Dacryocystography using cone beam CT in patients with lacrimal drainage system obstruction.

PURPOSE To assess the usefulness of cone beam CT (CBCT) for dacryocystography (DCG) using either direct syringing or passive application of contrast medium. METHODS Ten consecutive patients with epiphora who had CBCT-DCG in a sitting position were retrospectively analyzed. CBCT-DCGs were performed using 2 techniques: direct syringing with contrast medium or using the passive technique, where patients received 3 drops of contrast medium into the conjunctival sac before CBCT-DCG. Clinical and radiologic diagnoses were compared for both groups. RESULTS The 10 patients (men = 3) had a mean age of 63.2 years. Both techniques proved to be simple procedures with good delineation of the bone, soft tissue, and the contrast medium in the lacrimal system. No side effects were noted. CONCLUSIONS CBCT-DCG is a useful alternative to determine the localization of stenosis in patients with chronic epiphora.

Lacrimal excretory system sequelae in patients treated for leishmaniasis

A leishmaniose pode destruir os tecidos nasais resultando em alterações da via lacrimal excretora. OBJETIVO: Avaliar a ocorrência de alterações do sistema lacrimal excretor em portadores de leishmaniose na fase de pós-tratamento. MÉTODOS: Foi realizada a avaliação da via lacrimal excretora em 45 portadores de leishmaniose tratada (90 vias lacrimais) pelo teste de Jones I. Treze pacientes (26 ductos nasolacrimais) tiveram o teste de Jones I alterado, tendo sido submetidos a dacriocistografia e endoscopia nasal. RESULTADOS: A maioria dos indivíduos avaliados apresentava a leishmaniose na forma cutânea (64,4%). Entretanto, 69,23% dos indivíduos com alteração do sistema lacrimal excretor apresentavam a forma mucocutânea antes do tratamento. A alteração mais freqüentemente detectada foi ducto nasolacrimal permeável e dilatado (92,30%). Apenas 3,84% (1/26) das vias lacrimais estavam obstruídas. A endoscopia nasal mostrou hipertrofia de corneto (53,84%), desvio de septo (53,84%) e perfuração do septo nasal (23,07%). CONCLUSÃO: em portadores de leishmaniose tratada encontra-se como seqüela mais freqüente no sistema excretor lacrimal as vias lacrimais permeáveis e dilatadas.

Computed tomographic-dacryocystography (CT-DCG) of the normal canine nasolacrimal drainage system with three-dimensional reconstruction

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Clinical features and management of tumors affecting the lacrimal drainage apparatus

Purpose: To report the clinical features of a series of patients with lacrimal drainage apparatus tumors and present guidelines for management based on histopathology. Methods: A noncomparative retrospective chart review of the clinical, imaging, and pathologic findings of 37 patients presenting to four regional orbital Surgery departments with tumors affecting the lacrimal drainage apparatus between 1990 and 2004. Results: There were 37 patients, of whom 62% were male. The mean age at referral was 54 years. Epiphora, a palpable mass, and dacryocystitis were the most common presentations. Two thirds of the tumors were epithelial. with carcinomas being the most frequent (38%). followed by papillomas (27%). Lymphomas were the most common nonepithelial malignancy (30%). Epithelial tumors were more common in men (87%), whereas lymphomas were more common in women (57%). Treatment modalities included surgery, in addition to radiotherapy and/or chemotherapy and immunotherapy. Mean follow-up was 38 months. Thirty-three patients (89%) remain alive without evidence of disease and 4 patients died of recurrence and/or metastases. Conclusions: Lacrimal drainage apparatus tumors require careful initial management to ensure adequate local and systemic disease control. Atypical mucosa encountered during dacryocystorhinostomy should be biopsied and small papillomas or pedunculated tumors excised and analyzed with frozen sections. If a diffuse or infiltrative mass is encountered, it should be biopsied and managed on the basis of histopathology and extent of disease. Lymphomas should be treated according to protocols. whereas noninvasive carcinoma and extensive papillomas require complete excision of the system. Invasive disease requires en bloc excision. Long-term follow-up is essential for early detection of recurrence.

