BACKGROUND & AIMS: :Although associated with all plants, fungal endophytes (microfungi that live within healthy plant tissues) represent an unknown proportion of fungal diversity. While there is a growing appreciation of their ecological importance and human uses, little is known about their host specificity, geographic structure, or phylogenetic relationships. We surveyed endophytic Ascomycota from healthy photosynthetic tissues of three plant species (Huperzia selago, Picea mariana, and Dryas integrifolia, representing lycophytes, conifers, and angiosperms, respectively) in northern and southern boreal forest (Québec, Canada) and arctic tundra (Nunavut, Canada). Endophytes were recovered from all plant species surveyed, and were present in <1-41% of 2 mm2 tissue segments examined per host species. Sequence data from the nuclear ribosomal internal transcribed spacer region (ITS) were obtained for 280 of 558 isolates. Species-accumulation curves based on ITS genotypes remained non-asymptotic, and bootstrap analyses indicated that a large number of genotypes remain to be found. The majority of genotypes were recovered from only a single host species, and only 6% of genotypes were shared between boreal and arctic communities. Two independent Bayesian analyses and a neighbor-joining bootstrapping analysis of combined data from the nuclear large and small ribosomal subunits (LSUrDNA, SSUrDNA; 2.4 kb) showed that boreal and arctic endophytes represent Dothideomycetes, Sordariomycetes, Chaetothyriomycetidae, Leotiomycetes, and Pezizomycetes. Many well-supported phylotypes contained only endophytes despite exhaustive sampling of available sequences of Ascomycota. Together, these data demonstrate greater than expected diversity of endophytes at high-latitude sites and provide a framework for assessing the evolution of these poorly known but ubiquitous symbionts of living plants.

背景与目标： : 尽管与所有植物相关，但真菌内生菌 (生活在健康植物组织中的微真菌) 代表了未知的真菌多样性比例。尽管人们越来越认识到它们的生态重要性和人类用途，但对它们的宿主特异性，地理结构或系统发育关系知之甚少。我们调查了北部和南部北方森林 (加拿大魁北克) 和北极苔原 (加拿大努纳武特) 中三种植物 (石杉，云杉，马里亚纳云杉和干草) 的健康光合组织中的内生子囊菌。从调查的所有植物物种中回收内生菌，并且存在于每个宿主物种检查的2平方毫米个组织节段的 <1-41% 中。从核核糖体内部转录间隔区 (ITS) 获得280 558分离株的序列数据。基于其基因型的物种积累曲线仍然是非渐近的，并且bootstrap分析表明仍有大量基因型有待发现。大多数基因型仅从单个宿主物种中回收，并且在北方和北极社区之间仅共享6% 基因型。对来自核大核糖体亚基和小核糖体亚基 (LSUrDNA，SSUrDNA; 2.4 kb) 的合并数据进行了两次独立的贝叶斯分析和邻居连接的自举分析，结果表明，北方和北极内生菌代表独生菌，蛇纹菌，Chaetothyriomycetidae，Leotiomycetes和Pezizomycetes。尽管对子囊菌门的可用序列进行了详尽的采样，但许多支持良好的系统型仅包含内生菌。总之，这些数据证明了高纬度地点内生植物的多样性大于预期，并为评估这些鲜为人知但无处不在的生物共生体的进化提供了一个框架。

BACKGROUND & AIMS: :This study aimed to clarify the effectiveness of post-operative oral care, including tooth brushing, denture cleaning and tongue cleaning, after digestive tract surgery. Subjects included 30 elderly patients aged 60-98 years (74.9 +/- 7.8 years) who underwent digestive tract surgery. Subjects were randomly divided into an intervention group and a control group. In the intervention group, the following oral care was provided daily over a 5-min period in the morning starting at baseline (day of surgery) and continued for 5 days: gargling with povidone iodine, tooth brushing, denture cleaning using a special brush and tongue cleaning using a tongue brush. In the control group, the subjects only gargled with povidone iodine. We compared the following variables between the two groups at baseline and 5 days later: the sensation of dry mouth, intra-oral gas concentration, pulmonary sounds, body temperature and bacterial flora. The number of patients with abnormal pulmonary sounds (dry or moist rales) increased from 1 to 2 in the intervention group and from 0 to 4 in the control group (P < 0.05). The average number of bacterial species per subject for the control group was 3.64 +/- 1.34 pre-operatively and 3.50 +/- 1.74 post-operatively, whereas that for the intervention group was 3.08 +/- 0.95 pre-operatively and 2.62 +/- 0.65 post-operatively. In the intervention group, there was a significant decrease in the number of bacterial species (P < 0.05). These findings indicate that post-operative oral care in elderly patients undergoing digestive tract surgery lowers the number of bacterial species found in the oral cavity. This effect, in turn, might improve respiratory function.

