6-hydroxydopamine in the treatment of open-angle glaucoma.

We evaluated the effectiveness of subconjunctival injections of 6-hydroxydopamine in conjunction with epinephrine in lowering ocular tension in 63 eyes of 61 patients with open-angle glaucoma. A single injection caused a peak median reduction in ocular tension of 6 mm Hg four weeks after the injection. Ten eyes (16%) showed no significant decrease in ocular tension.

Neonatal effect of prolonged anesthetic induction for cesarean section.

The relationship of induction-to-delivery and uterine incision-to-delivery intervals to neonatal outcome was studied in 105 parturient women undergoing cesarean section. Sixty patients received general anesthesia and 55 were given spinal anesthesia. During general anesthesia, induction-to-delivery intervals of more than 8 minutes and uterine incision-to-delivery intervals of more than 3 minutes were associated with significantly more instances of neonatal acidosis (umbilical artery pH 7.

Epidural anesthesia for cesarean section in diabetic parturients: maternal and neonatal acid-base status and bupivacaine concentration.

Acid-base status and blood levels of bupivacaine were determined in 16 diabetic parturients and their infants after epidural anesthesia for cesarean section. The newborn infants were divided into two groups based on umbilical artery pH at birth. Group A consisted of 10 infants who had a pH of less than 7.

Management of primary optic nerve meningiomas. Current status--therapy in controversy.

The diagnosis, pathology, and management of primary optic nerve meningiomas are described from a study of 55 patients collected from the author's own series and the files of the Registry of Ophthalmic Pathology at the Armed Forces Institute of Pathology. Diagnosis may be confusing in childhood, especially in the presence of neurofibromatosis when it must be differentiated from optic nerve glioma. The disease is especially aggressive and life-threatening in the young.

Computed tomography in planning and evaluating orbital surgery.

Computed tomography (CT) scanning of the orbit has enhanced the diagnostic and surgical armamentarium of the orbital surgeon, localizing the lesion in the retrobulbar spaces and separating those expanding masses confined to the orbit from those that invade from adjacent structures. It relates an orbital lesion to the surgical spaces, optic nerve and globe, and bony orbital walls, guiding the operator in his surgical approach. If the lesion has escaped from the orbit into the intracranial cavity, CT scanning can detect it.

Epidural anesthesia for cesarean section: a comparison of bupivacaine, chloroprocaine, and etidocaine.

The authors studied three groups of patients undergoing elective cesarean section during lumbar epidural anesthesia with bupivacaine, 0.75 per cent (15 patients), chloroprocaine, 3 per cent (15 patients) or etidocaine, 1 per cent (ten patients). Excellent sensory and motor block were obtained with chloroprocaine and bupivacaine; sensory anesthesia was inadequate with etidocaine in most patients.

Effects of maternal position on epidural anesthesia for cesarean section, acid-base status, and bupivacaine concentrations at delivery.

In 25 patients excellent clinical anesthesia for elective cesarean section was obtained with lumbar epidural block using an average dose of bupivacaine of 130 mg (18 ml of 0.75 per cent solution). Supplemental drugs were not needed.

Oculomotor nerve regeneration after aneurysm surgery.

A 57-year-old woman had symptoms of oculomotor nerve palsy first appearing one year before successful surgical ligation of a saccular aneurysm arising from the right posterior cerebral artery. During the subsequent postoperative period of two years, oculomotor nerve functions improved as the result of regeneration. Extensive morphometric evaluation of the regenerated nerve was compared to the normal side at the light microscopic level.

Computed tomography of the visual pathways.

Many articles have discussed the anatomy and pathology of the orbits. Although this area is exquisitely visualized via computed tomography, the bulk of the visual apparatus lies behind the optic canal. A variety of pathologic conditions will manifest themselves by changes in the visual fields.

Transport of antibiotics and metabolite analogs by systems under cyclic AMP control: positive selection of Salmonella typhimurium cya and crp mutants.

