Shedding Light on Blepharospasm: A Patient–Researcher Partnership Approach to Assessment of Photophobia and Impact on Activities of Daily Living

This study assessed photophobia in patients with benign essential blepharospasm (BEB), and determined the impact of blepharospasm on activities of daily living. Utilizing a patient–researcher collaborative approach, this study was conducted in partnership with the Benign Essential Blepharospasm Research Foundation. Of 316 respondents, 94% reported light sensitivity and 25% reported severe activity limitations. Photophobia appears to be more prominent in BEB than previously thought. Light exacerbates and triggers symptoms that compromise quality of life by affecting daily activities. Collaboration with self-advocates can be an effective way to conduct questionnaire-based research. The authors recommend development of other studies that use this type of partnership.     

Assessment of testicular metabolic integrity with P-31 MR spectroscopy

To evaluate the reliability of phosphorus-31 magnetic resonance (MR) spectroscopy in the assessment of acute testicular ischemia, vascular integrity, and spermatogenesis, the authors studied in vivo canine and primate testicles grouped as follows: group 1 testes (n = 8), in situ canine controls; group 2 (n = 11), canine testes subjected to warm ischemia; group 3, canine (n = 4) and primate (n = 4) testicles from hormone-treated animals. Group 1 control testicles showed high monophosphoester (MP) levels; low levels of inorganic phosphate (Pi), phosphodiester (PD), and phosphocreatine; and high levels of adenosine triphosphate (ATP). Group 2 testes revealed a time-dependent decay of MP/Pi ratios (from 2.1 to 0.70). Regeneration of ATP was noted in the acute reperfusion period. After 6 weeks of pituitary gonadotropin suppression, group 3 testes showed a significant decrease (P less than .05) in MP/PD ratios from a control level of 2.6 +/- 0.3 and a decrease in the MP/beta-ATP ratio from 2.4 +/- 0.1 to 1.8 +/- 0.3. P-31 MR spectroscopy appears to be a potential method for noninvasively assessing testicular ischemic injury and the metabolic integrity of spermatogenesis.     

Penetrating chest wall and thoracic injuries

Two hundred seventy patients with penetrating chest wall and thoracic injuries were treated at the Metropolitan Nashville General Hospital in a 5.5-year period ending July 1982. Most (250) were males, and the average age was 29.3 years. One hundred thirty-four injuries were the result of gunshot wounds and 18 patients had sustained shotgun wounds. Stab wounds were the cause of injury in 117 patients. Most patients were successfully treated with closed tube thoracostomy. Twenty-five patients required emergency room thoracotomy, and 27 patients were stable enough to be transported to the operating room for thoracotomy and repair of injuries. Survival in the patients who had emergency room thoracotomy was 12 per cent and 78 percent in patients who had operating room thoracotomy. All but one of the patients who died following operating room thoracotomy died within 1 hour of admission. When thoracotomy is indicated, it frequently must be performed very soon after admission. The indications for emergency thoracotomy must be known and recognized early if it is to be an effective procedure.