Preventing expulsive hemorrhage using an anterior chamber maintainer to eliminate hypotony

We describe a method in which constant infusion inflow through an anterior chamber maintainer (ACM) is used to maintain positive intraocular pressure (IOP) during cataract extraction through a self-sealing tunnel incision. A retrospective review of patient records showed that the difference in the incidence of intraoperative suprachoroidal hemorrhage was significantly greater in eyes in which IOP was not constant throughout surgery than in eyes in which IOP was maintained using the ACM system.     

CT of appendicitis in children

PURPOSE: Our goal was to review the CT findings and to help define the role of CT in the evaluation of appendicitis in children. METHOD: Of 730 children with surgically proven appendicitis, 22 underwent preoperative CT evaluation. Their CT scans and operative and pathology records were retrospectively reviewed. The CT scans were evaluated for appendiceal wall thickness, diameter, and location, appendicoliths, pericecal inflammation, phlegmon, abscess, free fluid, small bowel dilatation, and bowel wall thickening. Criteria for diagnosing appendicitis were (a) appendiceal wall thickening (> 1 mm) or (b) presence of abscess, phlegmon, or pericecal inflammation associated with appendicolith(s). Prospective reports of ultrasound examinations performed within 2 days of the CT scans were available in 14 children and were correlated with the CT findings. RESULTS: An abnormally thickened appendix, with a diameter ranging from 9 to 18 mm, was seen in four children. Three appendices were retrocecal and one was near the cecal tip, anterior to the iliac vessels. Appendicoliths were present in 10 children, multiple in 1. Abscesses were seen in 13 of 22 children, multiple in 5. Phlegmon was seen in five children and pericecal inflammation in two. Bowel wall thickening was present in seven children and small bowel dilatation was noted in six. Other findings included free fluid, hydronephrosis, thickening of urinary bladder wall, air in the uterus and vagina, adenopathy, and thickening of the abdominal wall musculature. CT was diagnostic of appendicitis in 11 of 22 children (50%). In 14 children with both ultrasound and CT studies, CT was slightly better in diagnosing appendicitis and visualizing the abnormal appendix and was superior in defining the presence and extent of abscess and inflammation in 9 of 14 children. CONCLUSION: CT is a useful adjunct in diagnosing appendicitis in children, with a major role in cases of complicated appendicitis.     

Pediatric hemifacial spasm: the efficacy of microvascular decompression

Hemifacial spasm (HFS), generally a disease of the elderly, is caused by vascular compression of the seventh nerve. Vascular compression is thought to result from atherosclerotic changes within the vessels of the posterior fossa, and therefore rarely presents in childhood. Here we describe our experience with 12 patients with onset of HFS during childhood (age 18 or less) and who had surgical exploration of the cerebellopontine angle. These patients represent less than 1.2% of the patient population with HFS operated upon at this institution during the study period. Nine patients had follow-up data extending over 83 months. All 12 patients were found to have microvascular compression of the seventh nerve at the time of surgery. The most common operative finding was compression of the seventh nerve by a vein, alone or in combination with a branch of the anterior inferior cerebellar artery. At the time of discharge and after a mean follow-up period of 125 months, microvascular decompression resulted in complete relief of spasm in 67% of the patients.     

The effect of noncoherent infrared radiation on the bone tissue reparation of the mandible in an experiment

Exposure of rabbits with mandibular bone defects to coherent infrared radiation (IR) at a wavelength of 890 nm decreased the intensity of inflammation by accelerating the repair. The results of exposure of the injured site to noncoherent IR radiation are compatible with those of IR laser exposure.     

Persistence of hepatitis C virus in newborn mice brain cell culture

A model of chronic infection of primary cultures of suckling mouse brain (SMB) cells actively producing hepatitis C virus (HCV) is developed. Destruction and repopulation of cells was observed for at least 6 months; this phenomenon was paralleled by virus release in culture medium. Persistent HCV contained in SMB cultures induced a cytopathogenic effect in PS, BHK-21, Vero, HAK, and click embryo cell cultures, its infective titers being 10.0-12.0 lg TCD50/0.2 ml. Persistent HCV formed heterogeneous plaques under agar in chick embryo cells. The polymerase chain reaction (PCR) regularly detected the HCV RNA at the stage of cell destruction in the culture fluid of HCV-infected cell cultures. The cytopathogenic activity of persistent HCV was neutralized by anti-HCV positive patients' sera with the neutralization index of 8.0-9.0 lg. The results of persistent HCV neutralization were confirmed by PCR. Immunofluorescence detected virus-specific HCV antigens in 15-40% of infected cells. Hence, the SMB-HCV system realized the cytopathogenic potential of HCV circulating in the blood of patients with hepatitis C. This system is promising for the study of the pathogenesis of HCV infection at a cellular level, for screening for specific and nonspecific antiviral agents, and for preparing native virus-specific proteins and RNA.     

Vladimir Andreevich Oppel'' (1872-1932)

A total of 46 pregnant women with premature delivery and preserved amniotic sac were examined. The effect of tocolysis applied was recorded at different control periods of time with the aid of obstetrical monitor. The basic frequency of uterine contractions was more than 3--84.78%. In the 120th min after tocolysis with Partusisten 50% of the cases did not show any labour activity: after 120 min the inhibition was very successful--82.61%. This success was mainly recorded in the cases with uterine contractions over 4 for 10 min (31.61%) followed by those with 3-4 contractions (34.78%) and those with up to 2 uterine contractions (15.22%). On the basis of the results obtained it is concluded that the quicker and earlier the tocolytic was applied, the quicker and lasting was the effect. The statistical analysis revealed that all uterine contractions in the second and particularly in the third group depending on the time of tocolysis gradually passed into the first and second group.     

Polyclonal antibodies from blood and cerebrospinal fluid of patients with multiple sclerosis effectively hydrolyze DNA and RNA

It is known that in the blood of patients with some autoimmune diseases catalytically active antibodies hydrolyzing proteins, DNA, and RNA may be detected. In the present work homogeneous preparations of IgG antibodies (Ab) possessing high affinity for nucleic acids (NA) were obtained for the first time from blood and cerebrospinal fluid of patients with multiple sclerosis (MS). The fraction of IgG Ab as well as its Fab fragments and isolated light chains of both kappa- and lambda-types were shown to catalyze effectively the hydrolysis of DNA and RNA. It is shown by different methods that the capability for nucleic acid hydrolysis is an intrinsic property of the polyclonal Ab. NA-hydrolyzing Ab were detected in the blood of 69 of 72 and in the cerebrospinal fluid of 5 of 5 examined MS patients, while they were not detected in the blood of any of 50 healthy donors examined. Comparison of relative rates of RNA hydrolysis and of the substrate specificity in hydrolysis of various model RNAs--cCMP, poly(U), poly(A), and poly(C)--revealed pronounced differences of MS antibodies from ribonucleases of human blood, ribonuclease A, and all earlier described abzymes. The abzymes are usually characterized by relatively low specific activities in comparison with that of normal enzymes catalyzing analogous reactions. Ab from the blood of MS patients are the first example of autoabzymes whose specific activity in RNA hydrolysis is comparable or even higher than that of pancreatic ribonuclease A--one of the most active RNA-hydrolyzing enzymes.