Bilateral third and unilateral sixth nerve palsies as early presenting signs of metastatic prostatic carcinoma.

Purpose: To report four cases of cranial nerve palsy, which presented to the ophthalmologist as the only or one of the earliest manifestations of prostatic carcinoma. This is an infrequent complication of metastatic prostatic carcinoma usually only occurring late in the disease process in those with a history of prostatic carcinoma.

Methods: The case records of four patients with a history of a cranial nerve palsy who attended the ophthalmology department and who had a recent or subsequent diagnosis of prostatic carcinoma were reviewed.

Candida parapsilosis: two cases of endocarditis in association with the Toronto stentless porcine valve.

Candida parapsilosis endocarditis in association with prosthetic heart valves is rare. We report the first two cases of C. parapsilosis endocarditis on the Toronto stentless porcine valve (TSPV) and the first reported case of successful elimination of infection without lifelong antifungal therapy.

Severe cardiovascular depression with remifentanil.

Unlabelled: We compared the hemodynamic effects of a bolus administration of 1 microg/kg remifentanil for 1, 3, and 5 min (1, 0.33, and 0.2 microg.

Electronic cell counting to measure total cell numbers in bronchoalveolar lavage fluid.

Cell counting of bronchoalveolar lavage (BAL) fluid is performed manually in routine practice. This has both methodological and inherent errors; however, the accuracy and suitability of automated counting devices have been questioned. In this study, a Coulter Counter D Industrial model was calibrated and then used to measure the total cell count in unprocessed bronchoalveolar lavage fluid, and compared to a standard manual method.

Reduction of free radical generation minimises lower limb swelling following femoropopliteal bypass surgery.

Oxygen-derived free radicals have been implicated as contributors to the development of lower limb oedema observed after femoropopliteal bypass grafting. This study investigates the occurrence of free radical-induced lipid peroxidation after this operation and the possible effects of allopurinol (xanthine oxidase inhibitor) in reducing free radical injury in order to minimise lower leg oedema. Twenty-nine patients undergoing femoropopliteal bypass surgery were randomised in a double blind fashion into two groups; those in one were given allopurinol 200 mg orally (n = 15) at 24 h and 2 h preoperatively and again at 24 h postoperatively, while those in the second group received a placebo (n = 14).

A double-blind study of L-threonine in patients with spinal spasticity.

We conducted a double-blind, placebo-controlled, crossover study of oral L-threonine at 6 g/day in patients with spinal spasticity. Muscle tone from selected leg muscles, measured by the Ashworth Scale, was the principal measure of spasticity and was evaluated before and at the end of each treatment period. A 10% reduction in Ashworth score was regarded as a positive response to a treatment.

Special people.

I am writing in response to your article 'It's the patients who take us through' (News features Nursing Standard November 20).

Characteristics of the Pharmaseal continuous flushing device.

Pharmaseal continuous flushing devices were tested with regard to flow characteristics into simulated arterial and venous pressure systems. Two driving pressures were used and it was found that variation in driving pressure made a significant difference to the flow, while arterial or venous pressure made no significant difference. The flow devices had a wide variation although they were all of the same type.