One of the most recent advancements in laser technology is the development of ultrashort pulsed femtosecond lasers (FSLs). FSLs are improving many fields due to their unique extreme precision, low energy and ablation characteristics. In the area of laser medicine, ophthalmic surgeries have seen very promising developments. Some of the most commonly performed surgical operations in the world, including laser-assisted in-situ keratomileusis (LASIK), lens replacement (cataract surgery), and keratoplasty (cornea transplant), now employ FSLs for their unique abilities that lead to improved clinical outcome and patient satisfaction. The application of FSLs in medical therapeutics is a recent development, and although they offer many benefits, FSLs also stimulate nonlinear optical effects (NOEs), many of which were insignificant with previously developed lasers. NOEs can change the laser characteristics during propagation through a medium, which can subsequently introduce unique safety concerns for the surrounding tissues. Traditional approaches for characterizing optical effects, laser performance, safety and efficacy do not properly account for NOEs, and there remains a lack of data that describe NOEs in clinically relevant procedures and tissues. As FSL technology continues to expand towards new applications, FSL induced NOEs need to be better understood in order to ensure safety as FSL medical devices and applications continue to evolve at a rapid pace. In order to improve the understanding of FSL-tissue interactions related to NOEs stimulated during laser beam propagation though corneal tissue, research investigations were conducted to evaluate corneal optical properties and determine how corneal tissue properties including corneal layer, collagen orientation and collagen crosslinking, and laser parameters including pulse energy, repetition rate and numerical aperture affect second and third-harmonic generation (HG) intensity, duration and efficiency. The results of these studies revealed that all laser parameters and tissue properties had a substantial influence on HG. The dynamic relationship between optical breakdown and HG was responsible for many observed changes in HG metrics. The results also demonstrated that the new generation of therapeutic FSLs has the potential to generate hazardous effects if not carefully controlled. Finally, recommendations are made to optimize current and guide future FSL applications.

The aim of this thesis was to find out how much and in what way children are prepared for surgical procedures. For the research were selected children at the Department of Paediatric Surgery of the Kolín Regional Hospital, from February to June 2018. In the theoretical part, risk factors for developing anxiety disorders in childhood are described. In particular, anxiety and nervousness, fear, phobia, situational anxiety and mental resilience are defined. A mixed method was used in the research. The main tool was a written questionnaire. In the case of unclear answers, an oral interview was used. In the practical part, two types of questionnaires were used. One is for hospitalized children aged 7-15 and the other for their parents. The research found that seventeen children, out of seventy, were not informed at all, or immediately before surgery. All these children were restless, or even hysterical, they were screaming and crying. The children who were informed of the operation in some way tolerated it quite well. So we can say that most of the children were prepared. Mostly it was only by conversation with parents. The educational material was not used because there is not currently appropriate one.

INTRODUÇÃO: Embora a craniotomia pterional e suas variantes sejam os acessos mais utilizados em neurocirurgia, poucos estudos analisaram de forma quantitativa a exposição fornecida em cada uma delas. OBJETIVOS: Neste estudo, realizou-se avaliação comparativa das exposições cirúrgicas fornecidas pelas craniotomias pterional (PT), pré-temporal (PreT) e orbitozigomática (OZ) por meio de medidas quantitativas da área de exposição cirúrgica ao redor círculo arterial do cérebro, exposição angular e exposição linear da artéria basilar na fossa interpeduncular e cisterna pré-pontina. MÉTODOS: Oito cadáveres adultos frescos, com tempo máximo de 24 horas após a morte, foram utilizados no estudo. As craniotomias foram realizadas sequencialmente no mesmo cadáver, em um único lado, iniciando-se com a PT, seguido da PreT e terminando com a OZ. Após cada craniotomia, calculou-se a área de exposição cirúrgica, delimitada pelos seguintes pontos: (1) ponto