背景与目标： : 本研究旨在阐明消化道手术后口腔护理的有效性，包括刷牙，义齿清洁和舌头清洁。受试者包括30名60-98岁 (74.9 +/- 7.8岁) 接受消化道手术的老年患者。受试者随机分为干预组和对照组。在干预组中，从基线 (手术当天) 开始，在早晨的5分钟内每天提供以下口腔护理，并持续5天: 用聚维酮碘漱口，刷牙，使用特殊刷子清洁义齿和使用舌头刷子清洁舌头。在对照组中，受试者仅用聚维酮碘漱液。我们在基线和5天后比较了两组之间的以下变量: 口干感，口内气体浓度，肺音，体温和细菌菌群。肺音异常 (干或湿啰音) 的患者数量在干预组从1增加到2，在对照组从0增加到4 (P <0.05)。对照组每个受试者的平均细菌种类数术前为3.64 +/- 1.34，术后为3.50 +/- 1.74，而干预组的平均细菌种类数术前为3.08 +/- 0.95，术后为2.62 +/- 0.65。干预组细菌种类显著减少 (P <0.05)。这些发现表明，接受消化道手术的老年患者的术后口腔护理降低了口腔中发现的细菌种类的数量。反过来，这种作用可能会改善呼吸功能。

BACKGROUND & AIMS: :Detergent-solubilized plasma membrane protein of either adult bovine or calf lens and high-performance liquid chromatography-purified major intrinsic protein (MIP) of the lens were reconstituted into unilamellar vesicles and planar lipid bilayers. Freeze-fracture studies showed that the density of intramembrane particles in the vesicles was proportional to the protein/lipid ratio. At high ratios, these particles crystallized into tetragonal arrays as does MIP in lens fibers. Channels induced by either purified MIP or detergent-solubilized protein had essentially identical properties. The conductance of multichannel membranes was maximal near 0 mV and decreased to 0.49 +/- 0.08 of the maximum value at voltages greater than 80 mV. The dependence of the conductance on voltage was well fit by a two-state Boltzmann distribution. Voltage steps greater than 30 mV elicited an ohmic current step followed by a slow (seconds) biexponential decrease. The amplitudes and time constants depended on the magnitude but not the sign of the voltage. Steps from 100 mV to voltages less than 30 mV caused the channels to open exponentially with a millisecond time constant. Analysis of latency to first closure after a voltage step gave nearly the same time constants as multichannel kinetics. Single-channel conductance is proportional to salt concentration from 0.1 to 1.0 M in KCl. In 0.1M KCl, the channel had two preferred conductance states with amplitudes of 380 and 160 pS, as well as three additional substates. Multi- and single-channel data suggest that the channel has two kinetically important open states. The channel is slightly anion selective. The properties of the channel do not vary appreciably from pH 7.4 to 5.8 or from pCa 7 to 2. We propose that a channel with these properties could contribute to maintenance of lens transparency and fluid balance.

背景与目标： : 成年牛或小牛晶状体的去污剂溶解的质膜蛋白和高效液相色谱纯化的晶状体的主要内在蛋白 (MIP) 重构为单层囊泡和平面脂质双层。冷冻断裂研究表明，囊泡中膜内颗粒的密度与蛋白质/脂质比率成正比。在高比率下，这些颗粒像透镜纤维中的MIP一样结晶成四方阵列。由纯化的MIP或去污剂溶解的蛋白质诱导的通道具有基本相同的特性。多通道膜的电导在0 mV附近最大，并且在大于80 mV的电压下降至最大值的0.49 +/- 0.08。两态玻尔兹曼分布很好地拟合了电导对电压的依赖性。大于30 mV的电压阶跃引起欧姆电流阶跃，随后缓慢 (秒) 双指数下降。振幅和时间常数取决于幅度，而不取决于电压的符号。从100 mV到电压小于30 mV的阶跃导致通道以毫秒时间常数呈指数打开。对电压阶跃后首次闭合的潜伏期进行分析，得出的时间常数与多通道动力学几乎相同。单通道电导与KCl中0.1至1.0 M的盐浓度成正比。在0.1M KCl中，通道具有两个优选的电导状态，其幅度为380和160 pS，以及三个额外的子状态。多通道和单通道数据表明该通道具有两个在动力学上重要的开放状态。通道具有轻微的阴离子选择性。通道的性质在pH 7.4至5.8或pca7至2之间没有明显变化。我们建议具有这些特性的通道可以有助于维持镜片的透明度和流体平衡。

