A Case Report of an Unusual Cause of Dysphagia from Enlarged Subcarinal Lymph Node

Cough, hemoptysis, chest pain, and weight loss are classic symptoms of bronchial carcinoma. Small cell lung cancer presents late with obviously abnormal chest radiographs and with bulky, usually mediastinal lymph node involvement. Dysphagia rarely occurs in patients with bronchial carcinoma. There are many causes of dysphagia in bronchial carcinoma such as mediastinal lymphadenopathy, direct tumor invasion of the mediastinum, radiotherapy, secondary achalasia. This report presents a case of progressive dysphagia to solid foods and weight loss of a 28-year-old male, non-smoker due to subcarinal lymph node enlargement from metastatic bronchial adenocarcinoma.

Ivermectin: A Novel Method of Treatment of Nasal and Nasopharyngeal Myiasis

To evaluate the efficacy of oral Ivermectin, in patients suffering from nasal and nasopharyngeal myiasis. This was a prospective study, comprising 80 patients of nasal and nasopharyngeal myiasis. Patients underwent clinical examination and nasal endoscopy at the time of presentation and findings were recorded. The patients were randomly divided in two groups. In group-I the patients underwent manual extraction of the maggots after instillation of chloroform and turpentine oil mixture, whereas the group-II patients underwent manual extraction with administration of two doses (24 h apart) of oral Ivermectin (6 mg each). The patients were instructed to record the time when they noticed shedding of maggots, and evaluated for the clearance of maggots by endoscopy after 24, 48 h and 7 days after the initial examination. The mean maggot shedding time (by t test) in Group-I was 41.23 ± 4.23 h and in Group-II was 24.60 ± 3.15 h. The difference being highly significant statistically, (p = 0.0001). The endoscopic clearance of maggots (by Chi square test) between the two group of patients was also statistically significant at 24 and 48 h with p value of (p = 0.002) and (p = 0.006) respectively. Oral Ivermectin was effective in treating nasal and nasopharyngeal myiasis, in terms of early clearance, decreased morbidity and less hospital stay. We conclude that oral Ivermectin can be used as a safe and effective method for the treatment of nasal & nasopharyngeal myiasis.

Bimorph material/structure designs for high sensitivity flexible surface acoustic wave temperature sensors

A fundamental challenge for surface acoustic wave (SAW) temperature sensors is the detection of small temperature changes on non-planar, often curved, surfaces. In this work, we present a new design methodology for SAW devices based on flexible substrate and bimorph material/structures, which can maximize the temperature coefficient of frequency (TCF). We performed finite element analysis simulations and obtained theoretical TCF values for SAW sensors made of ZnO thin films (~5 μm thick) coated aluminum (Al) foil and Al plate substrates with thicknesses varied from 1 to 1600 μm. Based on the simulation results, SAW devices with selected Al foil or plate thicknesses were fabricated. The experimentally measured TCF values were in excellent agreements with the simulation results. A normalized wavelength parameter (e.g., the ratio between wavelength and sample thickness, λ/h) was applied to successfully describe changes in the TCF values, and the TCF readings of the ZnO/Al SAW devices showed dramatic increases when the normalized wavelength λ/h was larger than 1. Using this design approach, we obtained the highest reported TCF value of −760 ppm/K for a SAW device made of ZnO thin film coated on Al foils (50 μm thick), thereby enabling low cost temperature sensor applications to be realized on flexible substrates.

Induction chemotherapy with cisplatin and ifosfamide in locally advanced inoperable squamous cell carcinoma of the head and neck: A single-institution experience

BACKGROUND

Induction chemotherapy (ICT) in patients with head and neck cancer has been studied since a long time. The addition of taxanes to the cisplatin and 5-fluorouracil (5FU) (PF) regimen results in superior antitumor activity. We did this study to see the response and toxicity of ICT with cisplatin and ifosfamide followed by concurrent chemoradiotherapy (CRT) in locally advanced, unresectable squamous cell carcinoma of head and neck (SCCHN).

AIMS

The aim of this study was to see the results of ICT using cisplatin and ifosfamide regimen in locally advanced unresectable SCCHN in terms of acute and chronic toxicity and response to treatment.