mais lateral da fissura orbitária superior ipsilateral; (2) bifurcação da artéria cerebral média (ACM) ipsilateral; (3) ponto mais distal da artéria cerebral posterior (ACP) ipsilateral; (4) ponto mais distal da ACP contralateral; (5) ponto mais distal da ACM contralateral; (6) ponto mais lateral na asa menor do esfenoide contralateral. Calculou-se ainda, após cada craniotomia, a exposição angular nos eixos horizontal e vertical das seguintes estruturas vasculares: (1) bifurcação da ACM ipsilateral; (2) bifurcação da artéria carótida interna (ACI) ipsilateral; (3) topo da artéria basilar; (4) ponto médio da artéria comunicante anterior; (5) bifurcação da ACI contralateral; (6) ponto mais distal da ACM contralateral. Por fim, após cada craniotomia, mediu-se a exposição linear da artéria basilar na fossa interpeduncular e cisterna pré-pontina. Todas as aferições foram feitas utilizando-se um sistema de neuronavegação computadorizado. RESULTADOS: A OZ apresentou maior exposição cirúrgica em torno do círculo arterial do cérebro (PT = 844,7 ± 233,3 mm2; PreT = 1.134 ± 223,3 mm2; OZ = 1.301,3 ± 215,9 mm2) com aumento de 456,7 mm2 em relação à PT (p < 0,01) e de 167,4 mm2 comparado com a PreT (p < 0,05). A exposição linear da artéria basilar aumentou significativamente com a extensão da craniotomia PT para a PreT e sequencialmente para a OZ. A extensão da PT para PreT e OZ aumentou a exposição angular em todas as medições. Ao compararmos as craniotomias PreT e OZ encontramos um aumento na exposição angular horizontal do topo da artéria basilar (p = 0,02) e bifurcação da artéria carótida interna contralateral (p = 0,048). CONCLUSÕES: A craniotomia OZ oferece vantagens cirúrgicas significativas em relação à PT e PreT, no que diz respeito à área de exposição cirúrgica e exposição linear da artéria basilar. A remoção de parte da margem orbital e do arco zigomático forneceu aumento significativo da exposição angular, proporcionando maior liberdade cirúrgica para acessar estruturas da fossa interpeduncular, cisterna pré-pontina e cisternas subaracnóideas contralaterais. Os dados apresentados no estudo, somados à experiência do cirurgião podem auxiliar na escolha do melhor acesso cirúrgico para cada lesão a ser tratada / INTRODUCTION: Although pterional craniotomy and its variants are the most used approaches in neurosurgery, few studies have analyzed quantitatively the exposure provided by each of them. OBJECTIVES: In this study we compared the surgical exposures provided by pterional (PT), pretemporal (PreT) and orbitozygomatic (OZ) approaches through quantitative measurements of area of surgical exposure around the circle of Willis, angular exposures, and linear exposure of basilar artery in the interpeduncular fossa and prepontine cistern. METHODS: Eight adult fresh cadavers were used within 24 hours after death. The craniotomies were sequentially performed in the same cadaver, first starting with the PT, followed by the PreT, ending up with the OZ. After each craniotomy the area of surgical exposure was calculated, delimited by the following points: (1) lateral aspect of the superior orbital fissure in the ipsilateral sphenoid wing; (2) bifurcation of ipsilateral middle cerebral artery (MCA); (3) most posterior visible point of the ipsilateral posterior cerebral artery (PCA); (4) most posterior visible point of the contralateral PCA; (5) most distal visible point of the contralateral MCA; (6) most lateral visible point of the contralateral lesser sphenoid wing. After each craniotomy, the angular exposure in the horizontal and vertical axes of the following vascular structures was calculated: (1) bifurcation of the ipsilateral MCA; (2) bifurcation of the ipsilateral internal carotid artery (ICA); (3) basilar artery tip; (4) middle point of anterior communicating artery; (5) bifurcation of the contralateral ICA; (6) most distal point of the contralateral MCA. Finally, after each craniotomy, linear exposure of the basilar artery was measured in the interpeduncular fossa and prepontine cistern. All measurements were performed using a computerized neuronavigation system. RESULTS: OZ presented a wider surgical exposure of the circle of Willis (PT = 844.7 ± 233.3 mm2; PreT = 1134 ± 223.3 mm2; OZ = 1301.3 ± 215.9 mm2) with an increase of 456.7 mm2 in relation to the PT (p < 0.01) and of 167.4 mm2 to the PreT (p < 0.05). The linear exposure of the basilar artery significantly increased with the craniotomy extension to the PreT and then to OZ. The extension from PT to PreT and OZ increases angles in all measurements. When comparing the PreT and OZ we found an increase in the horizontal angular exposure to the basilar tip (p = 0.02) and contralateral ICA bifurcation (p = 0.048). CONCLUSIONS: The OZ approach offered significant surgical advantages compared to the traditional PT and PreT regarding to the area of exposure and linear exposure to basilar artery. With regards to the angular exposure, the orbital rim and zygomatic arch removal provided greater surgical freedom to access structures of the interpeduncular fossa, prepontine cistern, and contralateral subarachnoid cisterns. The data presented in the study added to the experience of the surgeon can help in choosing the best individualized surgical approach