BACKGROUND & AIMS: BACKGROUND:In early-stage lung cancer, evidence is accumulating for the benefits of lobectomy by video-assisted thoracic surgery (VATS) over open lobectomy. Few thoracic training programs offer sufficient experience in this technically demanding procedure. This article describes the evolution of a new graduate's practice from open thoracotomy to VATS lobectomy. STUDY DESIGN:Our model involves a transition in technique from posterolateral thoracotomy to muscle-sparing thoracotomy and, ultimately, to VATS lobectomy. This approach was evaluated by examining outcomes of open thoracotomy patients before VATS lobectomy and outcomes of the initial 30 VATS patients. Data were collected prospectively. RESULTS:Before undertaking VATS lobectomy, 94 major pulmonary resections were performed by thoracotomy. Mortality was 1.2% for lobectomy and 0% for pneumonectomy. Use of the muscle-sparing thoracotomy increased from 17% of patients in the first half to 70% in the latter half of this group. For the first 30 VATS lobectomy patients, the mean operative time was 168 minutes. Median blood loss was 200 mL. Conversion rate to open thoracotomy was 13.3%. Mortality was 3.3% and morbidity was 26.7%. After short-term followup (mean followup 16 months), overall survival for stage I lung cancer was 96%. CONCLUSIONS:With our approach, new graduates of thoracic surgery programs can safely transition to VATS lobectomy. Gaining experience with the lateral muscle-sparing thoracotomy is an important step in the transition, as it offers similar operative exposure. Longterm disease-free and overall survival data are needed to evaluate our oncologic efficacy with this approach.

背景与目标：

BACKGROUND & AIMS: Visual optics is taking on new clinical significance. Given that current refractive procedures can and do induce large amounts of higher order ocular aberration that often affects the patient's daily visual function and quality of life, we can no longer relegate the considerations of ocular aberrations to academic discussions. Instead, we need to move toward minimizing (not increasing) the eye's aberrations at the same time we are correcting the eye's spherical and cylindrical refractive error. These are exciting times in refractive surgery, which need to be tempered by the fact that after all the research, clinical, and marketing dust settles, the level to which we improve the quality of the retinal image will be guided by the trade-off between cost and the improvement in the quality of life that refractive surgery offers.

背景与目标： 视觉光学具有新的临床意义。鉴于当前的屈光手术可以并且确实会引起大量的高阶眼像差，这些像差通常会影响患者的日常视觉功能和生活质量，因此我们不能再将眼像差的考虑因素置于学术讨论中。相反，我们需要在校正眼睛的球形和圆柱形屈光不正的同时，朝着最小化 (不增加) 眼睛的像差的方向发展。在屈光手术中，这是激动人心的时刻，需要通过以下事实来缓解: 在所有研究，临床和营销尘埃落定之后，我们提高视网膜图像质量的水平将取决于成本与屈光手术提供的生活质量之间的权衡。

