Intrauterine light probe for photodynamic ablation therapy

BACKGROUND

Endometrial ablation by means of photodynamic therapy is currently being evaluated as an outpatient treatment for dysfunctional uterine bleeding. Photodynamic therapy requires the activation of a photosensitizer by laser light. We describe a new device specifically designed to provide light delivery to the uterus for endometrial photodynamic therapy.

INSTRUMENT

The intrauterine light probe consists of the three flexible optical fibers converging to one bundle resembling the shape of the uterine cavity. Each of the fibers contains a cylindrical light diffuser.

EXPERIENCE

The intrauterine light probe was tested in removed human uteri for its capability to distribute light in a tissue-simulating scattering medium and to deliver sufficient light throughout the endometrium. The light distribution of the intrauterine light probe in the scattering medium is uniform on eight axes tested around the diffusing fibers. The pattern of light distribution in human uteri is similar to that in the medium. At the endomyometrial junction, there is still one third of the light applied to the endometrial surface whereas deeper in the myometrium, the light power drops to less than 10%.

CONCLUSION

We propose a device that will deliver light to the uterine cavity to induce endometrial ablation by means of photodynamic therapy.

[Psychometric evaluation of the Hare Psychopathy Questionnaire in a Belgian prison population]

The PCL-R (Hare, 1991) presents high reliability and validity characteristics. The instrument is the measure of choice for the assessment of psychopathic personality. The PCL-R has never been submitted to psychometric analysis in french speaking european samples. The study examines the psychometric characteristics of the PCL-R on an Belgian prison sample. The study assessed the inter-raters reliability parameters, the Alpha Cronbach coefficient and the PCL-R mean scores. The two correlated factors extracted were compared with those of others European and Nord American samples. The study also described the concomitant validity of the instrument by computing the correlations between the PCL-R scores and the type of offence.

[Angioplasty in the stenosed hemodialysis shunt: experiences with 100 patients and 166 interventions]

PURPOSE

Failing dialysis fistulas are a severe complication for patients treated by chronic haemodialysis. This study was undertaken to evaluate the technical aspects of percutaneous transluminal angioplasty (PTA) of shunts and to report on our experience in 100 patients.

PATIENTS AND METHODS

In a 4-year period a total of 166 PTA procedures was performed in 100 haemodialysis patients with stenosis and occlusion of Brescia Cimino shunts and PTFE grafts (polytetrafluoroethylene). Patency rates were retrospectively evaluated for type and location of lesions, patient age, sex and the success of PTA.

RESULTS

Technical success was achieved in 97% (n = 161). Complications appeared in 11 cases (6.6%). Shunt occlusion or rupture of a vein is rare. The cumulative patency rate for primary PTA treatment was 55% at 6 months, 47% at 12 months and 32% at 24 months and for repeat PTA treatment 87% at 6 months, 80% at 12 months and 70% at 24 months. Residual stenosis and diabetes mellitus significantly reduced the patency rate.

CONCLUSION

PTA is an ideal method for accomplishing recurrent fistula failure due to its cost effectiveness and minimally invasive procedure. Recurrent stenosis has been a major problem of PTA as also in equal measure with surgical intervention.

Case report: acanthosis nigricans in association with primary biliary cirrhosis: resolution after liver transplantation

A case is described of a 58 year old Caucasian male with primary biliary cirrhosis (PBC) who first presented with acanthosis nigricans of both axillae, skin pigmentation, which was pronounced over the posterior surface of the neck, and generalized pruritus. Following orthotopic liver transplantation for progressive liver disease, the skin pigmentation, pruritus and acanthosis nigricans resolved. It is believed that this is the first reported case of acanthosis nigricans occurring in association with PBC, a phenomenon that resolved after liver transplantation.

Coeliac disease in adults. Presentation and management

Coeliac disease, also known as gluten-sensitive enteropathy or non-tropical sprue, is a relatively uncommon condition. The dietary presence of gliadin, an alcohol-soluble subfraction of gluten, in immunologically susceptible hosts will lead to small intestinal mucosal inflammation and subsequent mucosal villous atrophy which results in nutrient and vitamin malabsorption. The symptomatic presentations of patients with coeliac disease are related to this malabsorption process which can be reversed in the vast majority of patients with a gluten-free diet.

[The characteristic interrelationships of the anterior chamber angle in myopia]

Comprehensive ophthalmologic examinations of the anterior chamber angle were carried out in 130 patients (259 eyes) aged 16 to 39 (mean age 22.9 +/- 0.55 years) with myopia of 0.5 to 13.6 diopters. Study of the pattern of gonioscopic signs distribution has shown that the most characteristic factor related to myopia development and progress is the presence of goniodysgenesis signs, namely, expressed development of ligamentum pectinatum iridis, marked anterior position of Schlemm's canal combined with a wide anterior chamber corner, and pigmentation of anterior chamber corner. Analysis of gonioscopic signs, their mutual influences and relationships with other anatomicofunctional parameters will help assess the role of these signs in the development of complicated myopia, prediction of myopia course, and differential diagnosis of its pathogenetic forms.