INTRODUÇÃO: A tuberculose urogenital é rara, tem diagnóstico tardio e é potencialmente destrutiva ao trato urogenital masculino. A bexiga contraída ocorre nas fases tardias de sua evolução e está associada à alta freqüência de exclusão renal unilateral, refluxo vésico-ureteral, estenose ureteral e insuficiência renal. A ampliação vesical é o tratamento padrão para estes casos. O presente trabalho avalia o seguimento tardio de 25 pacientes com bexiga contraída por tuberculose submetidos à ampliação vesical. CASUÍSTICA E MÉTODOS: Vinte homens e cinco mulheres, com idade mediana de 40 (12 a 60) anos foram estudados. Antes da ampliação, três pacientes estavam em insuficiência renal crônica em programação para transplante renal. Os demais pacientes possuíam exclusão renal funcional unilateral. Em oito casos, a ampliação foi feita com segmento ileocecal não destubulizado, em quatro com sigmóide não destubulizado e em 13 com sigmóide destubulizado. Os pacientes foram submetidos à avaliação clínica, radiológica e urodinâmica pós-operatória. Foi considerado bom resultado, após a ampliação, a presença de intervalo miccional diurno maior que duas horas e a satisfação do paciente avaliada pela pergunta sobre qualidade de vida do questionário \"ICSmaleSF\". RESULTADOS: O seguimento pós-operatório médio foi de 11,1 ± 9,1 (1 a 36) anos com 68% dos pacientes com seguimento maior que cinco anos e 52% maior que 10 anos. Um paciente morreu por um adenocarcinoma na bexiga ampliada após 25 anos de ampliação e seis anos de transplante renal. Após a ampliação, houve manutenção da mesma função renal em todos os pacientes, com exceção de dois casos de evolução para insuficiência renal crônica. Em sete (28%) casos, houve alto resíduo pós miccional com resolução após desobstrução cirúrgica em três casos e autocateterismo nos demais. Bom resultado foi encontrado em 80% dos pacientes operados. O mau resultado foi associado estatisticamente com a utilização do sigmóide não destubulizado (p <= 0,05) e tendeu a se associar com a presença de prostatite por tuberculose (p = 0,09). A comparação dos pacientes de mau com os de bom resultado mostrou que estes apresentaram, ao exame urodinâmico, bexiga ampliada com maior capacidade (p < 0,01), maior complacência (p < 0,01) e sensibilidade normal (p = 0,03). Entretanto, não houve diferença na presença de contrações involuntárias (p = 0,27) entre os dois grupos. Nos pacientes com bom resultado, as contrações iniciaram-se com maior volume de enchimento vesical (p = 0,02). CONCLUSÕES: No seguimento tardio da ampliação da bexiga contraída por tuberculose, 80% dos pacientes atingem intervalo miccional maior que duas horas e a ampliação vesical não contribui para a piora da função renal. O cólon sigmóide deve ser destubulizado, mas o segmento ileocecal pode ser utilizado na sua forma original sem destubulização para a ampliação vesical. O bom resultado com intervalo miccional maior que duas horas necessita de bexiga ampliada com capacidade maior que 250 ml, complacência maior que 20 ml/cm H2O e sensibilidade normal, sem influência da presença de contrações involuntárias. / INTRODUCTION: Urogenital tuberculosis is a rare disease with delayed diagnosis and is potentially destructive for the male urogenital tract. Chronic tuberculous cystitis is a late event in the tuberculosis evolution and is associated with high frequency of unilateral nonfunctioning kidney, ureteral reflux or stenosis and renal failure. Bladder augmentation is the standard treatment in these cases. The present study analyzes the late results of 25 patients with chronic tuberculous cystitis submitted to bladder augmentation. PATIENTS AND METHODS: Twenty men and five women, with median age of 40 (12 to 60) years were evaluated. Prior to augmentation, three patients had chronic renal failure and were in kidney transplantation program. The remaining patients had unilateral nonfunctioning kidney. In eight cases the augmentation was performed