BACKGROUND & AIMS: OBJECTIVE:To assess the prevalence of night eating syndrome (NES) and binge eating disorder (BED) and their related behavioral and psychological correlates in persons who sought bariatric surgery. RESEARCH METHODS AND PROCEDURES:A consecutive series of 215 persons with extreme obesity (82% women, 70% European American) completed the Weight and Lifestyle Inventory and a semistructured interview as part of a pre-surgery behavioral/psychological assessment. Diagnoses for NES and BED were based on graded diagnostic criteria. RESULTS:Percentages of participants who met diagnostic criteria for NES by interview were 1.9% for the strictest definition and 8.9% across all definitions of NES. After interview, full DSM-TR criteria for BED were met by 4.2%; an additional 1.4% reported binge eating at least once per week. Self-reported prevalence of NES and BED were higher. Those with NES or BED had significantly more symptoms of depression and a greater history of psychological complications than the remaining sample. DISCUSSION:The prevalence rates of NES and BED among this population of bariatric surgery candidates were lower than expected based on previous reports. Findings and hypotheses regarding lowered prevalence rates are discussed.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The literature reports that the learning curve for laparoscopic Roux-en-Y gastric bypass (LRYGBP) is approximately 75-100 cases. This aim of the present study was to evaluate the safety and feasibility of shortening the learning curve for performing LRYGBP by an experienced laparoscopic surgeon. METHODS:This study analyzed retrospectively the first 100 consecutive LRYGBP cases performed by an experienced laparoscopic surgeon between April 2003 and September 2003. The surgeon performed these cases after first assisting in 30 cases, and the first 4 cases were proctored by an experienced laparoscopic bariatric surgeon. Two cases done after previous gastric stapling and Nissen fundoplication were excluded from the study. Outcome variables included operative time, complications, conversion, and mortality. RESULTS:For the first 100 LRYGBP patients, the mean age was 42.6 years (range, 22-62 years) and mean body mass index (BMI) was 47.6 kg/m2 (range, 36-71.8). The complications included 1 case of intestinal leak, 1 case of small bowel obstruction, 6 cases of gastrojejunal stenosis, 8 cases of wound infection, 1 case of wound seroma, and 2 cases of pulmonary embolism, resulting in 1 mortality. One case was converted to an open technique. Over the second 50 cases, there was a significant reduction in mean operative time, to 73 minutes (range, 39-145 minutes) from 113 minutes (range, 54-238 minutes) (P < .0001). However, despite the reduction in complication frequency (no gastrointestinal leak or obstruction, 2 cases of gastrojejunal stenosis, 2 cases of wound infection, no pulmonary embolism/deep venous thrombosis, and no mortality), there was no significant correlation between the mortality, conversion, and complication rates and the surgeon's experience. CONCLUSION:A bariatric surgical practice incorporating LRYGBP can be safely done by an experienced laparoscopic surgeon. With appropriate advanced laparoscopic skills, preparatory steps, proctorship, and adequate volume of cases, the learning curve for performing LRYGBP can be reduced to 50 cases. Further experience is associated with a significant reduction in operative time with acceptable mortality, complication, and conversion rates.

背景与目标：

BACKGROUND & AIMS: :Professional antigen-presenting cells (APC) are able to process and present exogenous antigen leading to the activation of T cells. Antigen-immunoglobulin (Ig)G complexes (IC) are much more efficiently processed and presented than soluble antigen. Dendritic cells (DC) are known for their ability to take up and process immune complex (IC) via FcgammaR, and they have been shown to play a crucial role in IC-processing onto major histocompatibility complex (MHC) class I as they contain a specialized cross-presenting transport system required for MHC class I antigen-processing. However, the MHC class II-antigen-processing pathway is distinct. Therefore various other professional APC, like macrophages and B cells, all displaying FcgammaR, are thought to present IC-delivered antigen in MHC class II. Nonetheless, the relative contribution of these APC in IC-facilitated antigen-presentation for MHC class II in vivo is not known. Here we show that, in mice, both macrophages and DC, but not B cells, efficiently capture IC. However, only DC, but not macrophages, efficiently activate antigen-specific MHC class II restricted CD4(+) T cells. These results indicate that mainly DC and not other professional APC, despite expressing FcgammaR and MHC class II, contribute significantly to IC-facilitated T cell activation in vivo under steady-state conditions.

背景与目标： : 专业抗原呈递细胞 (APC) 能够处理和呈递导致T细胞活化的外源性抗原。抗原-免疫球蛋白 (Ig)G复合物 (IC) 比可溶性抗原更有效地处理和呈现。树突状细胞 (DC) 以其通过FcgammaR吸收和处理免疫复合物 (IC) 的能力而闻名。并且它们已被证明在IC处理到主要组织相容性复合体 (MHC) I类上起着至关重要的作用，因为它们包含MHC I类抗原处理所需的专门交叉呈递转运系统。然而，MHC II类抗原处理途径是不同的。因此，其他各种专业的APC，如巨噬细胞和b细胞，都显示FcgammaR，被认为在MHC II类中呈现IC递送的抗原。尽管如此，这些APC在体内MHC II类的IC促进抗原呈递中的相对贡献尚不清楚。在这里，我们表明，在小鼠中，巨噬细胞和DC，但不是b细胞，有效地捕获IC。然而，只有DC，但不是巨噬细胞，有效激活抗原特异性MHC II类限制性CD4(+) T细胞。这些结果表明，尽管表达FcgammaR和MHC II类，但主要是DC而不是其他专业APC，在稳态条件下对IC促进的T细胞激活有显着贡献。

BACKGROUND & AIMS: :Fine needle aspiration cytology (FNAC) is an important tool in the investigation of thyroid nodules and has few reported complications. We present the first report of recurrent laryngeal nerve palsy arising as a complication of thyroid nodule FNAC. This complication led to inaccurate diagnosis and unnecessarily radical surgery, with consequent increased morbidity.

