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[Electronic calculation trainers for physically handicapped pupils--an example of how to use electronics in the field of individualized instruction at schools for the physically handicapped (author's transl)].

The article demonstrates, on the basis of arithmetic lessons with physically handicapped pupils, that individualised teaching methods can be considerably more effective with the aid of technology. The demand for extreme individualized instruction justified not only by psychological but also physical reasons, is attempted to be met in an important partial area, i.e., the acquisition of arithmetical skills by means of practice. Within the framework of a research project carried out on behalf of the Federal Minister of Labour, a device has been developed which takes into consideration the medical, special educational and technical viewpoints and helps to meet the practical requirements whilst taking into account the multidisciplinary problem complex. the device is an electronic trainer for mental arithmetic exercises which can be constructionally adapted to the pupil's physical deviation. It is programmed by the teacher in accordance with the different performance levels and is then a direct partner irrespective of the pupil's degree of disability.

Child↗

Study of the absorption of vitamin A oily preparation among school pupils from the rural.

Fasting and postabsorptive vitamin A level was studied in 55 school pupils aged 6-13 years, with giardiasis, ascaridiasis, or other parasites, both before and after their eradication with appropriate therapy; and in 6 pupils without parasites. Acceptable plasma vitamin A levels were detected in 20.7% of the cases. Mean fasting plasma vitamin A level among controls (Parasite-free) was 20.2 micrograms/dl. None of the parasitized pupils had acceptable mean plasma vitamin A concentrations. Prompt eradication of the giardia lead to significant improvement in the fasting plasma vitamin A concentration. Post absorptive vitamin A level above 100 micrograms/dl was detected in just one case. Post absorptive vitamin A level ranged between 31.5 and 67.7 in the rest, regardless of the type of parasite or treatment.

Absorption↗

Effect of timolol maleate on intraocular pressure and pupil cycle time in normal eyes.

One drop of 0.5% timolol maleate instilled into the normal eyes of four subjects produced a marked reduction of intraocular pressure that was maximal at 3 hours but not significant after 12 hours. Instillation of one drop a day for 30 days produced a reliable, maintained reduction of intraocular pressure in the treated eye. The pupil cycle time in both eyes was measured at least twice daily for 1 week before timolol treatment to assess the reproducibility of the test and then twice daily for the 30 days of treatment with timolol. The drug had no significant effect on the pupil cycle time. Measuring the pupil cycle time should afford the ophthalmologist a useful method of assessing the progress of glaucomatous damage to the optic nerve while the patient is undergoing treatment with timolol, an assessment that was not possible when patients were treated with pilocarpine.

Administration, Topical↗

Pupils with mild mental retardation in regular Swedish schools: prevalence, objective characteristics, and subjective evaluations.

Pupils in regular Swedish schools who met the psychometric criterion of mental retardation were identified and described. Using a national longitudinal data set, we compared a group of 13-year-old pupils (N = 116) not officially classified as having mental retardation to their peers without mental retardation across measures of school achievement, social background, self-evaluations of school experiences, and upper secondary school education. The results showed that the former group was low-achieving and had poor self-evaluations; however, some pupils in the general population shared these characteristics.

Achievement↗

Praziquantel side effects during treatment of Schistosoma mansoni infected pupils in Kibwezi, Kenya.

Four hundred and thirty six pupils in two primary schools in Kibwezi, Kenya aged between seven and sixteen years and positive for S. mansoni were treated as follows: 320 pupils with a single dose of praziquantel at 40 mg/kg body weight and 116 controls with a placebo. Immediate and delayed side effects of praziquantel were observed. The main side-effects were abdominal pain (36.3%), headache (35.3%) and nausea (13.1%). There was correlation between frequencies of these side-effects and intensity of infection measured as eggs per gram of faeces. Other side-effects included dizziness (9.7%), fever (7.8%), urticaria and bloody diarrhoea. Overall, the side-effects of praziquantel were mild and transient, and did not require any intervention. For ethical reasons, all pupils who served as controls were treated with praziquantel after the study.

Adolescent↗

[Follow-up study of obese pupils and their life styles in the lower grades of primary schools].

Physical examinations and a questionnaire survey of life style were carried out on all pupils (105 boys and 110 girls) at the first grade of primary school in Saigo town, Fuse village, Goka village, and Tsuma village of Shimane prefecture in 1992. In 1994, physical examinations and a questionnaire survey were again performed along with a newly-added blood examination on the same cohort. Parents of the pupils answered the questionnaire. The pupils who were included in both the first (in 1992) and the second (in 1994) examinations and surveys (89 boys and 101 girls, but 71 boys and 77 girls for blood examination) were subjects in this study to analyse the relationship between obesity and life style. The results showed (a) the proportional rates of obese boys and girls increased during the two years; (b) the obesity index of boys and girls in the third grades correlated with the obesity index of their mothers; (c) obese boys ate snacks frequently, had a higher speed in eating, and disliked physical exercise; and (d) the obesity index of boys and girls correlated with serum total cholesterol. These findings indicate that obesity occurs as early as the lower grades of primary schools and that it continues for at least two years.

