Retinal pigment epithelial tear associated with subretinal hemorrhage: a case report

Tears of the retinal pigment epithelium (RPE) are a recognized complication of pigment epithelium detachments associated with age-related macular degeneration (ARMD). The RPE tears are often associated with a poor visual prognosis and typically do not occur with subretinal hemorrhage. We report the case of a 76-year-old man with ARMD who developed an RPE tear associated with subretinal hemorrhage, without a demonstrable subretinal neovascular membrane. Temporally, there was a marked decrease in his vision that returned to his earlier baseline visual acuity over the course of six months of observation.     

Central and peripheral effects of oxytocin administration in prairie voles (Microtus ochrogaster)

The present study examined the hypothesis that oxytocin (OT) may influence female sexual behavior in prairie voles (Microtus ochrogaster). The effectiveness of OT to induce sexual behavior was tested in ovariectomized females that were injected daily with estradiol benzoate (EB, 0.02 micrograms, twice), a dose insufficient for estrus induction. On the third day females received intracerebroventricular (ICV) injections of OT (1, 300, or 1000 ng) or saline vehicle. In the presence of minimal estrogen stimulation, OT did not induce sexual receptivity, or influence autogrooming or other social interactions. The behavioral effects of OT were examined in another group of ovariectomized females that received daily oil or EB injections (10 micrograms, twice) followed on the third day by either ICV (1, 300, or 1000 ng) or intraperitoneal (IP) (1, 3, or 10 micrograms) injections of OT. Among EB-treated females, only those in confirmed estrus, prior to ICV or IP injection, were included in these studies. There was a dose-related decrease in the percentage of females that remained in behavioral estrus after ICV OT. In those females that continued to show sexual behavior, lordosis frequencies and durations were unaffected by ICV OT. Nonsexual behavior did not differ between mated females and those exhibiting OT-inhibited sexual behavior. In females that were EB-treated, autogrooming and side-by-side behavior increased after ICV OT, while there was a decline in aggression. Female sexual and nonsexual behaviors were not significantly affected by IP OT.(ABSTRACT TRUNCATED AT 250 WORDS)     

Multiple Cerebral Haematomata and Peripheral Nerve Palsies Associated with a Case of Juvenile Diabetic Ketoacidosis

A 15-year-old girl presented de novo in diabetic ketoacidosis having been comatose for 24 h (day 1). A CT scan and lumbar puncture performed on admission were normal and her conscious level slowly improved over several days. On day 7 she had central neurological signs of bilateral knee clonus and an extensor plantar response. In addition, she had developed lower motor neurological signs of an ulnar nerve palsy of the left forearm, and ulnar, median, and radial nerve palsies of the right forearm. Magnetic resonance imaging (MRI), performed on day 12, showed multiple small cerebral haematomata with appearances at least several days of age. The scattered lesions were localized particularly to the parieto-occipital region, with sparing of the basal ganglia and without cerebral oedema, a novel feature not previously described in juvenile ketoacidosis. Four months later there was minimal residual disability of her right arm. The clinical findings together with the MRI images suggested that the peripheral nerve and central lesions were temporally related, suggesting a common aetiology. However, it is likely that MRI showed cerebral lesions which may have been missed by the conventional CT scanning performed initially.     

Crohn's disease of the vulva

We have reported a case of Crohn's disease of the vulva, an unusual manifestation of inflammatory bowel disease. The initial management of this condition should be medical, using antibiotics and established regimens to control gastrointestinal symptoms. Surgical therapy is appropriate when medical management fails, as it did in our patient.     

Cytokines and growth factors in keratinocytes and sweat glands in chronic venous leg ulcers. An immunohistochemical study

The role of growth factors and cytokines in the impaired healing of chronic leg ulcers remains uncertain. The aim of this study was to determine whether changes in the amount and location of cytokines and growth factors may be associated with impaired healing in chronic leg ulcers. Biopsies from leg ulcers of 21 patients and from normal skin of nine healthy volunteers were examined immunohistochemically for selected growth factors and cytokines. Greater staining intensity was found in keratinocytes at the edges of ulcers compared to normal skin, or skin adjacent to the ulcers. Staining at the ulcer edge was more intense in nonhealing ulcers for only vascular endothelial growth factor and platelet-derived growth factor, whereas staining in the adjacent skin was more intense for all factors in the nonhealing phase. For all factors staining was cytoplasmic, suggesting production in these areas. This study shows up-regulation of the production of cytokines and growth factors in keratinocytes of chronic leg ulcers that is greater when the ulcers are nonhealing.     

Canal Master files: scanning electron microscopic evaluation of new instruments and their wear with clinical usage.

Canal Master instruments have a short, fluted cutting area and a small flexible shaft; they may be predisposed to rapid wear and breakage. This study examined new and used files as to tip, flute, and shaft design when new and with increasing time of canal preparation. One hundred files prepared 140 curved canals. Sizes #20, #40, and #60 files were examined unused and after 1, 3, 5, and 7 min of use. Evaluation was for uniformity when new and for deterioration and breakage with usage. The smaller sizes (#20 and #40) had some inconsistencies when new and were most predisposed to wear and breakage with time. Findings suggest that smaller files could have had improved quality control by the manufacturer. Also, they should be used with caution and discarded after short times of use in small, curved canals. This should minimize instrument separation and maximize cutting efficiency.