背景与目标： : 细针穿刺细胞学检查 (FNAC) 是检查甲状腺结节的重要工具，几乎没有并发症的报道。我们提出了作为甲状腺结节FNAC并发症引起的喉返神经麻痹的第一份报告。这种并发症导致不准确的诊断和不必要的根治性手术，从而增加了发病率。

BACKGROUND & AIMS: PURPOSE:Medication and nutrient administration considerations after bariatric surgery are discussed. SUMMARY:Bariatric surgery is categorized by surgical technique (i.e., restrictive procedure or a combination of restrictive and malabsorptive procedures). Roux-en-Y gastric bypass is the most frequently performed bariatric surgery in the United States. Patients who have undergone this surgery are at risk for nutrient deficiencies. Several factors, such as pH and absorption sites, should be considered when providing these patients with appropriate supplementation. Drug solubility and surface area for absorption are also affected by gastric bypass procedures. By bypassing major portions of the small intestine, Roux-en-Y procedures drastically reduce the surface area for absorption. These changes may warrant manipulation in drug route or dose to ensure adequate delivery. Drugs with long absorptive phases that remain in the intestine for extended periods are likely to exhibit decreased bioavailability in these patients. The reduced size of the stomach after surgery can place patients at risk for adverse events associated with some medications. Medications implicated in such adverse events include nonsteroidal antiinflammatory drugs, salicylates, and oral bisphosphonates. Drugs that are rapidly and primarily absorbed in the stomach or duodenum are likely to exhibit decreased absorption in patients who have had combination restrictive-malabsorptive procedures. Because reduced drug absorption may result in decreased efficacy rather than toxicity, increased patient monitoring for therapeutic effects can help detect potential absorption problems. CONCLUSION:Selection of appropriate nutrient salts can improve nutrient replacement in patients who have undergone bariatric surgery. Changes in dosage forms based on drug characteristics can improve bioavailability.

背景与目标：

BACKGROUND & AIMS: :The practice of duplicate publication has been condemned widely in the scientific community and several studies have been conducted to establish the level of the problem in various surgical fields. A retrospective review of original articles from the British Journal of Plastic Surgery and Plastic and Reconstructive Surgery during 2000 was conducted, using Medline (PubMed). A total of 431 abstracts were screened, from which 27 index articles related to 33 'suspected redundant' publications. Further evaluation was carried out by comparing the full text versions of these articles and assigning a grade of non-dual, dual, potentially dual and 'salami-slicing'. Only four suspect articles were confirmed as having some degree of redundancy, and these related to three index articles (3/431, <1%). The incidence of duplication in plastic surgery literature seems to be much lower compared to other surgical specialties, providing reassurance for reviewers, editors and readers of these journals.

背景与目标： : 重复出版的做法在科学界受到广泛谴责，并且已经进行了几项研究以确定各个外科领域的问题水平。使用Medline (PubMed) 对《英国整形外科杂志》和《整形与重建外科2000年》的原始文章进行了回顾性审查。总共筛选了431篇摘要，其中27篇索引文章与33篇 “可疑冗余” 出版物有关。通过比较这些文章的全文版本并分配非对偶，对偶，潜在对偶和 “萨拉米切片” 等级来进行进一步评估。仅四个可疑文章被确认为具有一定程度的冗余，并且这些与三个索引文章有关 (3/431，<1%)。与其他外科专业相比，整形外科文献中重复的发生率似乎要低得多，这为这些期刊的审阅者，编辑和读者提供了保证。

BACKGROUND & AIMS: We have used 600 MHz 1H NMR spectroscopy data to determine the solution structure of a 31-residue domain of a murine class II major histocompatibility (MHC) protein. This domain, I-Ab(beta)-(60-90), binds to the superantigen staphylococcal enterotoxin A. Distance geometry and dynamical simulated annealing calculations were performed using NOESY- and COSY-deduced constraints. I-Ab(beta)-(60-90), which is mostly alpha-helical, is more similar to the corresponding region of the class II MHC protein HLA-DR1 than to the class I MHC protein HLA-A2. Arg-72 and Arg-80 lie on the same side of the helix and face away from the antigenic peptide binding groove. His-81, implicated in both superantigen and peptide binding, is located midway between the surface defined by Arg-72/Arg-80 and residues that define the inside of the peptide binding groove, allowing for its participation in both types of binding.

