Surgical management of essential blepharospasm.

We have reviewed the surgical management of essential blepharospasm over the last 15 years, comparing the results from facial nerve avulsion with those from orbicularis muscle stripping. After facial nerve avulsion 50% of patients remained free of troublesome spasm for 15 months after surgery, but only 25% remained so for more than two years. Following orbicularis oculi myectomy 50% of patients were free of troublesome spasms for 30 months after surgery and 55% of patients had relief from spasm for more than two years.

Gliomatosis peritonei with malignant transformation: a case report and review of the literature.

Gliomatosis peritonei is the implantation of glial tissue within the peritoneal cavity associated with ovarian teratomas. Previous reports have emphasized improved outcomes when these implants are found to be mature, even if the ovarian component is immature. A 16-year-old female with grade 3 immature teratoma was found on two subsequent laparotomies to have extensive peritoneal implantation of mature glial tissue.

Capillary haemangiomas: an approach to their management.

Twenty-five children with eyelid haemangiomas were reviewed. Fifteen patients with enlarging lesions thought to be at risk of causing amblyopia were treated with intralesional steroids as soon after presentation as possible. This appeared to reduce significantly the incidence of amblyopia.

Medical canthal resection: an effective long-term cure for medial ectropion.

The results of 37 medial canthal resection procedures performed for the correction of severe paralytic or involutional medial ectropion are presented with an average follow-up of 5.4 years. Epiphora was improved in 33 out of the 37 cases and all but one patient had an anatomically improved lid-globe apposition, medial canthal angle, and posterofixation of the medial canthus.

Growth rates of subclinical abdominal aortic aneurysms--implications for review and rescreening programmes.

One hundred and six patients with abdominal aortic aneurysms (AAAs) of 2.5 to 3.9 cm in anteroposterior diameter were reexamined by ultrasound every 6 months for up to 3 years after diagnosis.

Molecular and cellular aspects of hydroxyindole-O-methyltransferase expression in the developing chick pineal gland.

The pineal gland influences circadian activity and seasonal breeding through the production of an indolic hormone, melatonin. The terminal step of melatonin biosynthesis is catalyzed by hydroxyindole-O-methyltransferase (HIOMT). Using an antibody directed against HIOMT, we examined the differentiation of the melatoninergic phenotype in the developing chick pineal gland.

Blepharochalasis. A review of 30 cases.

This paper presents the findings in a series of 30 patients with blepharochalasis, including the age of onset, sex, predisposing factors, symptoms and signs, frequency and duration of attacks, and length of the history. There were 16 bilateral and 14 unilateral cases. The condition can be divided into an active (early) and a quiescent (late) stage.

Eyelid surgery in facial palsy.

Paralysis of the orbicularis oculi muscle is by far the most serious consequences of loss of function of the facial nerve. The severity of the resultant ocular problems is related to the degree and duration of this paralysis. The primary goal of the ophthalmologist in managing the patient with orbicularis oculi paralysis is to protect the cornea.

Distribution of arrestin-like protein and beta-subunit of GTP-binding proteins in quail choroid plexuses.

Monoclonal antibodies (Mabs) directed against retinal arrestin (S-antigen) were used to detect and characterize this protein in choroid plexus (CP) of quails maintained during eight days, either under long-day photoperiods or in constant darkness. Immunocytochemistry and Western blotting confirmed the presence and the distribution of an arrestin-like protein in quail CP. Arrestin-like immunoreactivities in CP were compared with those obtained with Mabs to beta 36-subunit of G proteins (G beta), alpha-subunit of transducin and rhodopsin.

[Digital island autograft flaps in pulp defects. 18 cases].

Eighteen homodigital island flaps were performed for pulp defects over a period of two years in the Hand Emergency unit. Apart from one failure due to an incorrect indication, the results confirmed the excellent trophicity of the flap and its aesthetic appearance was appreciated by the 17 patients. Discrimination on Weber's test, the possibilities of advancement, and the fact that the size of the flap can be tailored to individual needs make it one of the most attractive alternatives in this type of indication.

Recent changes in the treatment of aortoiliac occlusive disease by the Oxford Regional Vascular Service.

Over the four years from 1 January 1985 to 31 December 1988, 192 patients were treated for aortoiliac occlusive disease by the Oxford Regional Vascular Service. The number of patients treated by percutaneous transluminal angioplasty increased from two in the first year of the study to 34 in the third year of the study. This increase was accompanied by a decrease in the proportion of patients treated by aortobifemoral bypass but the proportion of patients treated by extra-anatomic bypass remained constant at around 30 per cent.

