The Origins and Insertions of Rectus Muscles: Paul J. Tillaux and Charles B. Lockwood

Abstract

Purpose: Accommodative esotropia with a high accommodative element has been typically treated with bifocal lenses. This study assessed the age-dependent efficacy of progressive-addition lenses (PAL) for a high accommodative element in improving motor and sensory performance.

Methods: We evaluated PAL as an initial treatment modality or after initiating treatment with bifocals at various ages. Thirty-two patients, who did not undergo eye muscle surgery, were included in this retrospective study. Subjects were divided into 2 subgroups: 7 subjects who received PAL treatment only (median age 4.5 years), and 25 children treated with bifocals (median age 4.5 years) and then switched to PAL at the mean age of 9 years. Measurement of the deviation was performed by the alternate prism cover test. The Stereo fly test and Randot stereo test were used to assess stereoacuity. The mean follow-up periods for the subgroups were 57 and 46 months, respectively.

Results: The deviation at near decreased in the PAL-only group from an average of 28 prism diopters (PD) without correction at diagnosis to zero PD with correction. Stereopsis in the PAL first group improved from an average of 113” to 54” and in the bifocals first group improved from 541” to 141".

Conclusion: PAL treatment for accommodative esotropia with a high accommodative achieved good sensory and motor results. PAL and bifocals were equally beneficial as the initial treatment of young children with convergence excess esotropia.     

DNA-Chips in der Diagnostik hämatologischer Neoplasien

In hematological malignancies, gene expression profiling using DNA-microarrays led to the discovery of novel lymphoma and leukemia subgroups. The heterogeneous entity of diffuse large B-cell lymphoma could be subdivided into the germinal center B-cell-like and the activated B-cell-like subtype which differ in pathogenesis and clinical behavior. In leukemia, existing entities defined by morphological, cytogenetic, molecular and immunophenotypic criteria were confirmed on the global gene expression level; in addition, new important molecular subgroups could be identified. In retrospective clinical lymphoma and leukemia studies, robust gene expression signatures were discovered that predict the clinical course at the time of diagnosis. Given the huge potential of the DNA-microarray technology, application in the routine diagnostic setting appears possible.     

Primary pulmonary hypertension, congenital heart defect, central nervous system malformations, hypo- and aplastic toes: another case of Yunis-Varón syndrome or report of a new entity

Here we describe a patient with a new malformation syndrome which shows similarities with Yunis-Varon syndrome (YVS). Prenatal presentation included polyhydramnios, increased nuchal translucency, and bilateral hydrothoraces requiring pigtail insertion. Postnatal presentation revealed primary pulmonary hypertension (PPH), persistent hydrothoraces, one atrial and two ventricular septal defects, hypoplasia of the corpus callosum and cerebellar vermis, dilated interhemispheric ventricles, severe developmental delay with general muscular hypotonia, retinal anomalies, sparse scalp hair, sparse eyebrows and eyelashes, hypo- and aplastic nails, low-set dysplastic ears, loose nuchal skin, hypo- and aplastic distal phalanges of the toes as well as postnatal failure to thrive. High resolution molecular karyotyping in the patient did not reveal any causative chromosomal aberration. Since one patient with YVS and PPH has been previously reported, we assume a similar pathogenic pathway. However, molecular confirmation of the clinical diagnosis is not yet possible. It remains uncertain if the presented syndrome can be classified as YVS with PPH or if it constitutes a new YVS like entity.     

Maturation of shoaling behavior is accompanied by changes in the dopaminergic and serotoninergic systems in zebrafish

The zebrafish has been one of the preferred vertebrate model organisms of developmental biology, and is becoming an important research tool for behavioral neuroscience and behavior genetics. A prominent feature of zebrafish is their strong shoaling tendency. Most recently, the first study investigating the development of shoaling in zebrafish demonstrated that a few days after hatching zebrafish do not shoal, but that shoaling tendency gradually increases during development. The current study investigates this phenomenon using the nearest neighbor distance, a measure most frequently employed for the quantification of shoal cohesion in fish. We demonstrate that shoal cohesion increases with age, while thigmotaxis, "wall hugging," does not show a consistent age-dependent change. The mechanisms underlying the maturation of shoaling are unknown. HPLC analysis of whole brain extracts finds the concentration of dopamine, DOPAC, serotonin, and 5-HIAA normalized to total brain protein weight to increase with age. Although the behavioral and neurochemical results are only correlative at this point, they may open a new avenue into the investigation of the mechanisms and development of social behavior in zebrafish.     

Anuläres Erythem bei Sjögren-Syndrom

Annular erythema has been recognised as a cutaneous manifestation of Sjögren’s syndrome in the Asian literature and has been assumed to represent a distinct clinical entity. Since there are common pathophysiologic mechanisms, mainly the presence of anti-Ro/SSA or anti-La/SSB antibodies, it is difficult to separate the annular erythema from subacute cutaneous lupus erythematosus. Histological examination may reveal dermal mucin deposition resembling lupus erythematosus tumidus. We present a Chinese patient with widespread annular erythema, keratoconjunctivitis sicca, and anti-Ro/SSA antibodies. Clinical, histopathological, and immunogenetic findings are discussed reviewing the current literature, and the differences between annular erythema associated with Sjögren’s syndrome and cutaneous lupus erythematosus are emphasized.