Short-term outcomes of fetoscopic laser surgery for severe twin-twin transfusion syndrome from Taiwan single center experience: demonstration of learning curve effect on the fetal outcomes.

OBJECTIVE: To evaluate the learning curve effect on fetal outcomes while using fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS) as managed by a newly established single center in Taiwan. MATERIALS AND METHODS: Between October 2005 and October 2010, women diagnosed to have TTTS before 26 weeks of gestation were offered FLP surgery. Cases were divided into first-half and second-half groups to evaluate the learning effect on fetal outcomes including at least one survival rate, two survival rate, and gestational age of delivery. RESULTS: A total of 44 cases with a median gestational age of 20.1 weeks (range 16-25) at operation were included in the study. Overall, both twins survived in 22 (50.0%) cases, whereas only one twin was born alive in 13 (29.5%), and neither was born alive in the remaining nine cases (20.5%). The total survival rate was 64.8%. When comparing the first-half 22 cases and the second-half 22 cases, there were significant improvements in total survival rate (54.7% vs. 75.0%, p = 0.045), a prolonged interval between operation and delivery (62.1 vs. 89.1 days, p = 0.042), and more advanced gestational age of delivery (28.3 vs. 33.0 weeks, p = 0.008) in the second-half 22 cases. CONCLUSIONS: With increasing experience in using fetoscopic guide laser therapy for TTTS, the fetal survival rate could be improved with advanced gestational age at delivery.

Tratamiento de hemangiomas de mucosa oral utilizando láser de diodo en una sola sesión: reporte de dos casos / Treating oral mucous hemangioma with a diode laser in a single sesión: a two-case report

Los hemangiomas de la infancia tienen una incidencia de presentación en cabeza y cuello de un 50% con un porcentaje menor en cavidad oral. Se reportan dos casos de hemangioma en cavidad oral ybase de lengua, tratados con láser de diodo, en una sola sesión con mejoría importante.

50% of Childhood Hemangiomas are likely to appear in the head and neck. The percentage is smaller when it comes to the oral cavity. Two cases of Hemangioma in the oral cavity and the base of the tongue are being reported. These cases have been treated with a Diode laser, in a single session withsignificant improvement.

Reported symptoms and quality-of-life impacts in patients having laser treatment for sight-threatening diabetic retinopathy.

AIMS: To explore the patient experience of symptoms of eye disease related to diabetes and its treatment, including increase of symptoms over time and their relation to severity of the condition and the effect of multiple treatments and symptoms on quality of life. METHODS: A qualitative interview study was implemented at four eye clinics in the UK. This study design was intended to yield 240 interviews in patients having their first laser treatment or first follow-up and in multi-treatment patients with a clinically documented loss of visual function in at least one eye (VA

Topical estrogens combined with argon plasma coagulation in the management of epistaxis in hereditary hemorrhagic telangiectasia.

The aim of this study was to assess the value of topically applied estrogens in patients with hereditary hemorrhagic telangiectasia. Twenty-six patients with this disorder were treated with argon plasma coagulation and randomized into 2 groups: group A, which had postoperative application of estriol ointment (n = 14), and group B, which had postoperative application of dexpanthenol ointment (n = 12). Over a period of 12 months, the frequency and intensity of bleeding, the patient's satisfaction, and the success of the treatment were evaluated with a questionnaire. Before the operation, more than 90% of the patients in both groups complained of daily episodes of epistaxis. Twelve months after treatment, the frequency and intensity of bleeding had significantly decreased in group A as compared to group B. Of the patients in group A, 93% were satisfied with the treatment. Of the patients in group B, only 42% were satisfied with the treatment. In both groups, more than 90% of the patients were willing to undergo the same treatment again. The combined treatment approach with argon plasma coagulation and topical estriol enables us to significantly prolong the hemorrhage-free interval.

Interstitial laser photocoagulation for the treatment of osteoid osteoma.

We report the results of a prospective study of 23 patients in which interstitial laser photocoagulation (ILP) was used to treat an osteoid osteoma. ILP is a technique in which tumour tissue is destroyed by direct heating using low-power laser light energy delivered by thin (400 microm) optical fibres which are introduced percutaneously into the tumour under image guidance. Pain was evaluated before operation and at the latest follow-up using a visual analogue scale with 0 denoting no pain and 10 the worst pain imaginable. The mean follow-up was for 15 months. The results showed that the mean pain score decreased from 7.5 before operation to 0.95 at the latest follow-up. Fourteen patients had no pain and eight had minor discomfort, not requiring analgesia. One patient required a second procedure because placement of the fibre had not been accurate enough and one developed recurrent symptoms eight months after treatment. All patients were satisfied with the operation because of the rapid resolution of pain, the minimally invasive nature of the procedure, and the fact that there was no postoperative restriction of activity.