Characteristics of optic disc changes in Taiwanese patients with primary angle-closure glaucoma.

BACKGROUND AND PURPOSE: Primary angle-closure glaucoma (PACG) is the predominant form of glaucoma among Asians. Although numerous studies have been done to describe the characteristic optic disc changes in patients with primary open angle glaucoma (POAG) which is the predominant form of glaucoma among Western populations, few studies have evaluated the optic disc changes in patients with PACG. The aim of this study was to elucidate the characteristic intrapapillary and parapapillary disc changes in PACG in a cross-sectional study and to develop a practical approach to the detection of glaucomatous optic disc changes in PACG by ophthalmoscopic examination. METHODS: A total of 103 eyes in 103 PACG patients were studied. Forty one eyes of 41 age- and sex-matched healthy subjects served as controls. Three glaucoma-trained subspecialists examined stereophotographs of optic discs to evaluate the intrapapillary and parapapillary changes. The differences in PACG and control group eyes were compared. RESULTS: Concentric steep enlargement of the optic disc was found in 99 PACG eyes (96%). Local notching was noted in only 3 eyes, and vertically oval-shaped cupping of the optic disc in only 1 eye. Disc hemorrhage was not detected in any eye. Parapapillary atrophy of the alpha zone involving both temporal and nasal side of the optic disc and parapapillary atrophy of beta zone were significantly more frequent in the PACG group. The presence of an alpha zone or a beta zone simultaneously involving both the temporal and nasal side of the optic disc was associated with more severe optic nerve head damage. CONCLUSIONS: The intrapapillary change in the PACG group eyes reflected the development of cupping in PACG patients with small and compact optic discs. The parapapillary atrophy paralleled the intrapapillary optic disc cupping in eyes of the PACG group.     

Bilateral maxillary duplication: case report and literature review

Accessory maxillary jaws are extremely rare occurrences. Currently, there is only 1 report of bilateral accessory maxillary jaws in the English-language literature. We present a case of a 7-year-old girl with bilateral bony exostoses extending from the maxillary tuberosities. The patient also had restricted protrusive and lateral excursive movements of the mandible. The histologic report revealed teeth in various developmental stages within the bony exostoses. We concluded that these structures were an isolated form of bilateral accessory maxillary jaws.     

A randomised,double blind,placebo controlled study of celecoxib,a selective cyclooxygenase 2 inhibitor,on duodenal polyposis in familial adenomatous polyposis

BACKGROUND: Non-selective cyclooxygenase (COX) inhibitors (non-steroidal anti-inflammatory drugs) inhibit large bowel carcinogenesis in patients with familial adenomatous polyposis (FAP). Their role in the duodenum of these patients is less certain. The disease modifying activity of specific COX-2 inhibitors has not been explored in humans. Patients and methods: This was a randomised, double blind, placebo controlled study of celecoxib (100 mg twice daily (n=34) or 400 mg twice daily (n=32)) versus placebo (n=17), given orally twice daily for six months to patients with FAP. Efficacy was assessed qualitatively by blinded review of shuffled endoscopy videotapes comparing the extent of duodenal polyposis at entry and at six months and quantitatively by measurement of the percentage change in duodenal area covered by discrete and plaque-like adenomas from photographs of high and low density polyposis. RESULTS: Shuffled and blinded video review showed a statistically significant effect of 400 mg twice daily celecoxib compared with placebo treatment (p=0.033) with all five independent observers scoring a beneficial effect. Overall, patients taking celecoxib 400 mg twice daily showed a 14.5% reduction in involved areas compared with a 1.4% for placebo (p=0.436). However, patients with clinically significant disease at baseline (greater than 5% covered by polyps) showed a 31% reduction in involved areas with celecoxib 400 mg twice daily compared with 8% on placebo (p=0.049). CONCLUSIONS: A panel of five endoscopists found a significant reduction in duodenal polyposis after six months of treatment with celecoxib 400 mg twice daily. COX-2 inhibition may help this otherwise untreatable condition.     

