[Evaluation of the stabilizing action of the injection of a scleral-reinforcing agent on clinical ocular refraction in progressive myopia].
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Reports from oral surgeons suggested that packing bone defects with cellulose or collagen stimulated cancellous bone replacement. The study reported here was designed to evaluate a similar method for augmenting the remodeling of cancellous bone defects and graft donor sites. Gelatin sponge was implanted into bony defects created in the proximal humeral metaphysis of 5 adult Beagles after collection of cancellous bone. A similar defect created in the contralateral humerus was left unpacked. Four months after creation of the defect, the dogs were euthanatized, and the surgical sites were evaluated by use of correlated microradiographic and histologic examination. Unpacked sites had filled completely with loosely woven trabecular bone. Remodeling had not taken place in sites packed with gelatin sponge. Gelatin sponge did not elicit any reaction in the surrounding bone, but remained in situ and obstructed new bone formation. Gelatin sponge blocked rather than augmented cancellous bone replacement.
The authors studied the reaction of liver, spleen and kidneys in rats to the implantation of Polish made hemostatic gelatin-starch sponge. The sponge under study evoked no disadvantageous tissue reactions in the case of liver; it was readily resorbed and did not inhibit the wound healing. It facilitated the healing of lienal wounds without any suturing and produced neither local nor general disadvantageous results. When dressing renal wounds, the sponge was completely resorbed within 3 weeks and the wound was completely healed. The renal wounds healed without any complications despite of a greater tissue reaction compared with that of liver and spleen.
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This article reviews the history of topical bone hemostatic agents, listing advantages and disadvantages of the more commonly used agents. Gelfoam paste and bone wax were chosen to study the effects that bone hemostatic agents have on the occurrence and severity of postoperative edema and pain. The authors discovered 80% of the patients utilizing bone wax, and 91% of the patients receiving Gelfoam paste, had markedly decreased amounts of immediate postoperative edema. Furthermore, 90% of the patients treated with bone wax, and 75% of the patients treated with Gelfoam paste, reported less postoperative pain than anticipated with the surgical procedure performed.
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A 25 year old woman developed a mixed pilocytic and fibrillary astrocytoma in scar tissue 20 years after the brain contusion. The case fulfilled the criteria of traumatic etiology of this brain tumor.
Resection arthroplasty of the trapezium with either Gelfoam (Upjohn Co., Kalamazoo, Michigan) or tendon interposition was performed in 28 thumbs. Postoperatively, all thumbs were stable and all patients noted diminished pain and improvement in strength. Adduction contracture and metacarpophalangeal joint hyperextension must be corrected at the time of surgery. Interposition arthroplasty of the trapeziometacarpal joint accomplishes the surgical objectives and obviates the need for an implant. Subsequently, the rare complication of silicone synovitis following implant surgery is avoided.
The goal of this study was to evaluate histologically the tissue response to Marbagelan in the middle ears of guinea pigs after implantation. Three months after implantation there was a mass of unabsorbed Marbagelan in the bullae of all experimental animals. A pronounced formation of granulation tissue and obliteration of the middle ear cavity by new bone was observed in cases in which Marbagelan was firmly packed into the middle ear cavity. Small pieces of gelatin sponge filling the middle ear niches were covered with normal middle ear mucosa and separated from the rest of the cavity. Marbagelan is not suitable for implantation in the middle ear of guinea pigs and similar tissue reactions may occur in human middle ear surgery.
The histology and permeability of cats' round window membranes were described following surgical grafting with gelatin foam or fascia. An increase in the thickness of the round window membrane due to fibrosis, neovascularization, and epithelial metaplasia was observed 2 months following grafting with gelatin foam. Grafting with fascia did not increase the thickness of the round window membrane, but did form a thick layer of granulation tissue adjacent to and overlying the window membrane, with occasional adhesions between. The layer of granulation tissue consisted of cuboidal or columnar ciliated epithelial cells, fibrous tissue, lipid, and undigested grafted material. The granulation tissue did not always completely cover the round window membranes.
Three patients with recurrent uterine cancer, unresectable rectal cancer, and recurrent rectal cancer in the pelvis were treated by percutaneous superselective transarterial embolisation (TAE) of the hypogastric artery and it's branches with ethanol or gelatin sponge particles. TAE was performed for the control of life-threatening hemorrhage, severe pain and the diminishing tumor's bulk. In addition to conservative cares, this TAE needed minor surgical procedures such as urinary diversion, colostomy and drainage of abdominal abscess just when urinary bladder's necrosis, rectosigmoidal necrosis and peritonitis would be expected before and after the TAE. One local hematoma in the site inserted catheter and right ischiadic nerve paralysis occurred by TAE. Two patients died on 6 days and 2 months after TAE, respectively, however one patient is still alive one year after the TAE without the growth of tumours. As a result, this TAE with minor surgical procedures is expected as a suitable treatment for the improvement of the survival and quality of life in the patients with unresectable intrapelvic tumors.
Bronchial arteries embolization is a routine treatment of hemophtysis. In patients affected by cystic fibrosis hemophtysis is often very serious, dangerous for their life. The extent of pulmonary lesions, the frequent bilaterality and respiratory dysfunction are contraindications to operation. The authors report their experience on three patients affected by cystic fibrosis with hemophtysis, in which bronchial embolization has been the only therapeutic choice. It performed a good result with immediate stopping of hemophtysis. In all three cases results were not serious relapses, but only rare slight hemophtysis.
A prospective, controlled study on the efficacy of autologous tissue seal in myringoplasty was performed. In 29 patients with dry perforations, temporalis fascia was glued with tissue seal. In 30 patients the fascia was fixed with Gelfoam balls. No significant differences in take-rate was found between these two methods.