Mutants in the cyclic AMP (cAMP) control system in Salmonella typhimurium (cya = adenyl cyclase, crp = cAMP receptor protein) were partially resistant to growth inhibition by 22 antibiotics (including fosfomycin, nalidixic acid, and streptomycin) and 29 inhibitory analogs of normal bacterial fuel/carbon sources. This resistance was used as the basis for an efficient positive selection of cya and crp mutants. We propose that these antibiotics and analogs enter the bacteria through transport systems normally used for transporting fuel/carbon sources and that this is accomplished because of a structural similarity between the antibiotic and the natural substrate of the particular transport system involved.

Muscle pain following administration of suxamethonium to pregnant and non-pregnant patients undergoing laparoscopic tubal ligation.

The frequency of muscle pain following suxamethonium was studied in 50 pregnant (8-13 weeks' gestation) and 100 non-pregnant women, undergoing laparoscopic tubal ligation. The incidence of muscle pain in the non-pregnant group was 42%, but only 20% in the pregnant women. The intensity of fasciculation was less in the pregnant patients.

Mucoceles of the sphenoid sinus: neuro-ophthalmologic manifestations.

Seven examples of mucocele of the sphenoid sinus have been described. The characteristic symptoms and signs have been described, and the diagnostic neuroradiologic features have been demonstrated. The condition is not a benign one, as is demonstrated by total blindness which occurred in one patient (Case 2).

Neurobehavioral responses and drug concentrations in newborns after maternal epidural anesthesia with bupivacaine.

The neurobehavioral status of 20 newborn infants was evaluated after two to four hours of life following maternal epidural anesthesia with bupivacaine for labor and vaginal delivery. All infants were normal products of uncomplicated full-term gestations. The 20 infants, whose mothers had received continuous lumbar epidural anesthesia with bupivacaine, demonstrated no measurable difference from control infants and did not have the decrease in muscle tone and strength observed in infants whose mothers had received continuous lumbar epidural anesthesia with lidocaine or mepivacaine in a previous study.

Acidosis, local anesthetics, and the newborn.

Four newborn infants were studied following maternal epidural block with lidocaine or mepivacaine. Each of these neonates, born with a pH of 7.23 or below in the umbilical vein blood, showed an elevated fetal-to-maternal concentration ratio, a possible manifestation of ion trapping of a weak base.

The anesthetic eye: an investigation of changes in the anterior ocular segment of the monkey caused by interrupting the trigeminal nerve at various levels along its course.

Operations were performed at four different levels on the fifth nerve of the monkey to determine which procedure offers the best chance of avoiding ocular complications after surgical treatment of trigeminal neuralgia (Figure 18). (1) Section of the ophthalmic branch of N V results in immediate corneal anesthesia. After one week, chromatolysis of the unipolar gasserian ganglion cells subserving the first division occurs and Wallerian degeneration of the corneal nerves of the ipsilateral eye is seen.

Newborn blood levels of lidocaine and mepivacaine in the first postnatal day following maternal epidural anesthesia.

Distribution and elimination of lidocaine and mepivacaine were studies in 114 subjects after obstetric epidural anesthesia, Epinephrine significantly lowered the concentrations of lidocaine in the mothers' circulations by about 33 per cent, and the concentrations of mepivacaine by about 22 per cent. It also significantly altered their concentrations in the newborns' circulations at delivery and in the first 4 hours after birth. More mepivacaine than lidocaine crossed the placenta.

Cyclic 3', 5'-adenosine monophosphate phosphodiesterase mutants of Salmonella typhimurium.

Positive selection procedures for mutants of Salmonella typhimurium lacking cyclic 3', 5'7-adenosine monophosphate (cAMP) phosphodiesterase have been devised. The gene (cpd) coding for this enzyme has been located on the chromosome and shown to be 25% co-transducible with metC using phage P22. The mutants have been used to investigate the role of the enzyme in the control of genes whose expression is known to be dependent on cAMP.

A new method of fetal heart rate monitoring.

A new method of continuous fetal heart rate monitoring, employing for cardiotachometry the fetal electrocardiogram obtained from electrodes placed on the maternal abdomen, was evaluated over a period of 26 months at the Lying-in Division of the Boston Hospital for Women. A total of 2460 hours of intrapartum monitoring were analyzed. This "noninvasive" method of fetal ECG-based monitoring was shown to be as accurate as the direct scalp electrode method and more reliable than indirect ultrasound.