MATERIALS AND METHODS

Patients with Stage III and IV, nonmetastatic SCCHN were enrolled in the study. They were given two cycles of ICT with cisplatin and ifosfamide followed by CRT.

RESULTS

After ICT, the overall response rate (ORR) was 75.0% at the primary site and 70.0% at the nodal site. ORR for combined primary and nodal disease was observed to be 67.5%. The complete response (CR) and partial response (PR) for combined primary and nodal site were seen in 4 (10.0%) and 23 (57.5%) patients. Of 32 patients who received CRT after ICT, CR was 53.1% and PR was 31.3%. Mucositis, skin reaction, and pharyngeal and laryngeal toxicities were the most common but tolerable.

CONCLUSION

ICT with cisplatin and ifosfamide gives comparable results to the standard paclitaxel, PF regimen. We conclude that this combination regimen for ICT is not only an economical alternative of taxol-based regimen but also well tolerated by the patients.

Masses of nasal cavity, paranasal sinuses and nasopharynx: A clinicopathological study

An analysis of clinicopathological features of 240 cases presenting as mass in nasal cavity, paranasal sinuses and nasopharynx observed, both retrospectively and prospectively, over a period of 5 years in Jawaharlal Nehru Medical College. Aligarh. The incidence of masses in nasal cavity, paranasal sinuses and nasopharynx was 34.3 cases per year. Amongst the 240 cases studied, there were 144 cases (60%) of non-neoplastic lesions, 56 cases (23.33%) of benign lesions and 40 cases (16.67%) of malignant lesions. All age groups were involved and the mean age of presentation with the increasing age were: - non-neoplastic (22.5 years), benign tumors (26.8 years) and malignant tumors (35.3 years). The male to female ratio was 1.7:1 for non-neoplastic lesions; 3:1 for benign tumors: and 2.3:1 for malignant lesions. In this study maximum number of cases were present in nasal cavity (65%) followed by paranasal sinuses (20%) and least number of cases involved the nasopharynx (15%). The relative number of non-neoplastic and neoplastic lesions varies from region to region. A provisional diagnosis was made after clinical assessment and radiological investigation but final diagnosis was made after histopathological examination.

Juvenile onset ankylosing spondylitis with ankylosing tarsitis: a rare combination

Ankylosing spondylitis is the most common whereas ankylosing tarsitis is the least common subgroup of juvenile onset spondyloarthritides. In our recent study a male presented with ankle joint pain and swelling with limited movements and characteristic radiological changes including; periarticular swelling, thickened heel pad, hyperostosis and reduced ankle, calcaneo-cuboid and talo-navicular joint space for ankylosing tarsitis. He also had persistent inflammatory low back pain with radiological sacroilitis satisfying the clinical features for ankylosing spondylitis. The patient was treated with different anti-inflammatory agents including intra-articular methyl-prednisolone with short-term relief. Associated back pain was improved with spine mobilizing exercise.

Cancers of unknown primary site

A patient is considered to have tumour of unknown primary origin when a tumour is detected at one or more metastatic sites and routine evaluation fails to identify a primary tumour. Metastatic carcinoma of unknown primary origin constitutes 3-15% of all cancers and poses a major diagnostic and therapeutic dilemma, because cancer treatment is typically directed at the specific primary tissue type. The regression or dormancy of the primary tumour, the development of early, uncommon systemic metastases and the resistance to therapy are hallmark of this heterogeneous clinical entity. Still no consensus exists on whether cancer of unknown primary site is simply a group of metastatic primaries or a distinct entity with specific genetic and phenotypic characteristics that define it as "primary metastatic disease". In this review we briefly highlight the biologic behaviour and genetic aberrations of unknown primary tumours.

Field Dependence of the Spin Relaxation Within a Film of Iron Oxide Nanocrystals Formed via Electrophoretic Deposition

The thermal relaxation of macrospins in a strongly interacting thin film of spinel-phase iron oxide nanocrystals (NCs) is probed by vibrating sample magnetometry (VSM). Thin films are fabricated by depositing FeO/Fe(3)O(4) core-shell NCs by electrophoretic deposition (EPD), followed by sintering at 400°C. Sintering transforms the core-shell structure to a uniform spinel phase, which effectively increases the magnetic moment per NC. Atomic force microscopy (AFM) confirms a large packing density and a reduced inter-particle separation in comparison with colloidal assemblies. At an applied field of 25 Oe, the superparamagnetic blocking temperature is T(B) (SP) ≈ 348 K, which is much larger than the Néel-Brown approximation of T(B) (SP) ≈ 210 K. The enhanced value of T(B) (SP) is attributed to strong dipole-dipole interactions and local exchange coupling between NCs. The field dependence of the blocking temperature, T(B) (SP)(H), is characterized by a monotonically decreasing function, which is in agreement with recent theoretical models of interacting macrospins.