En bloc excision in malignant tumors of the lacrimal drainage apparatus

Purpose: To describe the surgical technique and results of en bloc excision in a series of patients with extensive malignant tumors of the lacrimal drainage apparatus (LDA). Methods: This was a noncomparative, retrospective chart review of the clinical and pathologic findings of 11 patients presenting with a malignant tumor affecting the LDA who underwent en bloc excision of the lacrimal system. Results: Of the 11 patients, 7 were male. The mean age at presentation was 58 years (range, 39 to 81 years), and all cases were unilateral. Histopathology revealed 4 squamous cell carcinomas, 3 transitional cell carcinomas, 2 mucoepidermoid carcinomas, and 2 melanomas. Epiphora and a mass were the most common presentations. An external lesion could be identified in 4 cases. Irrigation of the lacrimal system revealed nasolacrimal duct obstruction in 2 cases and common canaliculus obstruction in another 2 patients. The entire LDA and surrounding bony tissues were excised through a lateral rhinotomy approach. Adjuvant radiotherapy was given in 4 cases. Nine patients remain alive and well after a mean follow-up of 2 years (range, 6 months to 7 years). Three cases showed distant disease and 2 patients died of metastatic melanoma involvement. Conclusions: The use of en bloc excision as a radical treatment to remove the complete LDA and surrounding bony structures affords good local tumor control and may provide the best opportunity for enhanced patient survival.

Combined external-endonasal approach for complete excision of the lacrimal drainage apparatus

Purpose: The purpose of this study was to describe a new surgical technique for the complete excision of the lacrimal drainage apparatus (LDA) that combines external and endoscopic approaches. Methods: This study involved a noncomparative, retrospective chart review of the clinical and pathological findings of four patients presenting with LDA papillomas who underwent a combined open and endonasal excision of the lacrimal system. Results. Of the four patients, three were male. The mean age at referral was 41 years, and all cases were unilateral. Histopathology revealed two transitional cell papillomas, one squamous cell papilloma, and one combined transitional/squamous papilloma. Epiphora and an external lesion were the main complaints at presentation. Nasolacrimal duct obstruction was present in all four patients. Papilloma virus infection was suggested in two cases and was confirmed in the only patient who had recurrence. CT identified a solid enhancing mass in two cases. The surgical approach in all cases was performed with the patient under general anesthetic supplemented with infiltration of local anesthesia with vasoconstriction. The lacrimal sac was exposed as per an external dacryocystorhinostomy with biopsy collection from the lacrimal sac lumen to confirm the diagnosis prior LDA excision. The superior aspect of the LDA was isolated by using lacrimal probes in each canaliculus to stabilized parallel incisions and careful dissection toward the common canaliculus until they met the medial aspect of the lacrimal sac. The sac was then separated from the periosteum from the medial orbital wall, using sharp dissection. Finally, an endoscopic dissection of the lower end of the nasolacrimal duct released the most inferior aspect of the LDA, allowing the surgeon to pull and excise the complete system from the external wound. Conclusions: Extensive LDA papillomas required complete excision of the drainage system to prevent recurrence and/or malignant transformation. The use of a combined approach through an open excision of the superior part of the LDA in conjunction with the direct manipulation of the nasolacrimal duct guided by the nasal endoscope facilitates the complete excision of the system for extensive benign lesions.

An assessment of the efficiency of three active fish capture methods and a study of roach / bream hybrids on the Crossens drainage system near Southport.

An assessment of three methods of fish capture, to establish the best fishing method which reflects the best range of sizes and species of fish in a given area. The methods used were trawl netting, electrofishing, and seine netting which were assessed on the Crossens drainage system near Southport. The report also includes a study of roach / bream hybrids that were found at the site, which focuses on their distinguishing features and compared with the features of roach and bream.

