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A case of a 31-years-old young with swollen left eyelid, abundant discharge and giant conjunctival follicles of all palpebral conjunctiva. The existence of the left unilateral preauricular and submaxillary adenopathy associated with anatomo-pathological exam of the conjunctival follicles decides the diagnosis of Parinaud conjunctivitis.
Cervical or urethral scrapings were collected from 245 guinea pigs that had clinical signs of guinea pig inclusion conjunctivitis (GPIC) or were parents of newborn young having clinical signs of GPIC. Giemsa-stained smears were examined for cytoplasmic inclusion bodies, and samples were passaged in 6-day-old embryonating eggs. Complement-fixation tests were performed on 44 samples passaged through eggs in an effort to detect the presence of GPIC antigen. Unequivocal evidence of chlamydial infection of the genital tract was not found.
Maxaquin (lomefloxacin), a new fluoroquinolone antibiotic, was used in combined therapy of chlamydial conjunctivitis. The results of treatment of 72 patients were assessed by the clinical manifestations and the laboratory time course of Chlamydia trachomatis antigen in smears from the conjunctiva, detected by enzyme immunoassay. Clinical and laboratory findings proved the high efficacy of the drug and its advantages over traditional therapy and other fluoroquinolones.
The efficacy of lecrolin (2% sodium cromoglycate) eye drops was assessed in 22 patients with allergic conjunctivitis. Positive effect was attained in all the patients on day 4.0 +/- 1.2. Signs of the disease exacerbation completely disappeared in 68% of patients in 8.3 +/- 2.4 days. No side effects of any type were observed for a month of using lecrolin eye drops.
The 260 cases of acute hemorrhagic conjunctivitis seen at Siriraj Hospital during October to December, 1992 were studied. Evidence of coxsackie virus A24 variant (CA24v) infections was demonstrated in 76.8% of 95 cases. The isolation rates from conjunctival swabs and throat swabs were 68.2% and 32.8%, respectively. A four-fold rising titer of neutralizing antibody was shown in 59.5% of 42 cases. The disease was characterized by a short incubation period, sudden onset, a mild and self-limited course within 5 days without ocular sequelae. Lacrimation, swelling lida, itching, foreign body sensation and periorbital pain were common features with bilateral involvement in the majority of cases. Approximately 48% of eyes had a mucopurulent discharge. Preauricular lymphadenopathy, keratitis and subconjunctival hemorrhage were observed in 16.2%, 12.6%, and 10.1% of affected eyes, respectively. Respiratory disturbances accompanied the eye signs in some cases. Only one case developed neurological complications: facial palsy was observed for three months without recovery.
Conjunctivitis is a common infection among nursing home residents. The nursing home environment itself may expose residents to an increased risk of infection. Two major sources of infection are the hands of residents and nursing staff, and washing and bathing equipment. Clear guidelines on the prevention of cross-infection are needed in nursing homes.
The above ointments were used for local treatment of chlamydial conjunctivitis in 325 patients. The results demonstrated their high efficacy, good tolerance, advantages over tetracycline ointment, and absence to toxic allergic reactions.
The causative agent of an hemorrhagic conjunctivitis outbreak was assessed through the study of 18 conjunctival exudates using the indirect immunofluorescence technique and isolation in cell culture of human embryo fibroblasts. In addition, 395 paired serum samples were studied and Enterovirus 70 was found to be responsible for the outbreak.
A study of conjunctivitis cases with a possible viral cause was carried out in Havana City during June and August, 1993. Thirty seven cases from "Ramón Pando Ferrer" Ophthalmological Hospital were studied, of whom 13 isolations (35.1%) in cell culture of Hela cells were obtained. Isolations showed a cytopathic effect characteristic of Adenovirus. A direct immunofluorescence with conjugated serum of rabbit specific to Adenovirus was performed and results were positive in 100% of cases. A DNA restriction analysis of each isolated was performed for their classification. Restriction endonucleases SmaI and Hind III were used and 2 isolates were classified as Adenovirus type 3, and 6 as Adenovirus type 7b, 4 out of 13 isolates were not classified because of the degradation of the genetic material.
Levocabastine is an antihistaminic agent for topical application. It is without not advisable general side-effects and since many years is widely used for the treatment of pollinosis in adults and children more than 12 years of age. The group of 32 children aged from 5 to 11 years suffering from seasonal allergic rhinitis and conjunctivitis were treated by means of levocabastine applied topically by 20 days during the period of natural exposition to grass pollen. The clinical efficacy and tolerability including potential side-effects, were evaluated on the basis of clinical-laryngological investigations, visual analogs scales and diary cards filed in by parents of examined children. Levocabastine has been demonstrated to have rapid onset of action in children with SAR and the topical application of the drug does not irritate the mucosa of conjunctivas and nasal cavities.
