A clinicopathological study of loop recession in strabismus

This communication reports the histological structure of loop recessions of extraocular muscles from seven patients. In all cases the loops formed pseudotendons in which the typical histological structure was well established by four months. Subsequently, moulding of these pseudotendons occurred with improved alignment of collagen and decrease in vascularity. By three and a half years after the operation the pseudotendon had acquired a very close resemblance to true tendon.     

DEMODECTIC OPPOSITION IN THE EYELID

The normally torpid existence of demodectic mites of the eyelid changes with the onset of oviposition. There occurs a burst of activity characterized by flexion, extension and rotation.     

Risk factors for toxicity in elderly patients given aminoglycosides once daily

OBJECTIVE: To determine the risk factors for aminoglycoside toxicity in the elderly. DESIGN: Prospective observational study. SETTING: Acute care teaching hospital serving predominantly veterans. PARTICIPANTS: Consecutive patients aged 70 years and over receiving aminoglycosides. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Thirteen (15%) of 88 patients developed aminoglycoside-related nephrotoxicity and 3 (3.4%) developed otovestibular toxicity. Multivariate analysis showed that increasing duration of aminoglycoside therapy was the only factor significantly associated with development of toxicity. Elevated baseline serum creatinine level (p=.02) and use of allopurinol (p=.03) were risk factors specifically for nephrotoxicity. Only 2 (3.9%) of 51 patients receiving aminoglycosides 7 or fewer days developed nephrotoxicity, as compared with 11 (30%) of 37 receiving the drugs for 8 to 14 days and 4 (50%) of 8 treated for more than 14 days. CONCLUSIONS: Although toxicity is common in elderly patients treated with aminoglycosides, limiting the duration of aminoglycoside therapy to less than a week can substantially reduce risk of toxicity.     

AN UNUSUAL CASE OF ASYMPTOMATIC APLASTIC RENAL DYSPLASIA

The postmortem examination of a 59-year-old man who had suffered from acute abdominal pain for two days revealed that the cause of death was peritonitis secondary to perforated peptic ulceration. During examination,it was found that the urinary tract was abnormal. Here,we report a postmortem finding of aplastic renal dysplasia of the kidney and malformation of Lhe urinary tract.     

Supratentorial tanycytic ependymoma

Tanycytic ependymoma is a rare fibrillary variant of ependymoma with a predilection for the spinal cord. We present an unusual supratentorial subcortical tanycytic ependymoma in a 17-year old male presenting with seizures. Only two other cases of subcortical tanycytic ependymoma have been reported.     

Neonatal Herpes Simplex: Royal Women''s Hospital 10-year Experience with Management Guidelines for Herpes in Pregnancy

In the 10-year period 1982-1991 inclusive, 6 cases of neonatal herpes simplex were diagnosed at the Royal Women's Hospital, Melbourne (1 disseminated, 1 pneumonitis, 4 cutaneous [1 with central nervous system involvement]), resulting in an incidence of 1 in 11,000 livebirths for this population. Three cases were due to HSV 1 and 3 to HSV 2. In no case did the mother have a recent or past history of overt genital herpes infection. Two cases were acquired in utero, an uncommonly recognized form of infection. A favourable long-term outcome occurred in 2 of 4 cases in which diagnosis was prompt and antiviral therapy was instituted rapidly. Routine antenatal screening in the last trimester of pregnant women with a history of genital herpes before pregnancy is not advised, because the results have been shown to be unreliable in predicting viral shedding and hence the infants' risk of exposure to virus at delivery. A protocol for management of herpes in pregnancy is included.