Orbicularis oculi reflex in coma: clinical, electrophysiological, and pathological correlations

The orbicularis oculi reflex was studied in 48 comatose patients and the results were correlated with clinical and pathological findings. The late component of the reflex was absent or of minimal amplitude in all cases regardless of the site of lesions, reflecting a diffuse suppression of the reticular system rather than a specific or local block in the brain-stem. Alteration of the early component of the reflex, on the other hand, generally indicated primary or secondary structural changes in the pons, although reversible functional or pharmacological block of pontine conduction was also documented.     

APHAKIC KERATOPLASTY

This paper reports and analyses 53 keratoplasties carried out for either aphakic bullous keratopathy (ABK) 35 operations, or combined with cataract extraction (CGC) 18 operations. These operations were carried out on 43 patients. Some patients had keratoplasties on each eye and some eyes had more than one keratoplasty. Overall, 41 (77%) clear grafts were achieved, these being 28 (80%) in the ABK group and 13 (72%) in the CGC group. The ABK group was broken down into 3 groups on the basis of causative factors. In the Fuchs' dystrophy group, 90% clear grafts were achieved, in the complicated cataract group 67% clear grafts were achieved and in the multiple operations group 79% clear grafts were achieved. Two main conclusions were made. Firstly, in eyes with ABK where the pre-operative vision is accurate projection of light or better, a penetrating keratoplasty should be carried out as the first line of treatment. This will not only relieve distressing symptoms but yield a high percentage of clear grafts and improved vision. Secondly, in patients with both corneal disease and cataract contributing to decreased vision, a combined cataract and penetrating graft operation is advised because of the high percentage of success and decreased period of morbidity when the two operations are carried out simultaneously.     

A role for the P2X receptor in urinary tract physiology and in the pathophysiology of urinary dysfunction

OBJECTIVE: We provide a historical perspective of the P2X receptor class in bladder physiology and the pathophysiology of urinary dysfunction. METHODS: A literature search was performed using the MEDLINE database. RESULTS: Evidence suggests that P2X receptors serve a combined function in sensory and motor activity of human bladder. P2X receptors mediate excitation of sensory neurons and evoke muscle contraction in response to ATP release. Anatomical and functional defects in the P2X receptor signaling are associated with a variety of urologic diseases. CONCLUSION: Current research underscores the importance of P2X receptors in urologic physiology. Potential applications exist in relation to the diagnosis and treatment of urinary dysfunction. However, the detailed mechanism of P2X receptor function in bladder physiology and in urinary tract disease remains unknown and warrants further investigation.     

Epidemic viral gastroenteritis in Queensland coincides with the emergence of a new norovirus variant

Norovirus infections cause widespread morbidity and have significant economic impact on the community. An increase in outbreaks of norovirus gastroenteritis in hospitals, nursing homes and in the community was observed in Queensland in 2004. Molecular analysis of positive samples indicated the emergence of a single strain of norovirus. A 252 nucleotide sequence from the polymerase region (POL) was compared to sequences of the new variant genotype GII.4 that has caused epidemics in the Northern Hemisphere in 2002 and 2003. Sequence analysis indicated greater than 95 per cent similarity in the POL between the Queensland strain and the Northern Hemisphere 2002/3 GII.4 variant. Phylogenetic analysis revealed that the Queensland strain forms a branch within the GII.4 genotype separate from the 2002 variant from Europe and North America. Although norovirus genotype GII.4 had circulated in Queensland in the past, the 2004 strain was characterised specifically by three nucleotides not present in any other sequences held in our database covering the years 2002-June 2004.