Freshwater Salinization Syndrome Alters Retention and Release of 'Chemical Cocktails' along Flowpaths: from Stormwater Management to Urban Streams.

We investigate impacts of Freshwater Salinization Syndrome (FSS) on mobilization of salts, nutrients, and metals in urban streams and stormwater BMPs by analyzing original data on concentrations and fluxes of salts, nutrients, and metals from 7 urban watersheds in the Mid-Atlantic U.S. and synthesizing literature data.

Visual complaints from healthy children.

It is common for healthy children with specific visual complaints to be seen for eye examinations. After a complete eye examination has ruled out pathologic conditions as the cause of these complaints, it is appropriate for the clinician to explore the possibility that normal entoptic or physiologic visual phenomena might have provoked the child's report of vision problems. Some of these normal visual experiences are frequent causes of children's complaints of vision problems, such as physiologic diplopia, relaxation of the near synkinesis during reading, and vitreous body floaters.

Recurrent isolated sixth nerve palsy in children.

Six children had recurrent sixth nerve palsy the average duration of which was six weeks. One youngster, after several episodes of sixth nerve palsy, had residual esotropia and underwent strabismus surgery. The average interval between recurrences was 1.

Timolol in childhood glaucoma.

In determining the role of timolol in the treatment of childhood glaucoma, the difficulties of conducting investigational studies in children and the possible delayed appearance of longterm side effects are real concerns. However, an equally important consideration is the fact that young children may face a lifetime of blindness from uncontrolled glaucoma. Timolol is not always successful in lowering intraocular pressure on a longterm basis in severe glaucoma, but it often does help in managing extremely difficult cases.

Shortterm "escape" and longterm "drift." The dissipation effects of the beta adrenergic blocking agents.

The dissipation phenomena associated with timolol have important implications in the clinical management of glaucoma patients. Shortterm "escape" and longterm "drift" are clinical terms which describe the reduction of timolol's efficacy over a few days and over months and years, respectively. Recent physiological studies suggest a cellular explanation for these readjustments in tissue responsiveness to continued administration of timolol.

Congenital glaucoma unresponsive to conventional therapy: a clinicopathological case presentation.

A clinicopathological case report of a black male with congenital glaucoma is presented. The child died at age three months of the Sudden Infant Death Syndrome. The clinical course was characterized by persistent corneal clouding and elevated intraocular pressure in spite of vigorous medical and surgical therapy.

Optic atrophy and visual loss in craniometaphyseal dysplasia.

Four members of one family had craniometaphyseal dysplasia. Two of the four had severe optic atrophy with profound loss of vision as a complication of this disorder. Optic nerve decompression attempted in one patient may have caused a reduction in the vision of that eye.

Spontaneous absorption of the lens in the congenital rubella syndrome.

Seven eyes in five patients with the congenital rubella syndrome have shown partial or complete absorption of a cataractous lens without surgical intervention. The rare occurrence of spontaneous lens absorption should not be a reason for delaying the early removal of dense bilateral cataracts in this condition.

Timolol in uncontrolled childhood glaucomas.

Thirty-four patients with childhood glaucoma who had difficult management problems in spite of conventional glaucoma medications were entered into an investigational protocol designed at a time when timolol was not available commercially. Since controlled studies in adult glaucoma had demonstrated the efficacy of timolol, a trial of the drug in these difficult childhood cases seemed justified. The study was approved by the Human Studies Committees of the Children's Hospital Medical Center and the Massachusetts Eye and Ear Infirmary, Boston, MA.

Keratoconus and acute hydrops in mentally retarded patients with congenital rubella syndrome.

Four patients with the congenital rubella syndrome had keratoconus and evidence of acute or previous corneal hydrops. All four of the patients vigorously rubbed and poked their eyes. The keratoconus and acute corneal hydrops in these patients probably resulted from chronic traumatizing mannerisms common in other patients with mental retardation and are not specific for the congenital rubella syndrome.

Long-term drift and continued efficacy after multiyear timolol therapy.

The clinical courses of 41 patients who received timolol maleate for experimental protocols were reviewed. We reevaluated the conditions of 17 patients with the elevated pressures of primary open angle glaucoma who had received timolol alone or in combination with other glaucoma medications for a maximum of 35 months (average, 26 months). Withdrawal of timolol led to an average intraocular pressure rise of 5 mm Hg.

Late ocular complications in congenital rubella syndrome.

Ocular consequences of the congenital rubella syndrome are not limited to abnormalities noted in the neonatal period. Additional abnormalities may appear years and even decades after birth. Thirteen patients are presented in whom glaucoma has been diagnosed 3 to 22 years after birth.

The effect of bilateral superior oblique tenotomy on horizontal deviation in A-pattern strabismus.

In order to determine the horizontal effects of bilateral superior oblique tenotomy, all cases of superior oblique tenotomy performed at the Children's Hospital Medical Center and also in a private practice setting over the past ten years were analyzed retrospectively. A total of 18 patients underwent isolated bilateral oblique tenotomy. An average primary position exo-shift of 2 prism diopters was found; in upgaze a significant exo-shift of 11 prism diopters and in downgaze a significant eso-shift of 21 prism diopters were noted.

Timolol in the therapy of "ocular hypertension".

Timolol has been shown to be at least as effective as pilocarpine and epinephrine in the therapy of open angle glaucoma. To date there appear to have been few serious side effects from timolol when it has been used in patients without cardiac or pulmonary disease. The decision whether and when to treat a patient with elevated intraocular pressure depends upon a weighing of risk of glaucoma damage versus the side effects of the drugs used in therapy.

The treatment of glaucoma: role of beta-blocking agents.

The sudden development of a red painful eye with blurred vision may be an acute attack of angle closure glaucoma which requires emergency attention. Once the attack is controlled with medication, surgical intervention with a peripheral iridectomy is indicated to relieve relative pupillary block. Eyes subject to angle closure glaucoma are anatomically different with 'crowded' anterior segments.

The beta-adrenergic blocking agents and the treatment of glaucoma.

The autonomic nervous system is divided into the parasympathetic and sympathetic systems, with three types of adrenergic receptors: alpha (smooth muscle contraction), beta1 (cardiac acceleration and fatty acid mobilization) and beta2 (smooth muscle relaxation). Substances affecting the function of the adrenergic system are the agonists or stimulators, which mimic the effects of endogenous norepinephrine or epinephrine, and antagonists or blockers, which block the receptors and prevent stimulation by the agonists. Autonomic stimulation in the eye mediates various changes which apparently affect outflow facility and rate of formation of aqueous humor.

Psychotropic drugs, summer heat and humidity, and hyperpyrexia: a danger restated.

The authors note an apparent unawareness of, as well as a paucity of recent literature pertaining to, hyperpyrexia as a complication of psychotropic drug treatment. They report a case of hyperpyrexia in a patient receiving psychotropic agents during a summer heat wave; massive muscle destruction (rhabdomyolysis) with myoglobinuria and acute renal failure make this case of particular interest. Causative mechanisms, preventive measures, and the benefits of prompt recognition and treatment of this condition are discussed.

Clinical trial comparing timolol ophthalmic solution to pilocarpine in open-angle glaucoma.

A ten-week, double-masked, randomized, clinical trial compared timolol ophthalmic solution and pilocarpine in the therapy of open-angle glaucoma. Timolol decreased the intraocular pressure at least as much as pilocarpine and did not induce miosis, accommodative spasm, or other annoying side effects. The pulse was slowed by timolol, but blood pressure was unaffected.