Analysis of 24,444 surgical specimens accessioned over 55 years in an ophthalmic pathology laboratory

PURPOSE: To summarize the pathologic diagnoses of a large number of surgically-obtained specimens over an extended time period in a single ophthalmic pathology laboratory. METHODS: We analyzed the records of 24,444 surgically obtained specimens accessioned in the L.F. Montgomery Ophthalmic Pathology Laboratory, Emory University, Atlanta, GA between May 1941 and December 1995. Age, sex, topography, clinical procedure, and histologic diagnosis were entered into a database using the modified SNOMED coding system. The diagnosis of the surgically enucleated eyes were analyzed with respect to years of enucleation. RESULTS: The most common topographic area associated with a histologic diagnosis was the cornea (39.3%), followed by lens (16.0%), vitreous (12.0%), uvea (9.8%), eyelids (8.0%), conjunctiva (7.7%), retina (7.7%), and orbit (2.1%). The relative proportion of vitreous specimens has continuously increased and became the most common surgical specimen in 1995. The most common underlying disease of surgically enucleated eyes is trauma (40.9%), followed by ocular neoplasia (24.2%), 'surgical' diseases of the cornea, lens and retina including glaucoma (17.3%), vascular diseases (6.7%), and inflammatory conditions (6.7%). The relative frequency of trauma and ocular inflammation as a cause of enucleation decreased significantly (p < 0.05) over the time of the study period while the relative proportion of ocular neoplastic processes increased (p < 0.0001). CONCLUSIONS: The availability of new surgical techniques has caused a change in the relative frequencies of different ocular specimens submitted for histologic examination.     

Efficacy of surgical treatment in traumatic central cord syndrome

BACKGROUND: Controversy surrounds the treatment of traumatic central cord syndrome (TCCS), as there are strong advocates for nonsurgical treatment for most patients. However, conservative treatment has been shown to yield a longer period of discomfort from pain and weakness in certain cases. METHODS: In a retrospective review of 114 patients presenting with acute or chronic TCCS from 1988-94, four different age groups were separately observed under different treatments. Motor and sensory recovery were assessed. RESULTS: Better results were achieved in younger patients, with or without radiographic abnormalities, and in patients with clinically correlated encroaching cord lesions who received early surgical decompression. CONCLUSIONS: Surgical intervention for TCCS must be addressed with careful clinical and radiographic survey. Removal of offending lesions in the subacute period results in significant motor and sensory improvement in short-term and long-term follow-up.     

Loss performance of tagged and normal ATM cells at a partiallyshared buffer

The loss performance of tagged and normal ATM cells at a first-in-first-out (FIFO) buffer is studied. The authors show that if a partial buffer sharing mechanism is adopted the loss probability of normal cells can be firmly guaranteed, regardless of the traffic intensity of tagged cells     

Ophthalmologic findings in Usher syndrome type 2A

Thirty-seven patients, comprising 24 familial cases and 13 isolated patients with Usher syndrome type II (USH2), underwent ophthalmologic examination. Based on the degree of hearing loss, normal vestibular function, and gene-linkage analysis, familial cases were assumed to have USH2A. An analysis of genetic heterogeneity failed to reveal the presence of a second locus in the Dutch population. Although the patients appear to belong to a genetically homogeneous group, remarkable ophthalmologic variability was found. Corrected visual acuity decreased with age and remarkable differences in visual acuity were found within one family. Fundoscopic findings were classified as type A if attenuated vessels and bone corpuscles in all quadrants were found or as type B if findings other than these were found. The prevalence of type A significantly increased with age.     

The effect of a split in WAIS-R VIQ and PIQ scores on patients with cognitive impairment and psychiatric illness

To determine the most effective treatment for acrodermatitis chronica atrophicans, several clinical trials were undertaken in recent years to evaluate whether a 2-week course of ceftriaxone would be superior to oral antibiotics. Of the 46 patients suffering from acrodermatitis chronica atrophicans, 14 were treated with ceftriaxone 2g for 15 days. The remaining patients received either oral penicillin V 1.5 million IU t.i.d. or doxycycline 100 mg b.i.d. for 20 to 30 days. Patients were followed up for at least 1 year. Of the 14 ceftriaxone-treated patients four showed incomplete regression of the inflammatory skin changes after 6 to 12 months. Two out of five patients who were monitored for Borrelia burgdorferi DNA excretion were still positive after 12 months as compared to none of six patients who were treated orally for 20-30 days. Six out of 11 patients treated orally for only 20 days needed retreatment after 6 months because of continuing skin manifestations, neuropathy or arthralgia. A 30-day duration of treatment with oral antibiotics and not the chosen antibiotic is crucial for curing acrodermatitis chronica atrophicans. The duration of treatment with ceftriaxone needed for eradication of Borrelia in acrodermatitis chronica atrophicans has yet to be determined in future studies.     

Do chart reviews and interviews provide the same information about breast and cervical cancer screening?

Magnetic resonance imaging allows a noninvasive assessment of myelination during normal brain maturation as well as the detection of genetically determined and acquired diseases that affect the synthesis and maintenance of myelin. If this high sensitivity of magnetic resonance imaging for white matter changes is completed by adequate clinical and biochemical information, a unique diagnostic tool is available to gain new insights in the formation of myelin and pathogenesis of myelin disorders.     

Structure-function relationships in membrane segment 5 of the yeast Pma1 H+-ATPase

Membrane segment 5 (M5) is thought to play a direct role in cation transport by the sarcoplasmic reticulum Ca2+-ATPase and the Na+, K+-ATPase of animal cells. In this study, we have examined M5 of the yeast plasma membrane H+-ATPase by alanine-scanning mutagenesis. Mutant enzymes were expressed behind an inducible heat-shock promoter in yeast secretory vesicles as described previously (Nakamoto, R. K., Rao, R., and Slayman, C. W. (1991) J. Biol. Chem. 266, 7940-7949). Three substitutions (R695A, H701A, and L706A) led to misfolding of the H+-ATPase as evidenced by extreme sensitivity to trypsin; the altered proteins were arrested in biogenesis, and the mutations behaved genetically as dominant lethals. The remaining mutants reached the secretory vesicles in sufficient amounts to be characterized in detail. One of them (Y691A) had no detectable ATPase activity and appeared, based on trypsinolysis in the presence and absence of ligands, to be blocked in the E1-to-E2 step of the reaction cycle. Alanine substitution at an adjacent position (V692A) had substantial ATPase activity (54%), but was likewise affected in the E1-to-E2 step, as evidenced by shifts in its apparent affinity for ATP, H+, and orthovanadate. Among the mutants that were sufficiently active to be assayed for ATP-dependent H+ transport by acridine orange fluorescence quenching, none showed an appreciable defect in the coupling of transport to ATP hydrolysis. The only residue for which the data pointed to a possible role in cation liganding was Ser-699, where removal of the hydroxyl group (S699A and S699C) led to a modest acid shift in the pH dependence of the ATPase. This change was substantially smaller than the 13-30-fold decrease in K+ affinity seen in corresponding mutants of the Na+, K+-ATPase (Arguello, J. M., and Lingrel, J. B (1995) J. Biol. Chem. 270, 22764-22771). Taken together, the results do not give firm evidence for a transport site in M5 of the yeast H+-ATPase, but indicate a critical role for this membrane segment in protein folding and in the conformational changes that accompany the reaction cycle. It is therefore worth noting that the mutationally sensitive residues lie along one face of a putative alpha-helix.