Treatment of strabismus and nystagmus with botulinum toxin type A. An evaluation of effects and complications

PURPOSE: Injection of botulinum toxin type A into eye muscles leads to a temporary paralysis and the effects have been evaluated in strabismus or nystagmus. METHOD: A total of 112 patients with different types of concomitant and paralytic strabismus and acquired nystagmus were treated with botulinum toxin, according to well-established indications. RESULTS: The lasting effects of the injections on strabismic angle were largest in esotropia, consecutive exotropia and abducens palsy, and amounted to, on an average, 12 prism diopters or 6 degrees. The larger the strabismus the better was the effect. Repeated injections reduced the angle further. In complex nystagmus forms retrobulbar injections could be used. The side effects were mostly due to spread of botulinum toxin to the levator, producing ptosis (8%), or the inferior rectus muscle, causing vertical strabismus (10%). On an average 42% of the patients were later operated for strabismus and nystagmus. CONCLUSION: Injection of botulinum toxin A into eye muscles is a valuable adjunct to surgery in the treatment of strabismus and nystagmus.     

Distribution of CD4+ T-lymphocytes levels in patients with clinical symptoms of AIDS in three west African countries

The characteristics of airway responsiveness to acetylcholine (ACh) in congenitally bronchial-hypersensitive (BHS) and bronchial-hyposensitive (BHR) guinea pigs were clarified in vivo and in vitro. We measured the change in ventilatory mechanics in response to ACh inhalation by means of the bodyplethysmograph and the contractile responses of isolated trachea to ACh and carbachol (CCh). Further, muscarinic receptor subtypes involved these responses were identified. The basal values for ventilatory mechanics in BHS were not significantly different from those in BHR. Respiratory resistance to ACh was progressively increased in a time- and dose-dependent manner in BHS. The contractile responses of tracheal smooth muscle to ACh in BHS were significantly greater than those in BHR, but CCh-induced responses in BHS and BHR were similar. ACh- and CCh-induced contractions were mediated via M3 receptors. These results suggested that the falling-down of BHS in response to ACh inhalation was caused by the strong constriction of the airway and the reduction in ventilation. Moreover, the airway hyperresponsiveness to ACh in BHS might be partly dependent on the change in acetylcholinesterase activity.     

Selective perturbation of apical membrane traffic by expression of influenza M2, an acid-activated ion channel, in polarized madin-darby canine kidney cells

The function of acidification along the endocytic pathway is not well understood, in part because the perturbants used to modify compartmental pH have global effects and in some cases alter cytoplasmic pH. We have used a new approach to study the effect of pH perturbation on postendocytic traffic in polarized Madin-Darby canine kidney (MDCK) cells. Influenza M2 is a small membrane protein that functions as an acid-activated ion channel and can elevate the pH of the trans-Golgi network and endosomes. We used recombinant adenoviruses to express the M2 protein of influenza virus in polarized MDCK cells stably transfected with the polymeric immunoglobulin (Ig) receptor. Using indirect immunofluorescence and immunoelectron microscopy, M2 was found to be concentrated at the apical plasma membrane and in subapical vesicles; intracellular M2 colocalized partly with internalized IgA in apical recycling endosomes as well as with the trans-Golgi network marker TGN-38. Expression of M2 slowed the rate of IgA transcytosis across polarized MDCK monolayers. The delay in transport occurred after IgA reached the apical recycling endosome, consistent with the localization of intracellular M2. Apical recycling of IgA was also slowed in the presence of M2, whereas basolateral recycling of transferrin and degradation of IgA were unaffected. By contrast, ammonium chloride affected both apical IgA and basolateral transferrin release. Together, our data suggest that M2 expression selectively perturbs acidification in compartments involved in apical delivery without disrupting other postendocytic transport steps.     

Antimicrobial potentials of some plant species of the Bignoniaceae family

The methanol extracts of the leaves and stem bark of four Bignoniaceae plants Jacaranda mimosifolia D. Dol., Tecoma stans Linn., Tabebuia rosea (Bertol) D.C., and Crescentia cujete Linn. were studied for their antimicrobial activity using a wide range of Gram-positive and Gram-negative bacteria and fungi. Extracts of both the leaves and stem bark of majority of plant species studied showed variable but remarkable broad spectrum antimicrobial activity. However, methanol extracts of Tecoma stans leaves was found to be effective against only Candida albicans at the concentrations employed. It was observed that the extracts of stem bark generally showed better antimicrobial activity than those of the leaves and some organisms were selectively more sensitive to the extracts than others. Preliminary phytochemical screening of these plants revealed the presence of tannins, flavonoids, alkaloids, quinones and traces of saponins. The antimicrobial activity observed are discussed in relation to the chemical constituents reportedly isolated from these plants and their traditional uses.     

Prognostic factors of the probability of the occurrence of complications in the radiation therapy of malignant neoplasms

The authors present an analysis of the causes of radiation induced complications in 383 patients referred to the Chair of Clinical Radiology from different medical institutions of the country. It was found that under distant gamma therapy, to prevent the development of complications the value of TDF-factor should not exceed 105--110, for the associated radiotherapy--130--140, and that for close focal roentgenotherapy--130--150. In vast majority of patients (95.3%) the complications resulted from surpassing the normal tissue tolerance. To prevent radiation injuries it is suggested to take into consideration the TDF-factor values, while in planning radiotherapy to choose such schedules of irradiation, which preclude any surpassing of the tolerance of normal tissues and organs adjacent to the tumor.