Age Factors↗

The effect of phenylephrine and pilocarpine on pupil size and aqueous flare intensity in patients with diabetes mellitus.

PURPOSE: The aqueous flare intensity and pupillary size were studied before and after instillation of 10% phenylephrine and 4% pilocarpine in eyes with diabetes mellitus (DM). METHODS: Twenty-three patients with DM type I were compared with 30 age-matched controls, and 25 patients with DM type II were compared with 30 age-matched controls. Patients with DM were divided into two groups: 1) with mild-moderate nonproliferative diabetic retinopathy (NPDR), and 2) with advanced diabetic retinopathy (DR) which includes moderate-severe, severe NPDR and proliferative DR. The aqueous flare intensity and the horizontal diameter of the pupil were measured before and 60 minutes after topical instillation of 10% phenylephrine and 60 min after topical administration of 4% pilocarpine. RESULTS: Degree of induced mydriasis after phenylephrine instillation was not significantly different between diabetic groups and controls. Significantly less pronounced miosis was observed after stimulation of cholinergic receptors by pilocarpine in eyes with mild-moderate NPDR with DM type II and in eyes with advanced DR with DM type I and type II when compared to controls (p<0.05). Phenylephrine decreased flare intensity in all groups without a significant difference between groups. Pilocarpine instillation increased flare intensity in all groups as compared to flare intensity before any treatment. Also, a significantly smaller increase in flare intensity in eyes with advanced retinopathy in both DM type I and type II was found when compared to controls (p<0.05). CONCLUSION: Pharmacological response to cholinergic stimulation on pupil size and flare intensity is weaker in advanced stages of DR.

Administration, Topical↗

[Evaluation of the autonomic innervation of the pupil].

The purpose of the study was to examine vegetative innervation of the pupil in different diseases associated and not associated with vegetative disorders. In addition to the ++clinico-neurological method, the main method of examination was to study the pupillary cycle (determination of the time of the pupillary cycle (TPC) with the aid of a slit lamp). Fifty healthy test subjects and 262 patients suffering from different somatic and neurologic diseases were examined. The patients were divided in 9 clinical groups: spinal amyotrophy, neural Charcot-Marie amyotrophy, Guillain-Barre syndrome, diabetes mellitus, thyrotoxicosis, hemicrania, Raynaud's disease, idiopathic hyperhidrosis, vegetative crises. The data obtained demonstrate varying grades of the rise of the TPC in the indicated diseases, which reflects varying degrees of vegetative innervation of the pupil insufficiency. However, no well-defined correlation was obtained between the intensity of the psychovegetative syndrome and the TPC. Therefore, it has been shown that the method of determining the TPC is unsophisticated and noninvasive and can be successfully used in different forms of pathology to identify vegetative insufficiency at different stages of the disease.

Autonomic Nervous System Diseases↗

The computerized pupil.

An IBM-compatible computer graphics software program has been developed which simulates pupillary function. A light pen, electronically interfaced with the computer, simulates a pen light and, when it is placed on the computer image of the pupil, causes pupillary constriction; when it is withdrawn, the pupils redilate. A variety of abnormal pupillary responses are depicted. Anatomical diagrams and questions concerning various simulated pupillary conditions further enhances the educational experience. Medical students, residents in ophthalmology and the neurosciences, optometrists, nurses, ophthalmic assistants, and other health care professionals can utilize this program to learn a wide range of pupillary abnormalities in an interactive environment.

Audiovisual Aids↗

Tonic pupil and Czarnecki's sign following third nerve palsy.

A 71-year-old woman developed abnormal pupillary function in one eye after a third nerve palsy. Stimulation with light caused segmental constriction of the pupil, the near reflex was normal, and gaze upward elicited constriction of portions of the sphincter that were unreactive to light. This combination of findings has not been reported previously. We believe that this case supports the idea that a tonic pupil can be caused by aberrant reinnervation of the ciliary ganglion.

Aged↗

Oval pupils.

The records of 17 patients whose neurological examination disclosed oval pupils in one or both eyes were reviewed. Sixteen of the 17 had serious cerebrovascular illnesses--hypertensive cerebral hemorrhage (five patients), ruptured saccular aneurysm (five patients), epidural hemorrhage (one patient), bilateral cerebral infarction (two patients), brainstem strokes (two patients), and cerebral anoxia (one patient). One patient was recovering from an oculomotor palsy. Oval pupils usually represent a transient, unstable phase in progressive injury to the oculomotor complex and less frequently a transient phase of recovery.

Aged↗

Visual evoked response abnormality in myoclonus epilepsy with large pupils. Occurrence in a family with acorpuscular myoclonus epilepsy.