Osteopoikilosis

Osteopoikilosis is very rare autosomal dominant disorder of unknown etiology which is found incidentally on radiological examination. It is also known as Albers-Schonberg disease or osteopathia condensans disseminata, characterized by the presence of multiple and often symmetrical radio-dense lesion in osseous tissue. Here we report a case of osteopoikilosis in a 30 years old man presented with left hip joint pain and restricted movements. Radiological study showed typical features of osteopoikilosis. Necessary investigations were done to exclude osteoblastic metastasis, tuberous sclerosis and synovial chondromatosis. The patient was treated with pharmacological and non-pharmacological approach with significant improvement of joint pain and movements.

Complex Question Answering: Unsupervised Learning Approaches and Experiments

Complex questions that require inferencing and synthesizing information from multiple documents can be seen as a kind of topic-oriented, informative multi-document summarization where the goal is to produce a single text as a compressed version of a set of documents with a minimum loss of relevant information. In this paper, we experiment with one empirical method and two unsupervised statistical machine learning techniques: K-means and Expectation Maximization (EM), for computing relative importance of the sentences. We compare the results of these approaches. Our experiments show that the empirical approach outperforms the other two techniques and EM performs better than K-means. However, the performance of these approaches depends entirely on the feature set used and the weighting of these features. In order to measure the importance and relevance to the user query we extract different kinds of features (i.e. lexical, lexical semantic, cosine similarity, basic element, tree kernel based syntactic and shallow-semantic) for each of the document sentences. We use a local search technique to learn the weights of the features. To the best of our knowledge, no study has used tree kernel functions to encode syntactic/semantic information for more complex tasks such as computing the relatedness between the query sentences and the document sentences in order to generate query-focused summaries (or answers to complex questions). For each of our methods of generating summaries (i.e. empirical, K-means and EM) we show the effects of syntactic and shallow-semantic features over the bag-of-words (BOW) features.

Clinicopathological study of non-neoplastic lesions of nasal cavity and paranasal sinuses

An analysis of cases presenting as mass in nasal cavity (NC), paranasal sinuses (PNS), and nasopharynx (NP) was done over a period of 7 years in Jawaharlal Nehru Medical College, Aligarh. A provisional diagnosis was made after clinical assessment and radiological investigations, but final diagnosis was made after histopathological examination. The incidence of masses in NC, PNS, and NP was 34.3 cases per year, non-neoplastic lesions constituted 60% of these cases and their incidence was 20.7 cases per year. All the cases were carefully examined histopathologically and it was found that the region was affected by a variety of non-neoplastic lesions. Among 240 cases, 145 were non-neoplastic and 95 were neoplastic The lesions in the decreasing order of frequency were - nasal polyp, rhinoscleroma, tuberculosis, fungal infection, fibrous dysplasia, ossifying fibroma, cysts, nasal glioma, and cemento-ossifying fibroma. NP was involved by a range of neoplastic lesions; however, no non-neoplastic lesion was seen in this region.

Carbon nanotube-nanocrystal heterostructures fabricated by electrophoretic deposition

Alternating layer, carbon nanotubes-nanocrystal composite films, comprising multi-walled carbon nanotubes (MWCNTs) and iron oxide (Fe(3)O(4)) nanocrystals, have been fabricated via electrophoretic deposition (EPD) on stainless steel and gold substrates. Low field-high current and high field-low current EPD schemes were integrated to produce the composite films. The low field-high current EPD approach produced porous mats from an aqueous suspension of the MWCNTs, while the high field-low current EPD approach produced tightly packed nanocrystal films from a dispersion of the nanocrystals in hexane. Large electric fields applied during the nanocrystal EPD and strong van der Waals interactions among the nanocrystals facilitated the formation of tightly packed nanocrystal films atop the MWCNT mats to create CNT mat-nanocrystal film composites. The surface coverage and homogeneity of the nanocrystal films improved with repeated deposition of the nanocrystals on the same mat. The assembly of nanotube mats on top of the CNT mat-nanocrystal film composite confirmed the feasibility of multilayered CNT mat-nanocrystal film heterostructures suitable for a range of devices. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) techniques were employed to characterize the surface coverage, homogeneity, and topology of these composite films.

