Chemical Injuries of the Eye

This overview of the biochemical and pathophysiologic events after chemical burns of the eye is intended to act as a guide for appropriate therapy. Effective emergency measures must be instituted immediately followed by careful clinical evaluation to recognize and then treat problems at their inception. When and how to use the variety of drugs and devices is detailed. When these new methods and technology are applied successfully the clinical course may be improved and visual rehabilitation secured. The early results of conjunctival transplantation and hormonal therapy offer promise from experimental procedures. Exciting new treatments employing the foodstuffs ascorbate or citrate (orthomolecular therapy) are currently under investigation. The National Eye Institute sponsors our ongoing randomized clinical trial of these compounds in the treatment of the alkali burned eye. The outcome may change our thinking and our expectations after chemical burns of the eye.     

Filamentary granules in human bronchi

Mucous cells of human bronchial glands contain secretory granules with 5,5-7 nm parallel filaments. In contrast with the glycoproteic-rich mucous granules, filamentary granules exhibit weak reactivity with tannic acid, indicative of proteins. Exocytosis or discharge in glandular lumen are sometimes observed. These original granules may probably represent an additional component of fibrillar matrix in mucus.     

387. Differenzierte Therapie der distalen Radiusfrakturen

Zusammenfassung Exakte Reposition und Retention sind entscheidend für ein gutes Heilungsergebnis. Der Eingriff wird in Plexusanaesthesie ausgeführt. 1. Stabile Frakturen werden nach Reposition 6 Wochen im Unterarmrundgips ruhiggestellt. 2. Instabile Frakturen werden zusätzlich durch 2–3 transcutane K-Drähte gesichert und nach 4–6 Wochen entfernt. 3. Smith- und Barton-Frakturen erfordern die offene Reposition und Stabilisierung mittels T-Platte, ohne Ruhigstellung. 4. Offene und Trümmerbrüche werden mit dem gelenküberbrückenden Fixateur externe für 50 Tage ruhiggestellt. In 3 Jahren wurden bei 650 Patienten 20% mit K.Draht, 10% mit Fixateur externe, 1,5 % mit Plattenosteosynthese behandelt.     

The effects of ophthalmic drugs, vehicles, and preservatives on corneal epithelium: a scanning electron microscope study.

Scanning electron microscopy was found to be of considerable use in evaluating the effects of various commonly used drugs, vehicles, and preservatives on the corneal surface. Of the preparations tested 0.3 per cent gentamicin caused many central cellular microvilli to stand up prominently. Moderate losses of peripheral microvilli, with mild superficial cellular desquamation was noted with 0.25 per cent phospholine iodide, 2 per cent pilocarpine, 2 per cent fluorescein, and Fluor-I-Strip. The top layer of epithelial cells desquamated with 4 per cent cocaine or neopolycin treatment. The top two layers of cells were lost when 0.01 per cent benzalkonium chloride was instilled. When cell death occurred severe membrane disruption was accompanied by loss of microvilli and rupture of intercellular tight junctions. These studies show that the cytotoxicity of topical ocular preparations can be tested in an in vivo model and evaluated by scanning electron microscopy.     

Screening tests for blood donors presumed to have transmitted the acquired immunodeficiency syndrome

We investigated 18 sets of blood donors from 12 to 50 months after they donated blood to recipients who subsequently developed the acquired immunodeficiency syndrome (AIDS). Within each donor set, only one donor was suspected of having transmitted the disease (ie, member of an AIDS risk group). The other donors (n = 189) were not risk group members and served as controls. A number of laboratory tests distinguished suspected from nonsuspected donors, including determination of T helper/T suppressor cell ratio, antibody to hepatitis B core antigen, and immune complexes, but none of these was as sensitive and specific as tests for antibody to the human retrovirus, HTLV-III/LAV.     

Cefotaxime vs penicillin G for acute neurologic manifestations in Lyme borreliosis. A prospective randomized study

We randomly assigned 21 patients with painful Lyme neuroborreliosis radiculitis (Bannwarth's syndrome) and neuroborreliosis meningitis to a 10-day treatment with either penicillin G. 4 x 5 million U/d (n = 10) or cefotaxime sodium, 3 x 2 g/d (n = 11), intravenously. We were not able to demonstrate clinical differences between groups, either during the 10-day treatment period or at follow-up examination a mean of 7.7 months after antibiotic therapy. Cerebrospinal fluid cefotaxime concentrations reached the minimum inhibitory concentration at the 90% level for Borrelia burgdorferi in all patients, while none of the patients treated with penicillin G had cerebrospinal fluid concentrations above the minimum inhibitory concentration at the 90% value. We conclude that patients with acute neurologic manifestations of Lyme borreliosis may benefit from a 10-day treatment with cefotaxime or penicillin G. Cerebrospinal fluid antibiotic concentrations above the minimum inhibitory concentration at the 90% value, as observed in all patients treated with cefotaxime, offer the most hope for long-term prognosis.