Updating names, distribution and ecology of riverine fish of Kenya in the Athi-Galana-Sabaki river drainage system

Few studies of the riverine fish of the Athi-Galana-Sabaki river drainage area in Kenya have been carried out since the last comprehensive surveys of the 1950s and early 1960s. This paper presents updated information on scientific and recommended common names, distribution and ecology of selected fish species of this catchment. At least 28 riverine fish families consisting of 46 genera and 62 species occur in the drainage system, of which, 39 species are strictly freshwater (4 introduced) while 23 species are of marine origin. Five unique behavioural categories of the riverine fish of the drainage system are discussed. The four most speciated riverine fish in the system belong to the families Cyprinidae (14 species), Cichlidae (6 species), and Mormyridae and Gobiidae (4 species each). Thirty fish species occur in areas below the River Tsavo-Athi confluence, 18 fish species above the confluence, while 12 fish species occupy the entire drainage system. One cichlid fish, Oreochromis spilurus spilurus (Gunther, 1894), only occurs in the Tsavo river, while the occurrence in the entire system of one snoutfish species, Mormyprops anguilloides (Linnaeus, 1758) is uncertain. The use of information from this study is recommended when carrying out further studies of fish from the Athi-Galana-Sabaki river drainage.

Flood Risk Management In Small Urban River Using A Sustainable Urban Drainage System: Wortley Beck, Leeds, Uk

In the UK, urban river basins are particularly vulnerable to flash floods due to short and intense rainfall. This paper presents potential flood resilience approaches for the highly urbanised Wortley Beck river basin, south west of the Leeds city centre. The reach of Wortley Beck is approximately 6km long with contributing catchment area of 30km2 that drain into the River Aire. Lower Wortley has experienced regular flooding over the last few years from a range of sources, including Wortley Beck and surface and ground water, that affects properties both upstream and downstream of Farnley Lake as well as Wortley Ring Road. This has serious implications for society, the environment and economy activity in the City of Leeds. The first stage of the study involves systematically incorporating Wortley Beck’s land scape features on an Arc-GIS platform to identify existing green features in the region. This process also enables the exploration of potential blue green features: green spaces, green roofs, water retention ponds and swales at appropriate locations and connect them with existing green corridors to maximize their productivity. The next stage is involved in developing a detailed 2D urban flood inundation model for the Wortley Beck region using the CityCat model. CityCat is capable to model the effects of permeable/impermeable ground surfaces and buildings/roofs to generate flood depth and velocity maps at 1m caused by design storm events. The final stage of the study is involved in simulation of range of rainfall and flood event scenarios through CityCat model with different blue green features. Installation of other hard engineering individual property protection measures through water butts and flood walls are also incorporated in the CityCat model. This enables an integrated sustainable flood resilience strategy for this region.

Composition and quantification of the anthropogenic and natural fractions of wastes collected from the stormwater drainage system for discussions about the waste management and people behavior

A study was made of the composition of wastes collected from the pipes of the stormwater drainage system of Sorocaba, SP, Brazil (600 thousand inhabitants). A total of 10 samples weighing at least 100 kg each were sorted into 19 items to determine the fraction that can be considered natural (earth/sand, stones, organic matter, and water, the latter determined after oven-drying the samples) and the anthropogenic fraction (the remaining 15 items, especially construction and demolition wastes and packaging). Soil/sand was found to be the main item collected (52.5 % dry weight), followed by the water soaked into the waste (24.3 %), which meant that all the other wastes were saturated in mud, whose contents varied from 6.4 % (glass) to 87.2 % (metalized plastics packaging). In general, 83 % of the collected wastes can be classified as natural, but the remaining 17 % represent 2,000 kg of the most varied types of wastes discarded improperly every day on the streets of the city. This is an alarming amount of wastes that may clog parts of the drainage systems, causing troubles for all the population (like flooding) and must be strongly considered in municipal solid wastes management and in environmental education programs. © 2013 Springer Science+Business Media Dordrecht.