背景与目标： 我们使用了600 MHz 1H NMR光谱数据来确定鼠II类主要组织相容性 (MHC) 蛋白的31残基结构域的溶液结构。该结构域I-Ab(beta)-(60-90) 与超抗原葡萄球菌肠毒素A结合。使用NOESY和COSY推导的约束进行距离几何和动态模拟退火计算。I-Ab (β)-(60-90)，其主要是 α-螺旋的，比I类MHC蛋白HLA-DR1的相应区域更类似于I类MHC蛋白HLA-A2。Arg-72和Arg-80位于螺旋的同一侧，并远离抗原肽结合槽。His-81与超抗原和肽结合有关，位于由Arg-72/Arg-80定义的表面和定义肽结合凹槽内部的残基之间的中间，允许其参与两种类型的结合。

BACKGROUND & AIMS: BACKGROUND:Several case reports have raised serious concerns about the safety of shoulder surgery in the beach-chair position, related to global cerebral hypoperfusion. We summarize our experiences with 15,014 cases of shoulder arthroscopy over an 11-year period. Our primary aim was to evaluate the incidence of intraoperative or immediate postoperative neurologic events and secondarily to relate other perioperative complications. METHODS:We searched our online deidentified departmental quality improvement and patient safety database for adverse outcomes associated with arthroscopic shoulder surgery performed in the beach-chair position for the 11-year period between April 2001 and November 2011, as well as our hospital-system database and a statewide database. This was compared with the total number of such cases, available from our department billing database. RESULTS:The total rate of adverse events was 0.37%. Neurologic abnormalities suggestive of acute cerebral ischemia or hemorrhage did not occur in the immediate perioperative period. One new neurologic deficit was reported, secondary to ischemic stroke, which occurred 24 hours after the surgery. The most frequent complications detected were unplanned return to care (0.067%), local anesthetic systemic toxicity (0.053%), and airway compromise requiring unplanned intubation (0.033%). Complications were infrequent and did not vary in incidence over the course of the study. CONCLUSIONS:This retrospective study suggests that intraoperative or immediate postoperative stroke is rare when surgery is conducted in beach-chair position in conjunction with regional anesthesia, propofol sedation, and spontaneous respiration via natural airway.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To determine whether corneal topical application of mitomycin-C (MMC) results in measurable plasma levels of systemic absorption. SETTING:Madigan Army Medical Center, Refractive Surgery Center, Fort Lewis, Washington, and Micro-Constants Laboratory, San Diego, California, USA. DESIGN:Case-control study. METHODS:The study comprised male and female active-duty soldiers having excimer laser photorefractive keratectomy with MMC. Patients who met inclusion criteria were asked to provide a blood sample immediately after being treated with MMC 0.2 mg/mL (0.02%) for 30 seconds. Human plasma samples were evaluated by liquid chromatography mass spectrometry to determine whether MMC was present. RESULTS:Thirty samples were submitted for evaluation. There was zero detection of MMC in the submitted samples. The quantifiable limit was greater than 10.0 ng/mL. All samples were below this. CONCLUSIONS:In this study of 30 patients with topical application of MMC for refractive surgery, there was no measurable evidence of systemic absorption. Although systemic absorption has been found with use in larger quantities, it was not known whether MMC toxicity concerns could be extrapolated to the refractive surgery population. This information allows counseling of patients on the extremely low likelihood of systemic absorption or toxicity following current techniques for refractive surgery. FINANCIAL DISCLOSURE:No author has a financial or proprietary interest in any material or method mentioned.

背景与目标：

BACKGROUND & AIMS: :Twenty patients with strabismus and diplopia following surgery for retinal detachment were treated by botulinum toxin injection of the eye muscles. Twelve patients had regained fusion with elimination of diplopia in the primary position at the time of examination, 5 to 96 months after treatment (mean, 24 months). Three patients had partial diplopia elimination, and five patients continued to have diplopia.

背景与目标： : 通过肉毒杆菌毒素注射眼肌治疗20例视网膜脱离术后斜视和复视患者。12名患者在检查时恢复了融合，并在治疗后5至96个月 (平均24个月) 在主要位置消除了复视。3例患者部分复视消除，5例患者继续复视。