with tubularized ileocecal segment, in four with tubularized sigmoid and in 13 with detubularized sigmoid. All patients were submitted to postoperative clinical, radiological and urodynamic evaluation. It was considered a good result the miccional diurnal frequency of more than two hours and the patient?s satisfaction evaluated by the quality of life question from the ICSmaleSF questionnaire. RESULTS: The median follow-up time was 11,1 ± 9,1 (1 a 36) years. In 68% of the patients this time was higher than five years and in 52% higher than ten years. One patient died due to an adenocarcinoma in the augmented bladder 25 years after bladder augmentation and six years after kidney transplantation. After augmentation, all but two patients had the renal function preserved. In seven (28%) cases there was high post-void residue treated by surgery for bladder outlet obstruction in three cases and by intermittent self-catheterisation in the others. Good results were achieved in 80% of the patients. Bad results were statistically associated to augmentation performed with tubularized sigmoid (p <= 0,05) and in patients with prostatitis as a tendency (p = 0,09). The good result patients showed augmented bladder with higher capacity (p < 0,01), higher compliance (p < 0,01) and normal bladder sensation (p = 0,03) in comparison to the bad result patients. However, there was no difference in the frequency of involuntary contractions (p = 0,27) between these two groups. In good result patients the contractions started with higher bladder filling volume (p = 0,02). CONCLUSIONS: At late follow-up of bladder augmentation 80% of the patients with chronic tuberculous cystitis achieve miccional diurnal frequency of more than two hours and the augmented bladder does not contribute to the worsening of the renal function. The sigmoid has to be always detubularized but the ileocecal segment can be used in the tubularized form to augment the bladder. Augmented bladder with capacity of more than 250 ml, compliance of more than 20 ml/cm H2O and normal sensation is necessary to achieve miccional diurnal frequency of more than two hours and there is no interference of the presence of involuntary contractions.

O objetivo deste estudo foi avaliar o prognostico de portadores de insuficiência cardíacadoe diferentes etiologias, incluindo a Doença de Chagas, na década de noventa ern uma unica intituição. Foram avaliados 1 220 pacientes portadores de insuficiência cardíaca encaminhados para avaliação de tratamento cirúrgico, acompanhados por período de 25,6+- 26 meses. As idades variavarn entre 13 e 72 anos (45,5 +- 11 anos); 952 (78%) pacientes eram do sexo masculino e 268 (22%) do feminino.A insuficiência cardíaca foi considerada idiopática em 454 (37,2%) doentes. A etiologia da insuficiência cardiaca foi a Doença de Chagas em 242 (19,8%) pacientes, a isquemia em 121 (17,4%) a hipertensiva em 170 (13,9%) e outras etiologias em 142 (11,7%). O tratamento medicamentoso padrão incluiu os inibidordes da enzimaa conversora da anqiotensma. Depois da análise exploratória Inicial, foi realizada análise de sobrevivência, pelo método de Kaplan Meier para cada variável clínica observada. Em seguida, realizaram-se análises dos riscos proporcionais pelo método de Regressão de Cox univariada e multivariada para avaliar o proqnostico por meio de variáveis clínicas não invasivas por meio de variáveis clínicas não invasivas (modelo não invasivo) e variáveis obtidas do cateterismo cardíaco direito (modelo invasivo). Quatrocentos e vinte e cinco (34,8%) pacientes morreram na evolução 74 (6,1 %) foram submetidos a transplante cardíaco e 28 (2,3%) foram submetidos a outras intervenções cirúrgicas. Com o emprego do modelo não invasivo, foram identificados a etiologia da Doença de Chagas (risco relativo 2,72), o diâmetro diastólico do ventrículo esquerdo (risco relativo 1,13) e a fração de ejeção do ventrículo esquerdo (risco relativo 0,96), como as variáveis mais importantes relacionadas com o prognóstico. Com o emprego do modelo invasivo foram identificados o índice cardíaco (risco relativo 0,40) e a etiologia da Doença de Chagas (risco relativo 9,13) como as variáveis mais importantes relacionadas com o prognóstico. A Doença de Chagas foi identificada nesta casuística como o principal fator prognóstico em pacientes portadores de insuficiência cardíaca sintomática grave encaminhados para avaliação de tratamento cirúrgico / To evaluate clinical determinants of prognosis in a hospital based series of outpatients with severe failure of differente etiologies, including Chagas\' heart disease, we followed up a large series of patients in the nineties in a Instituition. 