Staghorn rhinolith in nasopharynx: an unusual case

The present case report is of a young female with complaint of foul smelling nasal discharge normal anterior rhinoscopic findings and an irregular mass on digital palpation of nasopharynx, confirmed by NCCT and extracted through oral route.

28-homobrassinolide protects chickpea (Cicer arietinum) from cadmium toxicity by stimulating antioxidants

In the present experiment the seeds of Cicer arietinum (L.) cv. Uday were inoculated with specific Rhizobium grown in sandy loam soil and were allowed to grow for 15 days. At this stage, the seedlings were supplied with 0, 50, 100 or 150 microM of cadmium in the form of cadmium chloride and sprayed with 0.01 microM of 28-homobrassinolide (HBL) at 30-day stage. The data indicated that plant fresh and dry mass, number of nodules, their fresh and dry mass, leghemoglobin content, nitrogen and carbohydrate content in the nodules, leaf chlorophyll content, nitrate reductase and carbonic anhydrase activities decreased proportionately with the increasing concentrations of cadmium but the content of proline and the activities of catalase, peroxidase and superoxide dismutase increased. The ill effect, generated by cadmium, was overcome if the stressed plants were sprayed with HBL.

Unusual presentations of foreign body in aerodigestive tract

Foreign bodies lodged in aerodigestive tract makes the commonest emergency in the otorhinolaryngology clinics. Diagnosis often becomes difficult with parental ignorance and lack of clear history. Patients with foreign body can have unusual presentations.

Performance and Design Considerations for Dissipative Semi-Active Suspension Systems for Automobiles

Following previous work aimed at determining the relative performances of automobile suspension systems of passive, active and semi-active types by calculation, similar theoretical methods are applied here to evaluate a class of semi-active system that contains a passive spring of fixed stifness in parallel with the active damper. The static attitude control of the vehicle derives from the springs and in the cases considered the spring stiffness is adequate from this point of view. Systems based on two alternative forms of control law are studied. Results which show the best systems to offer particularly good performance for rough road conditions are presented. By adaptation of the damper control law using continuously updated information some capacity to obtain good performance under moderate conditions is shown to exist, but performance comparable with that obtainable from a purpose designed or fully adaptive system on average main road and motorway conditions is not possible.

Effects of cervical traction and exercise therapy in cervical spondylosis

A randomised clinical trial was conducted in the Department of Physical Medicine, Chittagong Medical College Hospital from July, 2001 to June, 2002. The objectives of the study were to find out the effects of cervical traction (CT) and exercise on the patients with chronic cervical spondylosis. A total of 199 patients with cervical spondylosis were included in the clinical trial. One hundred patients were treated with cervical traction plus exercise and 99 patients were treated with non-steroidal anti-inflammatory drug (NSAID). Posture correction advice was given to all patients. The patients were treated for 6 weeks. There was a marked improvement in both the groups after treatment (P<0.001). But there was nearly significant difference regarding improvement in treatment with CT plus exercise than with NSAID (P = 0.06). The results indicate that the improvement of the patients with chronic cervical spondylosis was more in CT plus exercise than analgesics. So, CT & neck muscle strengthening exercise may have some more beneficial effects than NSAIDs on chronic cervical spondylosis.

Anesthesia for intraocular surgery

Surgeons must decide on the type of anesthesia to use when performing cataract surgery. These "viewpoints" articles provide a well-balanced discussion offering the pros and cons of both topical anesthesia and retrobulbar/peribulbar injection. Dr. Dutton gives an overview of both techniques, focusing on relevant orbital anatomy. Drs. Hassan, Edelhauser and Kim, review the various types of topical anesthesia currently in use, and Drs. Spriggs and Broocker examine retrobulbar and peribulbar injections. Both techniques are associated with advantages and risks, so each surgeon must decide which technique is best suited for his or her own practice.