Congenital eyelid retraction.

Twenty two patients with primary congenital lid retraction affecting either the upper or lower eyelids or both are presented. The clinical features and management are discussed in the hope that recognition of this clinical entity will prevent unnecessary investigation.

Which deaths in vascular surgery are avoidable? A review of 150 consecutive deaths occurring on the Oxford regional vascular service.

One hundred and fifty consecutive deaths occurring on the Oxford regional vascular service were reviewed using data collected prospectively by weekly audit to determine which deaths were avoidable. During the period of study there were 2449 admissions to the vascular service and 1796 operations were performed. Of those who died 71 (47%) had aneurysmal disease and 76 (51%) occlusive disease.

Ophthalmic management of seventh nerve palsy.

The management of acute and established seventh nerve palsy is discussed with reference to corneal exposure, paralytic ectropion and the cosmetic defect. Details are given of how these can all be improved with relatively simple procedures which can be performed under local anaesthesia as an outpatient.

N-acetylation of serotonin is correlated with alpha 2- but not with beta-adrenergic regulation of cyclic AMP levels in cultured chick pineal cells.

We investigated the role of cyclic AMP (cAMP) in alpha 2- and possible beta-adrenergic regulation of arylalkylamine-N-acetyltransferase (NAT), the penultimate enzyme in the biosynthesis of melatonin. The study was performed on primary cultures of dispersed chick pineal cells. Electron microscopy indicated that approximately 70% of the dispersed cells were modified photoreceptors.

Is percutaneous transluminal angioplasty better than exercise for claudication? Preliminary results from a prospective randomised trial.

Percutaneous transluminal angioplasty (PTA) is a commonly performed procedure for the treatment of intermittent claudication despite the lack of controlled studies. The aim of this study was to compare PTA with supervised exercise therapy for patients with arterial occlusive disease judged suitable for PTA at angiography. Patients were assessed before treatment commenced and at three monthly intervals afterwards.

A proposal for a precise definition of abdominal aortic aneurysm. A personal view.

Recent advances in Vascular Surgical practice have highlighted the urgent need for a precise internationally agreed definition of what an abdominal aortic aneurysm is. After consideration of possible alternatives a proposal is made that "An abdominal aortic aneurysm is present when the maximum external diameter of the infrarenal abdominal aorta is either (1) greater than 4.0 cm or (2) exceeds the maximum diameter of the aorta between the origin of the superior mesenteric and left renal arteries by at least 0.

A community detection program for abdominal aortic aneurysm.

This study aimed to discover the prevalence of undiagnosed abdominal aortic aneurysm in the community in men aged sixty-five to seventy-four. All 1,392 men in this age group registered with twenty general medical practitioners were invited for free health screening at hospital and 746 attended. The abdominal aorta was imaged by ultrasound and its anteroposterior diameter measured.

Micrographic (MOHS') surgery in the management of periocular basal cell epitheliomas.

The use of fresh tissue micrographic surgery offers distinct advantages over other currently available forms of treatment in the management of primary and recurrent periocular basal cell epitheliomas. The technique is described and the results of a prospective study of 22 patients are presented. The advantages in terms of both surgery of tumour excision and tissue preservation are discussed.

The Mersilene mesh ptosis sling.

A variety of materials are currently available for use in brow suspension ptosis surgery when an alternative to autogenous fascia lata is indicated. We describe the use of a Mersilene mesh sling, developed to overcome the problems of failure and extrusion commonly associated with substitute suspensory materials. The results and follow up in 23 cases of blepharoptosis are presented.

Two year prospective analysis of the Oxford experience with surgical treatment of abdominal aortic aneurysm.

During the two years from 1 November 1985 to 31 October 1987, 177 patients were admitted to a hospital in Oxford with the diagnosis of abdominal aortic aneurysm (AAA). The aneurysm had ruptured in 88 patients, of whom 75 underwent emergent surgical treatment, yielding an operative mortality rate of 36 per cent. Of the 13 patients who did not have surgical treatment, two died before transfer to the operating room; in the other 11 patients, a deliberate decision was made not to undertake surgical treatment--in ten patients, the reason was an age of 85 years or more and in one patient, severe debilitating Parkinson's disease.