1220 outpatients referred for treatment of heart failure in a tertiary care university hospital dedicated to cardiology were followed-up for 25.6 +- months. The ages of the patients ranged between 13 and 72 (45.5 +- 11) years, 952 (78%) patients were men and and 268 patients (22%) women. Heart failure was attrubuted to indiopathic dilated cardiomyopathy in 454 (37.2%) patients. Etiologies were Chagas\' heart disease in 242 (19.8%) patients, ischemic heart disease in 212 (17.4%) in hypertensive heart disease in 170 (13.9%) and others in 142 (11.7% ). Therapy included anqiotensin converting enzimy inhibitors titrated to the patients\' needs and standard therapy to heart failure. The probability of survival of the patients was assessed through Kaplan Meier method for each clinical variable. Subsequently, an univariate Cox proportional hazard was fitted and multivariate analysis was performed for evaluating prognosis, through pooled non-invasive clinical variables (invasive model). 425 (34.8%) patients died in the follow-up, 74 (6.1%) patients underwent heart transplantation and 28 (2.3%) underwent other surgical interventions. Through the non-invasive model Chagas\' heart disease etiology (relative risk 2.72), left ventricular injection fraction (relative risk 0.96) were identified as the leading determinants of prognosis. Through the invasive model Chagas heart etiology (relative risk of 9.13) and the cardiac index (relative risk 0.40) identified as the most important determinants of prognosis. Chagas disease etiology of heart failure referred to surgical treatment.

Atualmente, temos a disposição modernas técnicas de mapeamento eletroanatômico gerando imagens tridimensionais da propagação do impulso nas câmaras cardíacas através de catéteres endocavitários. Apesar disso, poucos estudos estão disponíveis a respeito do mapeamento eletrofisiológico epicárdico. A avaliação intraoperatória de contratilidade miocárdica imediatamente após a revascularização miocárdica é visual e Ecocardiográfica, porém este é muito pouco utilizado para este fim. Há, portanto, a necessidade de desenvolvimento de novos métodos capazes de avaliar o impacto funcional da revascularização miocárdica. Objetivo: Avaliar a resposta intra-operatória de contratilidade miocárdica regional mediante o mapeamento epicárdico com eletrodo decapolar. Métodos: 20 pacientes serão submetidos a revascularização miocárdica e será realizado o mapeamento epicárdico com eletrodo decapolar após confecção da anastomose distal com perfusão seletiva para área revascularizada com a aorta pinçada e portanto sem perfusão para as demais artérias coronárias. Nesta análise será avaliado a duração do impulso do eletrograma. Concomitante será realizada fluxometria dos enxertos e comparada com o resultado obtido no mapeamento epicárdico. Resultados: A técnica é uma forma eficaz de avaliar a contratilidade miocárdica regional após a revascularização miocárdica seletiva. O fluxo intravascular dos enxertos estudados não interfere na duração do impulso durante a perfusão seletiva das áreas estudadas / At present, we have available modern tecnics of electroanatomic mapping generating tridimensional images of impulse propagation on heart chambers through intracavitary catheters. Despite this, very few scientific studies are available about epicardial electrophysiologic mapping. Intraoperative evaluation of myocardial contractility right after coronary artery bypass is visual and Echocardiographic, even though this is rarely used to this end. Therefore, there is a need for development of new methods capable of evaluate the functional impact of myocardial revascularization. Objective: Evaluate the intra-operative response of regional myocardial contractility with epicardial mapping with a decapolar catheter. Methods: 20 patients will be submitted to coronary artery bypass graft surgery and epicardial mapping with decapolar catheter was performed after distal anastomosis is made with selective perfusion on the revascularized area with cross clamped aorta, therefore without blood perfusion to the other coronary arteries. On this basis it will be evaluated the duration of the electrogram impulse. It was held the grafts flowmetry and compared to the results obtained on epicardial mapping. Results: The presented tecnic is an effective way to evaluate the regional myocardial contractility after the selective myocardial revascularization. The graft flowmetry doesn\'t interfere with the duration of the impulse obtained during the selective perfusion for the studied areas.