Ultrasonography of the rotator cuff. A comparison of ultrasonographic and arthroscopic findings in one hundred consecutive cases

BACKGROUND

There has been limited acceptance of shoulder ultrasonography by orthopaedic surgeons in the United States. The purpose of this retrospective study was to determine the diagnostic performance of high-resolution ultrasonography compared with arthroscopic examination for the detection and characterization of rotator cuff tears.

METHODS

One hundred consecutive shoulders in ninety-eight patients with shoulder pain who had undergone preoperative ultrasonography and subsequent arthroscopy were identified. The arthroscopic diagnosis was a full-thickness rotator cuff tear in sixty-five shoulders, a partial-thickness tear in fifteen, rotator cuff tendinitis in twelve, frozen shoulder in four, arthrosis of the acromioclavicular joint in two, and a superior labral tear and calcific bursitis in one shoulder each. All ultrasonographic reports were reviewed for the presence or absence of a rotator cuff tear and a biceps tendon rupture or dislocation. All arthroscopic examinations were performed according to a standardized operative procedure. The size and extent of the tear and the status of the biceps tendon were recorded for all shoulders. The findings on ultrasonography and arthroscopy then were compared for each parameter.

RESULTS

Ultrasonography correctly identified all sixty-five full-thickness rotator cuff tears (a sensitivity of 100 percent). There were seventeen true-negative and three false-positive ultrasonograms (a specificity of 85 percent). The overall accuracy was 96 percent. The size of the tear on transverse measurement was correctly predicted in 86 percent of the shoulders with a full-thickness tear. Ultrasonography detected a tear in ten of fifteen shoulders with a partial-thickness tear that was diagnosed on arthroscopy. Five of six dislocations and seven of eleven ruptures of the biceps tendon were identified correctly.

CONCLUSIONS

Ultrasonography was highly accurate for detecting full-thickness rotator cuff tears, characterizing their extent, and visualizing dislocations of the biceps tendon. It was less sensitive for detecting partial-thickness rotator cuff tears and ruptures of the biceps tendon.

Fine needle aspiration cytology(fnac) versus hlstopathology in cervical lymphadenopathy

The present series includes 104 cases (36 males and 68 female) of lymph node swellings in the head and neck region in the mean age group of 30.6 years. The aspiration cytology was carried out as an outpatient department procedure and concomittant biopsy was performed in all the cases of this series. The overall diagnoitic accuracy rale of FNAC in the present histopathologically proved cases was found to be 92.3 percent. In 8 out of 104 cases (7.7 percent), the smears were unsatisfactory and therefore diagnosis could not be made by mere cytological examination.

Complications of pediatric thoracolumbar and lumbar pedicle screws

STUDY DESIGN

This was a retrospective review of 223 consecutive cases (1986-1996) from one institution where 759 thoracolumbar and lumbar pedicle screws were used in the treatment of various pediatric spinal disorders in patients less than 18 years of age.

OBJECTIVES

To determine the incidence of short- and long-term (> 2 years follow-up) complications in this group of patients-specifically, complications related to instrumentation and those directly attributable to pedicle screws in these pediatric patients.

SUMMARY OF BACKGROUND DATA

Although much has been written regarding the use of pedicle screws in the adult population, no published study has examined complication rates with regard to thoracolumbar and lumbar pedicle screws placed for pediatric spinal disorders.

METHODS

A retrospective review of 223 consecutive cases involving 759 pedicle screws placed for a variety of pediatric spinal disorders was performed. Complications were divided into short term and long term (> 2 years follow-up) and into those relating to instrumentation and those relating to pedicle screws specifically.

RESULTS

Short-term complication occurred in 5 patients (2.2%) for a total of 17 screws ultimately removed. Only two of these patients had screws removed for lumbar radicular complaints. No residual sequellae resulted. No long-term (> 2 years postoperative) complications were noted.

CONCLUSION

Low short- and long-term complication rates specific for pediatric pedicle screws suggests that for properly trained spinal surgeons, pedicle screws fixation in the pediatric population can be performed safely to treat a variety of spinal disorders.