Flash and pattern evoked responses were recorded from three siblings with myoclonus epilepsy who all had strikingly large pupils in daylight. Comparison with the visual evoked responses (VERs) of 15 normal and eight epileptic control subjects (including one with myoclonus epilepsy but normal pupils) disclosed a substantial reduction of the amplitude of the flash response as compared with the normal pattern response in these three patients. It is suggested that the VER constellation and the pupillary abnormality, together with the normal electroretinogram and diffusely distributed relative scotomas, were due to a ganglion cell loss in the retina.

Adult↗

Pupil-sparing oculomotor nerve palsy due to midbrain infarction.

Vasculopathic oculomotor nerve palsies with pupillary sparing are thought to be due to ischemic damage to the nerve in the subarachnoid space or the cavernous sinus. We present two cases of patients with isolated pupil-sparing oculomotor nerve palsies due to midbrain infarcts. Focal ischemic midbrain lesions should be considered in cases of pupil-sparing oculomotor nerve palsies.

Adult↗

Myotonic pupils in Charcot-Marie-Tooth disease. Successful relief of symptoms with 0.025% pilocarpine.

Twenty-seven members of a family with dominantly inherited Charcot-Marie-Tooth disease (CMTD) were examined. Fifteen members had CMTD and 13 of these had varying amounts of myotonic pupillary abnormalities similar in some ways to Adie tonic pupil syndrome. Those with graver neurologic disease showed greater pupillary abnormalities. Ten of the 15 patients had pupillary constriction with methacholine chloride (Mecholyl) and some of these had extensive iris atrophy. Several affected patients received symptomatic relief from 0.025% pilocarpine. Seven other patients with CMTD who were not related to our initial family were checked for myotonic pupils; two had findings similar to our initial family. Pupillary abnormalities in certain patients with CMTD appear secondary to a parasympathetic denervation of the iris sphincter and ciliary muscle, as shown by a positive methacholine test, and probably represent part of the autonomic nervous system dysfunction associated with the polyneuropathy in CMTD.

Adult↗

The relationship of visual acuity, refractive error, and pupil size after radial keratotomy.

To better define the relationship between residual refractive error, uncorrected visual acuity, and pupil diameter, we compared 42 eyes that had an eight-incision radial keratotomy according to the Prospective Evaluation of Radial Keratotomy Study protocol with 42 matched control eyes. The parameters measured were best corrected visual acuity, uncorrected visual acuity, and the change in cycloplegic refraction with enlarging pupil diameter. The best corrected visual acuity was 20/16 in both the radial keratotomy and control groups, but the variability (SD) was higher in the radial keratotomy group. The average uncorrected visual acuity was 0.35 (35%) better in the radial keratotomy group, but the variability was 1.77 times higher. Change in refraction with dilation occurred in 9% of the controls and 36% of the radial keratotomy patients, indicating a significant difference (P = .002). The change in refraction with dilation in the eyes with radial keratotomy was almost equally split between a hyperopic change (17%) and a myopic change (18%), which was much different than in the control eyes, only 2% of which changed in a hyperopic direction and 7% in a myopic direction. The radial keratotomy patients with a myopic change had the best uncorrected visual acuity, indicating that positive spherical aberration yielded the best aspherical surface for uncorrected visual acuity.

Adult↗

Pharmacological studies of the pupils in familial amyloid polyneuropathy.

Pharmacological studies of the pupils of 7 patients with familial amyloid polyneuropathy (FAP) were performed in order to demonstrate the site of the lesion. Supersensitivity to 1.25% epinephrine was observed frequently, but not to 2.5% methacholine. The lesions of the sympathetic nervous system, judging from the epinephrine and tyramine tests, were regarded as preganglionic in 2 patients and postganglionic in 4. Among 3 patients reexamined six months later, 1 had developed signs of sympathetic postganglionic disturbance and another showed a peripheral parasympathetic disturbance associated with progress of a sympathetic preganglionic disturbance. From these results it was suggested that in FAP, sympathetic abnormalities involve the pupils more often than parasympathetic disturbances, and pharmacological studies can detect the autonomic dysfunction before it becomes clinically apparent.

Adult↗

Behaviour of IOP and pupil size after topical tranylcypromine in the rabbit eye.

Repeated topical administration of tranylcypromine (TCP) to adult rabbit eyes causes a transient rise in intraocular pressure (IOP) for one half hour and a dilatation of the pupil for more than two hours. These effects are blocked by phenoxybenzamin but not by timolol. Indomethacin blocks the rise in pressure but not the pupillary dilatation. Chemical denervation blocks both effects. The rise in IOP is not followed by a hypotensive phase. It is suggested that TCP has a dual effect on the eye. Firstly, TCP as a releaser of endogenous nor-epinephrine (nE) and as a monoamine oxydase inhibitor will induce accumulation of nE at the receptor-side which in turn probably stimulates the synthesis of PGs to raise IOP. Secondly, TCP as a prostacyclin synthase inhibitor may be responsible for the absence of a hypotensive response. This is strengthened by the finding that TCP inhibits the hypotensive response to nE but potentiates the dilatation of the pupil.

Animals↗