outflow obstruction.
This paper reports a non-randomized study ...of 90 consecutive cases treated with a pushed Monoka intubation system (Masterka™). A metal guide is placed inside a silicone tube rather than being attached at the distal end of the tube, as done with traditional pulled intubations. Three probe lengths are available: 30, 35, and 40 mm.
The silicone stent was pushed into a punctum, canaliculus, and nasolacrimal duct by means of the guide. After passing through the valve of Hasner and reaching the nasal floor, the guide was then delicately withdrawn while remaining oriented along the axis of the lacrimal sac and duct. Throughout this phase, the anchoring plug was held in contact with the punctum. Three study groups were set up chronologically: group 1: endo-DCR procedures done with Masterka insertions under endoscopic observation. Group 2: Masterka insertions done with endoscopic guidance. Group 3: blind Masterka insertions without endoscopic guidance. The patients in groups 2 and 3 were selected on the information obtained by lacrimal probing. Only cases with mucosal nasolacrimal stenoses were included. All patients had surgery under general anesthesia with mechanically assisted ventilation (groups 1 and 2) or spontaneous ventilation (group 3). The anchoring plug was inserted into the punctum and vertical canaliculus, either by pulling on the probe (group 1) or using an inserting instrument.
A total of 90 pushed Monoka intubations were done. Endoscopic examination (groups 1 and 2) demonstrated visually that the pushed intubation method was effective. In none of the 28 cases did the silicone bunch up when the guide was withdrawn. DEGREE OF DIFFICULTY: This was dependent upon proper selection for pushed Monoka intubation; the length of the probe and confirmation that there no false passage was created. The pushed intubation technique was only slightly more difficult than a simple lacrimal probing. The average operating time, excluding the anesthetic procedures, was respectively 5 min (group 2) and 4 min (group 3). COMPLICATIONS DURING SURGERY: There were no anesthetic or general problems observed in the three groups. Epistaxis was also not noted.
Fifteen percent (13/90). The 13 complications noted were: two cases of canaliculitis, one intracanalicular migration, eight probes that disappeared, one keratitis, and one case of involuntary removal by the patient. DELETERIOUS SIDE EFFECTS: Tearing with the probe was in place was noted in 21.1% of the cases (19/90). This tearing disappeared as soon as the probe was removed in 50% of these cases (10/19).
Overall, the success rate (absence of epiphora, absence of mucous discharge) was 90% (81/90) with an average follow-up period of 19 weeks (Range, 1 day to 60 weeks). Two cases were lost to follow-up at day 1 and day 7. Group 1: 90.9% (20/22 cases; average age: 65 years, with an average follow-up period of 24 weeks). Group 2: 100% (6/6 cases; average age: 3.1 years, with an average follow-up period of 14 weeks). Group 3: 88.3% (53/60 cases excluding the two cases that were lost to follow-up; mean age: 2.3 years, with an average follow-up period of 16 weeks).
From a technical perspective, pushed nasolacrimal intubation is much simpler than the traditional pulled types of nasolacrimal intubation. The anesthetic procedure required is the same as that for a late probing procedure, but the functional results are better. The Masterka is an alternative to simple late probing in the treatment of mucosal nasolacrimal stenoses in patients of over 12 months of age.
CuOx loaded mesoporous silicas with highly ordered mesoporous structures (Cu-SBA-15) and different silicon to copper ratios were synthesized by using P123 as a template under mild acidic conditions. ...XRD and N2 sorption results confirm the well-ordered 2D mesoporous structure with a high specific surface area and a large pore volume. The pore diameter of Cu-SBA-15 increases from 7.9 to 8.5 nm with a concomitant decrease of the specific surface area from 865 to 802 m2/g as the amount of Cu in the silica framework is increased. We also show the introduction of Cu in the SBA-15 makes a significant change in the final morphology, which changes from rod to curve shaped morphology when the amount of Cu in the SBA-15 is increased. XRD results confirm the presence of CuO nanoparticles inside the nanochannels of SBA-15. The materials were used as adsorbents for high pressure CO2 adsorption at different temperatures −5, 0, 10 and 25 °C and pressures up to 30 bar. The highest CO2 adsorption of 27.6 mmol/g at −5 °C was achieved for Cu-SBA-15 sample with a nSi/Cu ratio of 5 and was found to be much higher than that of pure SBA-15 silica under similar conditions, illustrating the role of CuOx doping in the SBA-15 framework.