Immunopathologic features of Staphylococcus epidermidis-induced endophthalmitis in the rat

PURPOSE

To investigate the clinical, histopathologic and immunologic responses to Staphylococcus epidermidis endophthalmitis in a rat model.

METHODS

Experimental rats received an intravitreal injection of viable S. epidermidis (7000 organisms), while control rats received sterile saline. The clinical scores, cellular infiltrate in vitreous, and levels of serum and vitreous IgM, IgG and IgA to glycerol teichoic acid (GTA), the major antigenic determinant of S. epidermidis cell wall, were all measured from day 1 to day 30 after injection.

RESULTS

The ocular inflammation was largely resolved by day 14. The red reflex was abolished in 50% of rats between days 3 and 10. The bacteria were cleared from the vitreous by day 7. In vitreous, the neutrophils peaked at day 1 and decreased by day 7, and plasma cells were seen between days 1 and 3. Presence of B cells (CD45+/CD3-) was confirmed by flow cytometric analysis of pooled vitreous humor. IgM and IgG but not IgA antibodies to GTA were found in vitreous of injected eyes. The peak of anti-GTA IgM was observed in vitreous of S. epidermidis-infected rats on day 1 and declined by day 7. In contrast to vitreous antibodies, serum anti-GTA IgM antibodies were significantly elevated throughout the course of S. epidermidis endophthalmitis. A weak IgG but no IgA response were observed in serum. Anti-GTA antibodies were also found in low level in normal sera but not in normal vitreous.

CONCLUSIONS

The vitreous antibodies may be involved in neutrophil-mediated opsonophagocytosis leading to 'spontaneous sterility' of the bacteria, and may play a role in the immunopathogenesis of staphylococcal endophthalmitis in the rat.

Maladaptive neural compensatory mechanisms in Bell's palsy-induced blepharospasm

We described four patients with Bell's palsy and blepharospasm and evaluated potential mechanisms that may be responsible for an apparent association between the two disorders. Eyelid movements in spontaneous blinks were studied by the search coil technique in patients with this novel disorder. Kinematic analyses documented bilateral eyelid spasm subsequent to unilateral Bell's palsy. The temporal interval between the onset of palsy and onset of blepharospasm was highly variable (weeks to > 20 years). Changes in the relationship between spontaneous blink peak velocity and amplitude, the main sequence, shared features previously found in uncomplicated Bell's palsy and blepharospasm patients. Furthermore, as in patients with typical Bell's palsy and idiopathic blepharospasm, both normal blinks and spasms were conjugate in spite of interocular differences in blink amplitude/peak velocity. We suggest that there is a correlation between the eyelid palsy and subsequent blepharospasm, and have designated this potentially new disease entity as Bell's palsy-induced blepharospasm. We propose a two-stage model for Bell's palsy-induced blepharospasm in which blink adaptive systems may produce the maladaptive consequence of eyelid spasms.

The role of blink adaptation in the pathophysiology of benign essential blepharospasm

OBJECTIVE

To investigate eyelid movements in patients with benign essential blepharospasm (BEB), with an emphasis on the characterization of the kinematics of normal and spastic blinks, assessment of interocular differences, and further delineation of the role of adaptive blink mechanisms in eyelid movement disorders.

PATIENTS AND METHODS

The electromagnetic search coil technique was used to record the metrics of blinks bilaterally in 5 patients with untreated BEB. Eyelid kinematics and the main-sequence (peak velocity vs amplitude) relationships were analyzed.

RESULTS

Patients with BEB exhibited a decrease in blink amplitude and peak velocity. Moreover, the main-sequence slope was decreased bilaterally. Spasms were bilateral and relatively conjugate. There was no change in the coordination of normal blinking across the 2 eyelids.

CONCLUSIONS

These data demonstrate the operation of the adaptive regulation of blinking in an eyelid movement disorder. The findings suggest that the adaptive regulation of blink is a bilateral event. Blink-adaptive control systems can act on the blink reflex excitability and main-sequence relationships, changing these either together or independently. The hyperexcitable blink reflex of BEB is met by what is believed to be an adaptive decrease in the main-sequence slope that would decrease the strength of debilitating spasms. Collectively, these data extend the knowledge of the pathophysiology of BEB and, perhaps more important, establish the role of blink system plasticity in eyelid movement disorders.