Esse estudo foi realizado de maneira prospectiva e randomizada com o objetivo de comparar duas técnicas de vasectomia. Foram avaliados 644 pacientes. Na técnica sem bisturi foram utilizadas duas pinças específicas. O tempo médio da técnica sem bisturi foi de 20,95 minutos e da convencional 22,95. Infecção de ferida operatória e epididimites foram menores na técnica sem bisturi. Não houve diferença entre as técnicas nas complicações intra-operatórias e pós-operatórias. Dez pacientes apresentaram espermatozóides vivos no espermograma de controle. A técnica sem bisturi apresenta um menor tempo cirúrgico e um menor índice de infecção que a técnica convencional. O índice de falha foi semelhante em ambas as técnicas / This study was carried out with objective of comparison two techiniques of vasectomy. Six hundred and fourteen four patients were assessed. For the no-scalpel technique, two specific clamps were used. The operating time for the no scalpel technique was less than for the conventional technique. There was a smaller percentage of infection of the operative wound and epididymitis in the no scalpel technique. There was no difference between the techniques with respect to complications during the operation and later complications. The no scalpel technique requires less time in surgery and has a lower infection rate than the conventional technique. The failure rate was similar for both techniques

Choi Kup Sze. / "June 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references (p. 122-127). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

As a good and competent surgical simulator, it should provide surgeons with visual, tactile and behavioral illusion of reality. In literature, methods for object deformation range from non-physically based models to physically based models. Early works of non-physically based models focused on pure geometrical models that were originally employed in computer-aided design. These methods could be used to produce vivid deformable effects in computer animation. However, the soft tissue simulation in surgical applications requires more realistic models based on physical properties of human tissues. As a result, the mass-spring model and the finite element model have become the most popular representations for deformable organs in surgical simulation. Our research focuses on the real-time soft tissue deformable model based on the finite element method for surgical application. / Extended from the hybrid condensed finite element model, an interactive hybrid condensed model with hardware acceleration by the graphics processing unit (GPU) is proposed. Two methods are developed in order to map the data onto the GPU in accordance with the application data structure. The performance of the primary calculation task in the solver is enhanced. Furthermore, an improved scheme is presented to conduct the newly applied forces induced by dragging or poking operations in the non-operational region. / In the thesis, new approaches to establish a physically based model for soft tissue deformation and cutting in virtual-reality-based simulators are proposed. A deformable model, called the hybrid condensed finite element model, based on the volumetric finite element method is presented. By this method, three-dimensional organs can be represented as tetrahedral meshes, divided into two regions: the operational region and the non-operational one. Different methods treat the regions with different properties in order to balance the computational time and the level of the simulation realism. The condensation technique is applied to only involve the calculation of the surface nodes in the non-operational region while the fully calculation of the volumetric deformation is processed in the operational part. This model guarantees the smooth simulation of cutting operation with the exact cutting path when users manipulate a virtual scalpel. Moreover, we discuss the relevant aspects on what affect the efficiency of implementing the finite element method, as well as the issues considered for choosing the effective solving method to our problem. Three numerical methods have been examined in our model. / Surgical simulator, which benefits from virtual reality techniques, presents a realistic and feasible approach to train inexperienced surgeons within a safe environment. It plays more and more important role in medical field and also changes the world of surgical training. Especially, the minimally invasive microsurgery, which offers patients various attractive advantages over the traditional surgery, has been widely used in otolaryngology, gastroenterology, gynecology and neurology in the last two decades. / Through the combination of these approaches, a physically based model which allows users to freely perform the soft tissue cutting and detecting, such as poking or dragging operations, with soft tissue deformation is achieved in real-time. / Wu Wen. / "August 2006." / Adviser: Pheng Ann Heng. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1745. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 112-127). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