A Prospective Comparative Study of the Aetiology of Cerebral Palsy and Epilepsy in a One-Year Birth Cohort from Northern Finland

ABSTRACT. The one-year birth cohort from Northern Finland comprises 12058 children, representing 96% of all live births in 1966 in the two northernmost provinces of Finland, Oulu and Lapland. Only 14 children, 1.2 per thousand, were lost during the follow-up to 14 years of age, in which data were collected prospectively on development, mortality and morbidity using questionnaires and registers. When all 47 children with cerebral palsy fulfilling the criteria of the Little Club of London (1959) were included, a prenatal risk factor was detected in 13 infants (27.7%) and a perinatal one in 25 children (53.2%), whereas 9 children (19.1%) represented an untraceable form of this disorder. There were 208 children with epilepsy, among which 18 (8.7%) had a prenatal risk factor, 38 (18.2%) a perinatal one, 33 (15.9%) a postnatal one, and 119 (57.2%) no identifiable risk factor. Among the 11320 healthy children in the cohort alive at 14 years of age, there were 992 (8.8%) with risk factors for cerebral palsy and epilepsy. The relative risk attached to these aetiological factors was lower for epilepsy than for cerebral palsy.     

Valgancyclovir as maintenance therapy for cytomegalovirus retinitis in a lung transplant patient--a case report

The purpose of this article is to report the use of valgancyclovir as maintenance therapy for cytomegalovirus (CMV) retinitis in a lung transplanted patient. RESULT: A 30-year-old woman with underlying pulmonary lymphangioleiomyomatosis received a lung transplant 1 year ago. CMV retinitis developed 4 months later but subsided after intravenous ganciclovir treatment. Unfortunately, the CMV retinitis recurred three times in 1 year while on oral ganciclovir maintenance therapy. To treat the latest relapse, valgancyclovir 900 mg once daily was used as maintenance therapy after intravenous gancyclovir induction. With a 6-month follow-up, the fundoscopic examination revealed old atrophic scar and no active CMV retinits. The patient was able to maintain best-corrected visual acuity of 20/20 in both eyes. In conclusion, Valganciclovir may be used as maintenance therapy in CMV retinitis.     

Localization of Low Molecular Weight Acrosin-Trypsin Inhibitors in the Boar Genital Tract by Immunofluorescence

Immunofluoreszenzstudien zur Lokalisation der niedermolekularen Akrosin-Trypsin-lnhibitoren im Genitaltrakt des Ebers
Mit Hilfe der indirekten Immunfluoreszenz wurde das Vorkommen von niedermolekularen, säurestabilen Akrosininhibitoren im Ebergenitaltrakt unter Verwendung von spezifischen, gegen Akrosininhibitoren des Seminalplasmas gerichteten Immunglobulinen von Kaninchen untersucht. Die Akrosininhibitoren wurden in den Mucosazellen der Cauda epididymis, des Ductus deferens, der Bläschendrüsen, der Urethra und in bestimmten eng begrenzten Drüsenabschnitten der Prostata nachgewiesen. Diese Verteilung der Akrosininhibitoren innerhalb des Ebergenitaltraktes weist auf eine Schutz-funktion gegenüber der zerstörenden proteolytischen Wirkung von Akrosin hin, das z.B. während der Spermatozoenalterung aus zerfallenden Spermatozoen freigesetzt wird.

Resumen

Localización por inmunofluorescencia de inhibidores de acrosina-tripsina de peso molecular bajo, en el aparato genital del verraco
Utilizando la técnica de inmunofluorescencia indirecta se hizo un estudio de la existencia y distributión de los inhibidores de acrosina ácido estable de peso molecular bajo en el plasma seminal (BSAI) del tracto genital del verraco. El estudio se realizó aplicando inmunoglobulinas especificas de conejo de inhibidor-directo.
Los inhibidores de acrosina están localizados en las células mucosas de la cola del epididimo, deferentes, vesiculas seminales, uretra y en diferentes estructuras glandulares de la próstata.