Orbital CT in the management of blow-out fractures of the orbital floor

The CT-examinations of 15 patients with blow-out fractures of the orbital floor were reviewed. All patients were examined with coronal/semicoronal CT-imaging, and 7 patients also were evaluated with semisagittal projections. Only in one case the semisagittal images gave more information than coronal sections when using the classification of Gilbard et al. (1985) of the inferior rectus muscle/fracture relationship. The anterior and posterior fracture margins were better delineated with semisagittal imaging. Two patients exhibiting positive traction tests with hooked, and not entrapped muscles on CT still had diplopia 5 1/2 and 12 weeks after the trauma.     

Exteroceptive suppression periods in jaw-closing muscles. Variability and relation to experimental pain and sustained muscle contraction

The duration of the late exteroceptive suppression period (ES₂) of temporal muscle EMG activity has been reported to be reduced in patients suffering from chronic tension-type headache. Methods of recording and analysing ES₂ have varied between centers and reproducibility of results within subjects , although insufficiently studied, has generally been poor. ES₂ was investigated in 30 healthy subjects, using a computerized technique of recording, rectifying and averaging the EMG signals. Hour to hour and week to week variations of ES₂ durations were calculated, and the influence of pain during a cold pressor test and of sustained muscle contraction on ES₂ durations was investigated. The intra-individual variation of ES₂ durations was 16.0% from hour to hour and 20.7% from week to week. The inter-individual variation was 36.7%. The present method for analysis of ES₂ periods proved to be reliable, as the intra-observer variation was 4.2% and the inter-observer variation 4.6%. ES₂ periods were significantly shorter on the first compared to the second day of examination ( p = 0.006) and during experimental pain ( p = 0.0005). We recommend the use of the computerized averaging technique in future studies and caution against the dependence of results upon factors such as conditioning and pain.     

Mortality and cancer incidence among marine engineers and machinists in Iceland

A retrospective cohort study of mortality and cancer morbidity was carried out among 295 marine engineers and 182 machinists with special regard to cancer of the lung. The cohort was defined as all graduates from engineering and machinists school in Iceland during 1936-1955. During vocational training, as well as in their professional lives, marine engineers and machinists are exposed to asbestos, different kinds of mineral oils, and exhaust gases with marked individual variation as regards mode and magnitude of exposure. For deaths occurring between 1951 and 1982 information was obtained from the Statistical Bureau of Iceland. Significantly increased standardized mortality ratios were determined for cancer of the trachea, bronchus, and lung for the entire cohort. Record linkage with the Cancer Register revealed 36 cancers in the period 1955-1982. No statistically significant excess was found for the overall cancer incidence or for the incidence of cancer at any particular site. A special survey of smoking status showed that cigarette smoking was not as common among the subjects of the cohort as among the general male population in Reykjavik. These results support the suggestion that the increased mortality of lung cancer in the study group had a causal relationship to occupational exposure, particularly to asbestos exposure.     

Success and complications of pneumatic retinopexy

Fifty-eight consecutive patients with rhegmatogenous retinal detachment were treated by pneumatic retinopexy using intravitreal perfluoropropane gas. Reattachment was achieved in 29 of 35 eyes (83%) having single retinal breaks (up to 45 degrees in extent), including dialyses (up to 60 degrees), and groups of breaks within one clock hour. The cumulative reattachment rate was 37 of 58 eyes (64%), including eyes with detachments with multiple breaks 30 to 120 degrees apart and vitreous hemorrhage as well as aphakic and pseudophakic eyes. Pneumatic retinopexy was successful in 18 of 22 (82%) myopic eyes (-3 to -11 diopters). Virtually all complications developed in the inferior retinal quadrants, and included preretinal vitreous condensations or membranes in 27 of 58 eyes (47%), new retinal breaks in seven eyes (12%), and rhegmatogenous or tractional detachments in previously attached areas in 14 eyes (24%). Postoperative proliferative vitreoretinopathy occurred in six eyes (10%) and macular pucker in two (3%).     

Acute pericarditis as the initial manifestation in Still's disease in an adult

Almost 90% of primary acute pericarditis are idiopathic. Between specifics forms, a very low percentage of cases are due to chronic rheumatic diseases. A case of adult Still's disease (juvenile chronic rheumatoid arthritis) with acute pericarditis being the first clinical manifestation (besides fever and general syndrome) is presented. Therapy with oral prednisone was rapidly effective, and pericardial effusion resolved after 3 weeks of treatment, as echocardiography showed.     

Porphyria cutanea tarda associated with autoimmune hypothyroidism, vitiligo and alopecia universalis.

The aetiology of porphyria cutanea tarda (PCT) has not been elucidated, but the possibility of an autoimmune mechanism has been proposed. We report a case of an unknown clinical combination of PCT with autoimmune hypothyroidism, alopecia universalis and vitiligo with thyroid and parietal cell circulating antibodies. This is highly suggestive of underlying autoimmune damage in this patient.     

The cardioprotective action of nifedipine during short-term transient ischemia

To determine the therapeutic activity on regional myocardial function of nifedipine intravenous administration (0.16 mg/kg) during short term myocardial induced ischemia, we used 6 mongrel dogs anesthetized and intubated those who we have implanted 3 pairs of ultrasonic crystals in the subendocardial layer. Utilizing an open chest canine model we performed total 1 minute and partial 2 minutes 30 seconds alternative obstructions, controlled with electromagnetic flowmeters in the anterior descending (AD) and circumflex (Cx) coronary arteries before and after drug administration. During the 70-80% obstructions we have shown a significant improvement in segment shortening, reduced by ischemia, in the ischemic and peri-ischemic zone. The ischemic markers, per cent increment of end diastolic length (% IEDL) and per cent increment of end systolic length (% IESL), have shown significant improvement during partial obstructions in the ischemic and peri-ischemic zone. After total obstructions the improvement on regional myocardial function is less marked and limited to ischemic zone.