Age-related changes in human blinks. Passive and active changes in eyelid kinematics

PURPOSE

The authors analyzed eyelid kinematics in normal aging subjects to test the hypothesis that eyelid movements exhibit age-related changes and that blink disorders prevalent among the elderly, in turn, represent an outcome of normal aging processes.

METHODS

The electromagnetic search coil technique was used to study blinks in normal human subjects for each decade from 40 to 89 years. Blink metrics (amplitude, peak velocity, and duration), main sequence relationships, and conjugacy were assessed.

RESULTS

Mean amplitude and peak velocity of blinks decreased with age for spontaneous blinks and, to a lesser extent, for voluntary blinks. Some but not all, of this decline could be attributed to a peripheral phenomenon, narrowed palpebral fissure width. The spontaneous blink down phase main sequence slope also declined with age. By contrast, blink rate and the coordination of movements of the two eyelids--blink conjugacy--exhibited no change.

CONCLUSIONS

These data demonstrate that disorders of blink systems typically seen in persons 50 years of age or older occur on a background of normal age-dependent changes in eyelid kinematics. Alterations in main sequence slope imply the operation of central adaptive systems during aging. Reduction in main sequence slope is interpreted as a reduction in aggregate orbicularis oculi motoneuron activity. Such a central neurologic adjustment in the motor output of blink systems may serve to compensate for an age-related increase in blink reflex excitability. Compensatory reduction in the main sequence relationship may offset a potentially hyperexcitable blink reflex, thereby reducing the likelihood of disorders such as blepharospasm. The authors conclude that although there are changes in the kinematics of blinking with age, such changes do not necessarily predispose an aging population to eyelid motility disorders.

Immunopathologic features of Staphylococcus aureus endophthalmitis in the rat

PURPOSE

To study the clinical, histopathologic, and immunologic responses to Staphylococcus aureus endophthalmitis in rats.

METHODS

Experimental Lewis rats received an intravitreal injection of viable S. aureus (65 organisms), and control rats received sterile saline. The clinical scores, cellular infiltrate, delayed hypersensitivity reaction in skin tests, and serum and vitreous enzyme-linked immunosorbent assay titers of immunoglobulin (Ig) M, IgG, and IgA to ribitol teichoic acid (RTA), the major antigenic determinant of S. aureus cell wall, were measured and compared on days 3, 7, 10, 14, 21, and 30. The differences were statistically assessed using Mann-Whitney nonparametric t-tests and analysis of variance.

RESULTS

The red reflex was abolished in the majority of rats between days 3 and 21. Ocular inflammation resolved by day 30. The vitreous of eyes injected with S. aureus showed bacterial growth on days 3 and 7, followed by a decrease in numbers on days 10 and 14 and disappearance on days 21 and 30. In the vitreous, a peak neutrophil count was observed at day 3 that rapidly declined by day 7. The number of lymphocytes and plasma cells peaked on day 3 but declined more slowly. Plasma cells and Mott cells were seen on days 10 and 14, suggesting intraocular antibody production. IgM titers to RTA increased progressively in serum and vitreous, reached a peak on day 21, and declined on day 30. A weak IgG but absent IgA response to RTA was observed in serum and vitreous. S. aureus endophthalmitis was not associated with delayed hypersensitivity to the bacteria in skin tests.

CONCLUSIONS

S. aureus endophthalmitis is associated with the infiltration of neutrophils, lymphocytes, monocytes, and plasma cells in vitreous. Neutrophils, the predominant infiltrating cells, may be involved in bactericidal activity and opsonophagocytosis. In rat staphylococcal endophthalmitis, IgM rather than IgG may be the protective antibody.

Audiometric changes following spinal anaesthesia

A prospective study on audiometric changes following spinal anaesthesia with different gauge spinal needles was carried out in 125 patients; the patients were randomly divided into five groups according to gauge of needles used i.e., 20, 22, 23, 24 and 25 with twenty five patients in each group. Twelve percent and 8% decrease in audiometric values were recorded on first postoperative day at 250-500 Hz frequencies with 20 and 22 gauge needles respectively and these changes were highly significant (P < 0.001); these audiometric alterations returned to within normal limits by the 5th postoperative day. Eight percent decrease in audiometric values were observed on first postoperative day at 250-500 Hz frequencies with 23 gauge needle which was also statistically significant (P < 0.05); these changes returned to near normal limits by the 5th postoperative day. There was no significant decrease in the audiometric values following spinal anaesthesia with 24 and 25 gauge needles.