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•CuOx (x = 0 to 1) decorated ordered mesoporous silica SBA-15 prepared via in situ hydrothermal process.•Materials exhibit highly ordered structure and doughnut shaped morphology.•CO2 adsorption isotherms obtained at different analysis temperature window of 268K–298K and pressure up to 30 bar.
The capture of photons by the photosynthetic apparatus is the first step in photosynthesis in all autotrophic higher plants. This light capture is dominated by pigment-containing proteins known as ...light-harvesting complexes (LHCs). The xanthophyll-carotenoid complement of these LHCs (neoxanthin, violaxanthin, and lutein) is highly conserved, with no deletions and few, uncommon additions. We report that neoxanthin, considered an integral component of LHCs, is stoichiometrically replaced by lutein-5,6-epoxide in the parasitic angiosperm Cuscuta reflexa, without compromising the structural integrity of the LHCs. Lutein-5,6-epoxide differs from neoxanthin in that it is involved in a light-driven deepoxidation cycle similar to the deepoxidation of violaxanthin in the xanthophyll cycle, which is implicated in protection against photodamage. The absence of neoxanthin and its replacement by lutein-5,6-epoxide changes our understanding of the structure-function relationship in LHCs, has implications for biosynthetic pathways involving neoxanthin (such as the plant hormone abscisic acid), and identifies one of the early steps associated with the evolution of heterotrophy from autotrophy in plants.
We studied the possibility of placing a new type of monocanalicular nasal intubation under general anesthesia with spontaneous mask ventilation in congenital nasolacrimal duct obstruction.
This was a ...non-randomized study of consecutive cases using a monocanalicular stent called the "pushed Monoka". The benefits of anchoring with meatus fixation are similar to the original Monoka device, but the probe guide or introducer is inside the silicone tube. The external diameter of the "pushed Monoka" is 0.96 mm (versus 0.64 mm in the traditional Monoka). There are three lengths: 30, 35, and 40 mm. General anesthesia was administered by inhalation of a halogen gas using a facial mask. The technique was selected by lacrimal exploration to evaluate the extent of the stenosis (simple or complex). The location and freedom of movement of the stent into the inferior nasal meatus was tested using a second lacrimal probe. Only simple stenosis cases with positive metal-to-metal contact were included in the study. INSERTION TECHNIQUE: The introducer pushes the stent into the lacrimal duct. The introducer should be removed from the silicone sleeve very carefully by gently pulling it out, millimeter by millimeter. This action is carried out while paying careful attention to keeping the stent aligned with the major axis of the lacrimal sac. Throughout this phase, the anchoring plug should remain in contact with the lacrimal punctum. Once the introducer is completely removed, the anchoring plug is secured into the vertical canaliculus. A single-use plug inserter was used.
Fourteen children (18 sides) with congenital nasolacrimal duct obstruction were consecutively included in the study. The pushed intubations were all performed under general anesthesia with spontaneous ventilation. The average age of the children was 26.2 months (range: 14 to 46 months). The average duration of the procedure, measured between the moment that the facial mask was put into place and the child's awakening (crying, restlessness) was 14 minutes (range: 9 to 27 minutes). The most variable parameter was the use of the venous portal. The introduction of the pushed probe itself required an average 7 minutes (range: 3 to 11 minutes). None of the children showed epistaxis. In general terms, no intraoperative or postoperative complications were noted. The "pushed Monoka" tubes were withdrawn during postoperative appointments with a mean intubation duration of 34 days (range: 1 to 59 days). Postoperative success (absence of epiphora, absence of mucous discharge) was achieved in 88% of cases (16/18 sides). The average follow-up was 8.7 weeks (range: 3 to 26 weeks). Complications and side effects were minimal. One stent was withdrawn on day 1 due to a keratitis with respect to the anchoring plug. Three stents were spontaneously lost (16%) between day 2 and day 30. Anterior rhinoscopy found none of the stents in the inferior nasal meatus. These four cases were all considered successful as there was no postoperative epiphora noted.
Pushed nasolacrimal intubation can be safely utilized under general anesthesia with spontaneous mask ventilation. This technique appears to be a simple and safe alternative to late and very late probing in the treatment of membranous congenital nasolacrimal duct obstruction in children older than 12 months.