by Lau Wan Yee, Joseph. / Thesis (M.D.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 145-189). / Title Page --- p.1 / Dedication --- p.2 / Table of Contents --- p.3 / Hypotheses --- p.7 / Precis to the thesis --- p.8 / List of Publications of my research work used in this thesis --- p.19 / List of Figures --- p.25 / List of Tables --- p.26 / Acknowledgments --- p.27 / Statement of Originality --- p.28 / Chapter PART I --- HISTORICAL REVIEW --- p.30 / Chapter Chapter 1 --- History of Endoscopic and Laparoscopic Surgery --- p.31 / Chapter 1.1 --- History of Endoscopic Surgery --- p.31 / Chapter 1.2 --- History of Documentation of Endoscopic and Laparoscopic Surgery --- p.38 / Chapter 1.3 --- History of Laparoscopic Surgery --- p.39 / Chapter 1.4 --- The future of Endoscopic and Laparoscopic Surgery --- p.52 / Chapter Chapter 2 --- History of Perforated Peptic Ulcer --- p.53 / Chapter PART II --- SIZE OF THE PROBLEM --- p.57 / Chapter Chapter 1 --- Incidence of Feptic Ulcer in Different Parts of The World --- p.58 / Chapter Chapter 2 --- Incidence of Peptic Ulcer in Hong Kong 1970 -1993 --- p.60 / Chapter Chapter 3 --- Incidence of Perforated Peptic Ulcer --- p.70 / Chapter 3.1 --- Incidence of Perforated Peptic Ulcer in Different Parts of The World --- p.70 / Chapter 3.2 --- Incidence of Perforated Peptic Ulcer in Hong Kong --- p.71 / Chapter 3.3 --- "Incidence of Perforated Peptic Ulcer in Prince of Wales Hospital, Hong Kong" --- p.71 / Chapter PART III --- CURRENT TREATMENT OF PERFORATED PEPTIC ULCER --- p.74 / Chapter Chapter 1 --- Recent Developments in Treatment of Uncomplicated Peptic Ulcer --- p.75 / Chapter Chapter 2 --- My Contributions to the Medical Treatment of Uncomplicated Peptic Ulcer --- p.78 / Chapter Chapter 3 --- Review on Current Treatment of Perforated Peptic Ulcer --- p.79 / Chapter 3.1 --- Introduction --- p.79 / Chapter 3.2 --- Currently Available Treatment Options --- p.80 / Chapter 3.2.1 --- Perforated Duodenal Ulcer --- p.81 / Chapter [A] --- Nonoperative Treatment --- p.81 / Chapter [B] --- Laparotomy and patch repair --- p.83 / Chapter [C] --- Definitive Ulcer Surgery --- p.84 / Chapter [D] --- Laparoscopic Treatment --- p.87 / Chapter 3.2.2 --- Perforated Gastric Ulcer --- p.89 / Chapter PART IV --- DEVELOPMENT OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER IN OUR CENTRE --- p.91 / Chapter Chapter 1 --- Development of the Technique of Laparoscopic Suture Repair of Perforated Peptic Ulcer --- p.92 / Chapter 1.1 --- Surgical Technique --- p.93 / Chapter 1.2 --- Initial Results of Laparoscopic Suture Repair --- p.95 / Chapter Chapter 2 --- Development of the Technique of Laparoscopic Sutureless Repair of Perforated Peptic Ulcer --- p.98 / Chapter 2.1 --- Animal Studies --- p.98 / Chapter [A] --- Pilot Animal Study --- p.99 / Chapter [B] --- Mortality Rate on Different Methods of Repair of the Perforations --- p.100 / Chapter [C] --- Strength of the Repair Site by Studying the Bursting Pressure --- p.103 / Chapter [D] --- Detailed Histological Study --- p.108 / Chapter 2.2 --- Clinical Studies --- p.111 / Chapter [A] --- Surgical technique of Laparoscopic Sutureless Repair --- p.113 / Chapter [B] --- Initial Results of Laparoscopic Sutureless Repair --- p.114 / Chapter PART V --- TESTING THE HYPOTHESES OF THIS THESIS --- p.117 / Chapter Chapter 1 --- A Non-randomised Clinical Study --- p.119 / Chapter Chapter 2 --- A Randomised Clinical Study --- p.126 / Chapter PART VI --- CONCLUSIONS --- p.140 / Chapter PART VII --- THE FUTURE OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER --- p.142 / Chapter PART VIII --- REFERENCES --- p.145 / References to the Precis --- p.146 / References to Part I Chapter 1 --- p.147 / References to Part I Chapter2 --- p.157 / References to Part II --- p.162 / References to Part III --- p.168 / References to Part IV --- p.183 / References to Part V --- p.186 / References to Part VII --- p.189 / APPENDIX I BRIEF SUMMARY OF MY CONTRIBUTIONS TO THE MEDICAL TREATMENT OF UNCOMPLICATED PEPTIC ULCER --- p.190