Serum lactate dehydrogenase in head and neck malignancy patients

50 patients of head and neck malignancy were selected for this study while excluding those associated with renal, hepatic, cardiac and metabolic diseases. Age and sex matched even number of controls were also included for comparison. Serum LDH levels in the control group were 124.2 +/- 3.50 I.U./L. Higher levels of LDH were observed in patients with malignancy of head and neck (335.50 +/- 21.60 I.U./L, P < 0.001). Serum LDH level was also related to histopathological stage of malignancy, being higher in poorly differentiated tumour as compared to moderate and well differentiated malignancy. Patients without metastasis had insignificantly lower serum LDH levels as compared to those with metastasis.

Central auditory toxicity of sisomicin in guineapigs

The central auditory toxicity of sisomicin was studied in guineapigs administered sisomicin (135 mg/kg body weight) sc for 10 days. Total lipids, phospholipids and cholesterol were estimated in the pons, inferior colliculus, medial geniculate body and auditory cortex. While the total lipids were increased in a non-preferential manner in all the regions studied, phospholipids and cholesterol levels registered no change. This study suggests the possible central auditory toxicity following sisomicin administration.

Gentamicin induced dose related alterations in lipid levels and lipid peroxidation in central auditory pathway of the rat

A study was carried out on the effect of gentamicin on the central auditory pathway in rats. Rats were administered graded doses of gentamicin (60 mg, 100 mg and 160 mg/kg b.wt., i.m.) daily for 21 days. Levels of total lipids, phospholipids and cholesterol showed dose related increment in the central auditory pathway. On the other hand, the rate of lipid peroxidation was inhibited in all regions of the central auditory pathway of the rat.

Is random plasma glucose an efficient screening test for abnormal glucose tolerance in pregnancy?

Random plasma glucose was determined in 276 apparently healthy pregnant women attending our antenatal clinic at 28 to 32 weeks gestation. Mean and standard deviation values within 2 h and greater than 2 h after a meal were calculated. A standard 75-g oral glucose tolerance test was then given to 250 of the 276 pregnant women. Three patients were found to be diabetic and 46 had post-load concentrations indicative of impaired glucose tolerance according to the criteria of the World Health Organization (1980). Using a cut-off point whereby 15% of the population would be tested, we would have identified only 2 of the 3 diabetics and 12 of the 46 with impaired glucose tolerance. This poor predictive power cannot be resolved by altering cut-off points for screening, or by altering the criteria for abnormal glucose tolerance. The basic problem is lack of a close relation between 2-h glucose tolerance value and random glucose when this has been taken greater than 120 min after a meal. In this population with a high prevalence of abnormal glucose tolerance, random plasma glucose is not an efficient screening test.

Studies on effects of tamoxifen (ICI 46474) on agonistic encounters between pairs of intact mice

The anti-estrogen tamoxifen (Tam), which has been shown to dramatically suppress offensive behavior in male rats without markedly influencing other aspects of the social encounter, was tested for its effectiveness in mice. TO strain albino mice were given control injections or 50 or 100 micrograms of Tam for 4 or 8 days. Subsequently, mice were tested in pairs (for a particular dose and treatment duration) in which both animals received Tam, one animal received Tam and one saline, or both animals received saline control injections. Ten-minute videotaped encounters were analyzed in terms of total times allocated to nonsocial investigation, social investigation, offense, defense, sexual activity/intense social investigation, and immobility. The lower dose given for the shorter duration produced less social investigation and more nonsocial investigation when Tam-treated subjects were paired together (cf. the Tam vs saline pairing). At all the other doses and durations, Tam reduced offense. Defense also changed in those pairings, but that activity seemed related to the amount of attack received. Tamoxifen had little influence on the weights of accessory sex glands. The data confirm that Tam is a potent suppressor of "androgen-dependent" aggression in male laboratory mice and provide further support for the aromatization hypothesis.