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•Mineral composition of the bottom part of the peat deposit was studied.•This part of deposit is characterized by a change in the environmental conditions.•Clay minerals of peat ...layers have been inherited from the underlying loam layer.•Geochemistry of peat layer is different from the organo-mineral sediments and loam.•Authigenic sulfides have formed in the reducing conditions of the basal peat.
This paper is devoted to a study of the nature and origin of the mineral matter in the Vasyugan Mire in Western Siberia. Based on mineralogical and geochemical analyses, new results were obtained concerning the mineral composition within the bottom part of the peat deposit for different landscape zones in the Vasyugan Mire. This part of the peat deposit represents a transition sequence from peat through organo-mineral sediments (OMS) to basal loams and is characterized by a gradient change in the physicochemical and environmental conditions with depth. In the same sequence, pH and peat ash yield increase, while moisture decreases. The clay minerals identified in the basal layers of the mire, consisting of loam, OMS and peat, include illite, chlorite, kaolinite and smectite. All these clay minerals found in the OMS and peat layers are believed to have been inherited with little change from the underlying loam layer during the initial transient stage of mire development. That this is indeed the case is strongly suggested by the extraordinary correspondence in the mean content of over 40 trace elements between the OMS and loam layers. In the overlying peat layer, however, some elements, including U, W, Sb, Sn, Mo, Zn, Cd, Nb, Ta, Br and B, are present in higher concentrations than in the OMS and loam. Scanning electron microscope observations suggest that this can be at least partly accounted for by the precipitation of sulfide phases in the strongly reducing and acidic environment of the peat, although whether by inorganic or microbial processes is unknown. The age of the Vasyugan Mire within the Holocene succession is discussed and it is concluded that it developed either during the Atlantic Period (8 ka–6 ka BP) or during the upper part of the Sub-Boreal Period (4 ka BP).
Cosmetic eyelid surgery Ruban, J-M; Barbier, J; Malet, T ...
Journal francais d'ophtalmologie
37, Številka:
1
Journal Article
Recenzirano
Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic ...surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary.
Tetracycline (TC), a commonly used antibiotic for studying bacterial illnesses in living organisms, poses a significant risk to the aquatic environment. Despite various conventional methods having ...been attempted to remove TC antibiotics from water solutions, they have not proven effective. Consequently, the focus of the research is on the photocatalytic degradation of TC. According to the research, MWCNTs were successfully incorporated into NiFe2O4 nanoparticles, which reduced the pace at which charge carriers recombined after joining with MWCNTs. Subsequently, the catalyst's efficacy was assessed in a batch reactor by analyzing the weight percentage change of the nanocomposite, the initial concentration of TC antibiotics, the effects of pH and contact time. The identical operational parameters were employed to investigate the degradation of TC using NiFe2O4 and MWCNTs as individual pure materials. The findings indicated that the photocatalytic process using NiFe2O4/MWCNTs achieved a degradation efficiency of 95.8% for TC at a pH value of 9. This result was obtained after a reaction time of 120 minutes, the concentration of TC solution was 10 mg L−1, with a nanocomposite dose of 0.6 g L−1 of TN 04 and 120 W m−2. The pseudo-first-order approach was used to estimate the rate at which TC degrades. After four consecutive uses, it was observed that the photocatalysts maintained their original properties, with only a slight decrease of approximately 2.4% in the removal efficiency. The study demonstrated that the NiFe2O4/MWCNTs nanocomposite exhibited considerable efficiency in degrading TC. Due to its simple manufacture and useful recovery, it has the potential to function well as a catalyst for the removal and degradation of pharmaceutical organic contaminants.
Environmental sustainability encompasses various problems, including clean air, renewable energy, climate change, safe environments, and the capacity to live in a healthy community. One possible ...strategy for addressing these global problems is the circular bio-economy. Cleaner and lower-carbon environments may be fostered via the production of bioenergy and biomaterials, which can also help to maintain the energy-environment connection. To improve sustainability and the state of the planet, scientists are looking at renewable energy sources like ethanol. Compared to gasoline, ethanol has a reduced carbon footprint and a greater energy density, making it a viable alternative fuel. This study gives an overview of ethanol as a possible alternative fuel for flex-powered power generators in India to meet the goals of the circular bio-economy. This paper details the results of flex-fuel testing conducted on a light-duty power generator using an ethanol-gasoline mix. The findings reveal improved thermal efficiency and lower fuel consumption rates than basic fuel. The emissions of both carbon monoxide and unburned hydrocarbons were shown to be reduced.
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