Role of radiotherapy in the treatment of cancer of the ovary.

The initial management of carcinoma of the ovary is surgical. The need for further treatment is determined by a consideration of tumor stage, grade, and the presence of residual disease. Approximately one-third of patients are suitably managed by primary post-operative radiotherapy directed to the entire abdomen and pelvis with curative intent.

How far can a medial rectus safely be recessed?

Previous studies have suggested that the location of the equator should be important in determining the site of a "safe maximum recession" of a rectus muscle, and that the location of the equator should be a function of axial length. Exactly where in relationship to the equator a muscle can be safely recessed has never been scientifically determined. Over a 4-year period, we measured axial length on all patients we operated on for strabismus.

Factors influencing response to strabismus surgery.

Based on analyses in a series of 116 patients, we found that the response to strabismus surgery (degrees of change of ocular alignment per millimeter of rectus recession) correlated significantly with the preoperative deviation for esotropic and exotropic patients. The prediction of response to strabismus surgery was not improved significantly with the inclusion of axial length, age, and/or preoperative refractive error beyond the prediction provided with use of only the preoperative deviation, even though we have previously suggested that the response to strabismus surgery should be related to axial length. We believed that larger eyes should have a smaller response for the same number of millimeters of surgery than smaller eyes.

Postoperative binocularity in adults with longstanding strabismus.

The authors tested preoperatively and postoperatively for binocularity with the Bagolini lenses in a series of 359 adults who underwent surgery for long-standing constant strabismus. Eighty-six percent of patients showed a binocular response with the Bagolini lens test almost immediately after surgery. Regardless of the type of deviation present preoperatively, the duration of strabismus, or the depth of amblyopia in the deviating eye (if present), the vast majority of patients developed binocularity.

A comparison of performance measures of an added-purpose task versus a single-purpose task for upper extremities.

Occupational therapists often employ multidimensional tasks. These tasks, referred to as added-purpose tasks, provide a person with necessary exercise, yet direct the focus of attention toward another objective or outcome. The assumption is that the additional purpose will result in improved task performance, provided it is sufficiently distracting or meaningful to the person.

Variation in axial length and anatomical landmarks in strabismic patients.

The authors calculated axial length measurements in 185 consecutive patients undergoing strabismus surgery and found a mean measurement of 21.98 +/- 1.59 mm (range, 18.

The Emory cubicle bed: an alternative to restraints for agitated traumatically brain injured clients.

As traumatically brain injured (TBI) clients emerge from coma, there may be transitory periods of agitation during which they pull at feeding tubes and intravenous catheters and thrash about, thus placing themselves at high risk of injury. During these periods, staff traditionally have resorted to restraints. But chemical restraints actually may be detrimental to cognitive recovery, and physical restraints often serve to increase agitation and foster dependence.

Should recessions of the medial recti be graded from the limbus or the insertion?

In a series of 27 patients who were operated on for esotropia, we compared patient response to surgery and the distance the medial recti were recessed from the insertion and corneoscleral limbus. We found a much more significant correlation between the response and the amount the muscles were recessed from the insertion than from the corneoscleral limbus. Using partial correlation coefficients, we found that when we corrected for the amount of recession from the insertion, there was not a significant correlation between the response to surgery and the amount the muscles were recessed from the corneoscleral limbus.

The influence of axial length on the response to strabismus surgery.

We performed axial length determinations preoperatively on a series of patients undergoing strabismus surgery. A statistically significant inverse correlation was found between axial length and the response (prism diopters per millimeter of medial rectus recession) for esotropic patients. The data suggest that a surgical formula designed to take axial length into account would decrease the variability in response to strabismus surgery in esotropic patients.

LL-F28249 antibiotic complex: a new family of antiparasitic macrocyclic lactones. Isolation, characterization and structures of LL-F28249 alpha, beta, gamma, lambda.

A new family of antiparasitic macrolides has been isolated from Streptomyces cyaneogriseus sp. noncyanogenus. The compounds, designated LL-F28249 alpha, beta, gamma and lambda, possess potent antiparasitic activity.

Treatment of partly accommodative esotropia with a high accommodative convergence-accommodation ratio.

We conducted a prospective, randomized, masked comparison of two treatments for the nonaccommodative element in esotropic patients with a high accommodative convergence-accommodation ratio. One group received symmetric medial rectus recessions with posterior fixation sutures; the other received symmetric medial rectus recessions without posterior fixation sutures but augmented according to formula taking into account the near deviation. Previous experience had suggested that our surgical formula based solely on the distance deviation would lead to excessive undercorrections.

Chemistry of maduramicin. II. Decarboxylation, abnormal ketalization and dehydration.

The behavior of the free acid and ammonium salt of maduramicin towards heat and alcohols is examined. In refluxing lower alcohols the free acid material is decarboxylated. In addition a bisketal decarboxylated compound as well as an A-ring monoketal decarboxylated derivative are formed.

Chemistry of maduramicin. I. Salt formation and normal ketalization.

The formation of monovalent and divalent salt complexes of maduramicin is described and the 13C NMR chemical shift assignments of these materials are tabulated and discussed. In the spectrum of the thallium salt, 20 of the 47 signals are split due to the thallium-carbon coupling. Similarly the preparation of both the free acid and the sodium salt complexes of the normal methyl and ethyl ketal derivatives of maduramicin are outlined.

Biosynthesis of the antibiotic maduramicin. Origin of the carbon and oxygen atoms as well as the 13C NMR assignments.

The biosynthesis of maduramicin alpha and beta in a culture of Actinomadura yumaensis has been studied using 13C, 14C and 18O labeled precursors. The alpha component of this recently discovered polyether antibiotic, containing forty-seven carbon atoms in a seven-ring system, is derived from eight acetate, seven propionate and four methionine molecules. The beta component which is missing one methoxy group incorporates three methionine methyl groups.

New antitumor antibiotic, LL-C10037 alpha. Fermentation, isolation and structure determination.

A new antitumor antibiotic, LL-C10037 alpha was isolated from the fermentation filtrate of a Streptomyces by adsorption, partition and reverse phase column chromatography. Its chemical structure was determined by 1H NMR, 13C NMR, UV, IR and mass spectral data. LL-C10037 alpha is a gamma-aminoepoxysemiquinone and is related to the epoxyguinone class of antibiotics.

A randomized comparison of surgical procedures for infantile esotropia.

In a prospective, randomized, masked study we compared the treatment of infantile esotropia using bilateral medial rectus muscle recessions of a graded amount from the insertion to standard 10.5-mm recession from the corneoscleral limbus. Of the patients undergoing recession of the medial recti muscles 10.

Isolation and identification of piperacillin amide as an impurity in piperacillin.

Piperacillin amide (IV) was successfully identified as the predominant impurity in commercial lots of piperacillin monohydrate (III). The impurity was isolated via a preparative liquid chromatographic scheme utilizing Florisil as the adsorbent and a mobile phase of water-acetonitrile (4:96, v/v). The isolated component had nearly the same reverse-phase HPLC properties as piperacillin and was chemically and thermally unstable.

Components and degradation compounds of the avoparcin complex.

The isolation and characterization of many of the components of the avoparcin complex are described. A number of mild degradations products from this complex are similarly treated. Conditions for the analytical and preparative HPLC resolution of these materials are outlined.

The role of funduscopy and fundus photography in strabismus diagnosis.

Fundus photographs taken in 66 patients with vertical strabismus were analyzed in a blind study with respect to ocular torsion. The objective presence or absence of ocular torsion was then correlated with the patient's clinical diagnosis. The presence or absence of objective ocular torsion as seen in fundus photographs had a sensitivity of 0.