Giant aneurysm arising from the anterior cerebral artery and causing an isolated homonymous hemianopsia

A case of a giant aneurysm arising from the anterior cerebral artery and producing a left homonymous hemianopsia is presented. The aneurysm caused lateral compression of the posterior part of the optic chiasm. After preoperative dynamic assessment of the circle of Willis by angiography and by electroencephalographic recording during carotid artery compression, the aneurysm was trapped with microclips on the anterior cerebral artery proximal and distal to it. Visual field examination 6 months postoperatively showed complete visual field recovery. This is the first case of homonymous hemianopsia caused by an angiographically proven giant aneurysm of the ACA.     

Kinship versus friendship: social adaptation in married and widowed elderly women

The qualities of daughter versus same-sex friend relationships were described by 151 married and widowed elderly women. The relation of these qualities to life satisfaction was assessed. Relationship qualities predicted life satisfaction in widowed women but not in married women. Significant predictors of life satisfaction for widows included the emotional support of daughters, the instrumental support of friends and friendship strength. In a comparison of the relationship qualities, both married and widowed respondents described daughters as providing more stimulation, ego support and utility than friends. Respondents also reported that relationships with daughters were stronger than those with friends. Married women described relationships with both daughters and friends as more stimulating than widowed women. The value of assessing qualitative indices compared to quantitative indices of later life relationships is discussed.     

Hybridization of laboratory strains of sibling species A and B of Anopheles quadrimaculatus

Adult mosquitoes of the Anopheles quadrimaculatus complex were collected from Montgomery County, AL (MON) and Alachua County, FL, (KBG) and laboratory stocks of species A and B were established through a selection procedure employing isofemale lines. Progeny from a cross of species B females to ORL males were usually semisterile females and sterile males. Progeny of the reciprocal cross were also semisterile females and sterile males, but the sex ratio was variable and ranged from normal to no males because of male mortality during the pupal stage. Conspecific crosses between strains from the two locations resulted in fertile offspring. Crosses between the sibling species from the two locations invariably gave semisterile females and sterile males (or lethal effects). This evidence confirmed previous data from hybridization and electrophoretic analyses of field populations indicating that Anopheles quadrimaculatus is a species complex.     

A new member of the Anopheles quadrimaculatus complex, species C

A new member, species C, of the Anopheles quadrimaculatus complex was recently found in collections from the northwest coast of Florida. This new species cannot be differentiated from the other 2 species with available taxonomic keys. Evidence for this taxon as a sibling species includes data on hybrid sterility and distorted sex ratios in the progeny of crosses to species A and B, chromosomal differences, and diagnostic allozymes.     

Clinicopathologic correlation of pigmented epiretinal membranes

We performed clinicopathologic correlation on ten surgically removed pigmented epiretinal membranes causing macular pucker. All cases occurred in eyes with existing retinal holes or tears, including eight cases of macular pucker after previous retinal detachment. These cases probably represented a limited form of proliferative vitreoretinopathy. All membranes contained pigment epithelial cells with polarity, basement membrane, and melanosomes. Cytoplasmic melanin granules accounted for the clinical feature of pigmentation in these eyes.     

Isolating the color vision loss in primary open-angle glaucoma

We evaluated the results of Farnsworth-Munsell 100-Hue tests in age- and lens density-matched eyes of normal subjects, glaucoma suspects, and patients with primary open-angle glaucoma. With these controls in place, no significant correlation between the test results and age or between the test results and lens density was found. However, a significant difference in the total error scores on the 100-Hue test remained. This difference could not be explained by pupil size or medications taken. We concluded that color vision loss in glaucoma is in part attributable to the disease process and cannot be explained solely on the basis of changes in age and lens density.     

Infrared angiography in increased intraocular pressure

Infrared angiography of the fundus was performed twice on a number of eyes of healthy subjects and glaucoma patients, once when IOP was normal and again when it was increased by around 20 mmHg. The passage of contrast medium through the eye, visible as increasing blackening of the film, was recorded quantitatively by computer-aided image analysis. In both groups there was a considerable diminution of fluorescence, in particular of the choroid; the effect on the central artery and the optic disk was somewhat less pronounced.     

Influence of site of obstetric care and delivery on pregnancy management and outcome

A retrospective cohort study of 863 pregnancies cared for by family physicians at three sites--rural-rural (RR), rural-urban (RU), and urban-urban (UU)--was designed to test the hypothesis that ready on-site access to perinatal subspecialists would improve pregnancy outcome. No differences in delivery type, length of gestation, birth weight, or nursery care were found. An Apgar score of less than 7 at 1 minute or less than 8 at 5 minutes was 2.17 and 2.31 times more likely at RU and 2.48 and 2.60 times more likely at UU, respectively, than at RR. The overall Cesarean section rate was 9.6 percent, forceps rate was 7.2 percent, and nonroutine nursery care rate was 7.9 percent. Neonatal and perinatal mortality rates were 3.5 and 4.6 per 1,000 live births. There is no evidence that on-site perinatal subspecialists improve perinatal outcome when care is provided by board-certified family physicians. Small obstetric centers provide quality perinatal care with outcome dependent on physician's skill rather than on technology.     

Analysis of the degree of precision of a computer-assisted dietary survey method

A computer-assisted method for the registration of food intakes in real time according to a concise and simple procedure was subjected to a series of controls in order to assess precision. The method employs the 'portion' of a composite dish as unit of measure. The constancy of the portion was tested. The results show that the recipes of the diet of a subject may be stored and utilized in deferred time without loss of precision: data to be recorded in real time are then very limited. The length of period of analysis was also studied. The time of investigation should not be shorter than two weeks to obtain precise information on the feeding habits of an individual subject, whereas for a group of subjects the diary of a single day provides information of sufficient precision.