BACKGROUND: Topical anesthetics, unlike injectable anesthetics, can be applied painlessly and can provide sufficient pain control to maintain patient comfort throughout a variety of laser procedures. Although the use of topical lidocaine is considered relatively safe, instances of cardiotoxic and neurotoxic adverse events have been reported to occur. OBSERVATIONS: A 52-year-old woman underwent fractional photothermolysis for management of severe hypopigmentation and scarring of several years' duration. Shortly after termination of treatment to her face and neck, which required prolonged exposure to a 30% lidocaine gel compound both before and during surgery, she developed clinical signs and symptoms consistent with systemic lidocaine toxicity. The results of laboratory studies confirmed serum lidocaine levels within the toxic range. We postulate that the combination of the high concentration of topical lidocaine required to achieve sufficient anesthesia, together with the laser-induced disruption in epidermal barrier function, may have been responsible for this phenomenon. CONCLUSIONS: Application of a 30% topical lidocaine gel to a limited area in conjunction with fractional photothermolysis may generate serum lidocaine levels high enough to elicit systemic toxicity. Laser surgeons should be alert to this phenomenon, particularly in patients with underlying hepatic, endocrine, cardiac, or central nervous system/psychiatric dysfunction; in patients with a low body mass index; and in patients who are taking medications that may interfere with hepatic lidocaine metabolism.
Methylphenidate (MPH; Ritalin: methyl-alpha-phenyl-2-piperidinacetate hydrochloride) is utilized for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. Recently, we described a rapid enantioselective liquid chromatography/tandem mass spectrometry (LC/MS/MS) method for the determination of the enantiomers of MPH (Rapid Commun. Mass Spectrom. 1999; 13: 2054). A lower limit of quantification (LLOQ) of 87 pg/mL was attained for the human plasma assay. The present paper describes a high-throughput sample preparation procedure in conjunction with racemic LC/MS/MS analysis for MPH with a LLOQ of 50 pg/mL. A semi-automated robotics method using liquid-liquid extraction (LLE) in a 96-well plate format was developed and validated. The correlation coefficients were > or =0.998 for MPH indicating good fits of the regression models over the range of the calibration curve. The accuracy and precision of the semi-automated approach were comparable to those obtained using the manual sample preparation technique reported previously (vide supra). The current method can easily be adapted to the enantioselective LC/MS/MS assay of MPH. The assay was simple, fast, specific, and exhibited excellent ruggedness.
BACKGROUND: Speech and swallowing problems due to velopharyngeal incompetence may follow soft palate resection and reconstruction. Over the past 3 years, we have developed the use of a superiorly based pharyngeal flap in conjunction with a radial forearm flap for soft palate reconstruction. METHODS: This paper describes the technique in detail and compares the functional results in a study with patients undergoing soft palate resection for squamous cell carcinoma treated with or without a pharyngeal flap as an adjunct to a radial forearm free flap for soft palate reconstruction. Seven patients had one quarter or one half soft palate defects reconstructed with a radial forearm flap alone. Of the 11 patients undergoing three quarter or total soft palate resections, all were reconstructed with a radial forearm flap, but 5 were treated with an additional superiorly based pharyngeal flap. The functional outcome for all the patients was analyzed and compared. RESULTS: Our results show that the addition of the superiorly based pharyngeal to the radical forearm flap in soft palate reconstruction results in improved speech and swallowing. We recommend the use of the additional flap in resections in which more than one quarter of the soft palate is included.
The removal of impurities and contaminants from PCR-amplified fragments is important for mutation detection methods which identify mutations based on shifts in electrophoretic mobility. This is particularly critical for assays and detection methods which use target DNA that is labeled prior to analysis and electrophoretic detection. We examined several procedures for purifying DNA amplified by the polymerase chain reaction (PCR) and their use in conjunction with a novel DNA scanning method, the Cleavase fragment length polymorphism (CFLP)* assay. In this study, a 480 bp DNA fragment, fluorescently labeled on the 5'-end of one strand, was amplified and subjected to various widely used purification procedures, including several commercially available clean-up kits. We demonstrate that visualization of the fluorescent label, as opposed to simple ethidium bromide staining, reveals the presence of considerable levels of labeled, truncated, amplification products. The various procedures were evaluated on the basis of their ability to remove these unwanted DNA fragments as well as on the degree to which they inhibited or promoted the CFLP reaction. Several procedures are recommended for use with CFLP analysis, including isopropanol precipitation, gel excision, and several commercially available spin columns. Concurrently, we evaluated (compared) a number of commonly used visualization platforms, including fluorescence imaging, chemiluminescence, and post-electrophoretic staining, for the ability to detect CFLP pattern changes. The advantages and disadvantages of different methods are discussed and amounts of DNA to be used for CFLP analysis on different detection platforms are recommended.
The notion of overlap between encoding and retrieval processes is central in cognitive theories of episodic memory, but to date most functional neuroimaging studies have emphasized differences between these processes. In the present study, overlap between encoding and retrieval processes was investigated by analyzing data from a positron emission tomography (PET) study of encoding and retrieval of different kinds of event information. Using a conjunction analysis, we specifically aimed at identifying overlap in activation patterns for encoding and retrieval of three classes of event information: item, temporal, and spatial. It was found that both encoding and retrieval of spatial information activated posterior parietal areas bilaterally. In addition, item encoding and retrieval were associated with increased activity in the right temporal pole, and temporal encoding and retrieval with left inferior frontal and left inferior temporal regions. These findings suggest that when specific episodic information is retrieved from memory, regions involved in encoding of the same information are engaged.
During the 1970s, information obtained from animal tumor models and from patients with a spectrum of solid tumors indicated the worth of a variety of immunostimulating agents. These findings provided a biological and clinical rationale for conducting randomized trials to evaluate the worth of those agents. Consequently, in May 1977 the National Surgical Adjuvant Breast and Bowel Project (NSABP) implemented a randomized trial to determine whether Corynebacterium parvum (C. parvum, CP) plus chemotherapy would be more effective than chemotherapy alone in prolonging the disease-free survival (DFS) and survival (S) of patients with primary operable breast cancer and positive axillary nodes. The results of that trial through 8 years of follow-up fail to indicate that treatment with CP used in conjunction with l-phenylalanine mustard (L-PAM) plus 5-fluorouracil (PF) results in a better DFS and S than that observed after chemotherapy alone. Use of the immunomodulator has instead resulted in a poorer, but not statistically significant, outcome. Despite adjustments made to account for any imbalance in distribution of prognostic factors between the two treatment groups and despite considering treatment compliance as a factor, the unfavorable outcome persisted. A high incidence of fever and chills was associated with the administration of CP. The administration of hydrocortisone before each CP treatment reduced the frequency of those and other systemic effects. The failure to demonstrate a benefit from CP is in keeping with the failure of other nonspecific stimulating agents to contribute to the creation of a new paradigm for the treatment of breast cancer.
Although fine-needle aspiration (FNA) is accepted as the method of choice for the initial evaluation of lymph nodes for metastatic carcinomas, its utility as the initial diagnostic procedure for hematopoietic processes is less established. We review our experience over a 3-year period with 127 FNA cases accompanied by flow cytometric (FC) analysis from 117 patients. Fifty cases had subsequent histologic examination. A hematopoietic process was identified in 85 cases, a reactive process in 27 cases, and a nonhematopoietic process in 15 cases. All non-Hodgkin lymphomas (NHL) were B-cell processes except for one T-cell lymphoma. By FNA/FC, 44 NHL had sufficient findings to be subtyped; of these, 27 had subsequent histologic examination. The correlation between the FNA/FC and histologic classification in these cases of NHL was 100%. One case was insufficient for diagnosis by FNA and six cases were inadequate for FC. We conclude that FNA in conjunction with FC can be used as the initial diagnostic approach for both primary and recurrent hematopoietic processes.
The phosphoglycerides profile of guinea pig kidney, fetal, young adult, and aged, and their in vitro response to the endogenous lipolytic enzymes, mainly in the phospholipase group were determined by TLC technology in conjunction with densitometric measurement. Changes in phosphoglycerides profile subsequent to in vitro incubation of these tissues at pH 7.4, and 38 degrees C for 45 min and prior to phospholipid extraction has provided evidence relating to their respective lipolytic enzymes capabilities and age. These changes are mainly related to endogenous cardiolipin (CL), alkenyl phospholipids (phosphatidyl ethanolamine and phosphatidyl choline) and their endogenous deacylation to their respective lyso derivatives monolysocardiolipin (MLCL), lyso alkenyl phosphatidyl ethanolamine (LPE), and lyso alkenyl phosphatidyl choline (LPC) by endogenous phospholipases. The hydrolysis of the plasmalogen confirms the action of endogenous PLA(2) on sn-2 fatty acids of these compounds.