Alterations in brain neurocircuitry following treatment with the chemotherapeutic agent paclitaxel in rats.

Human and animal studies suggest that both traumatic nerve injury and toxic challenge with chemotherapeutic agents involves the reorganization of neural circuits in the brain. However, there have been no prospective studies, human or animal, using magnetic resonance imaging (MRI) to identify changes in brain neural circuitry that accompany the development of chemotherapy-induced neuropathic pain (i.e. within days following cessation of chemotherapy treatment and without the confound cancer). To this end, different MRI protocols were used to ascertain whether a reorganization of brain neural circuits is observed in otherwise normal rats exposed to the taxane chemotherapeutic agent paclitaxel. We conducted an imaging study to evaluate the impact of a well-established paclitaxel dosing regimen, validated to induce allodynia in control rats within eight days of treatment, on brain neural circuitry. Rats received either paclitaxel (2 mg/kg/day i.p; cumulative dose of 8 mg/kg) or its vehicle four times on alternate days (i.e. day 0, 2, 4, 6). Following the cessation of treatments (i.e. on day 8), all rats were tested for responsiveness to cold followed by diffusion weighted magnetic resonance imaging and assessment of resting state functional connectivity. Imaging data were analyzed using a 3D MRI rat with 173 segmented and annotated brain areas. Paclitaxel-treated rats were more sensitive to a cold stimulus compared to controls. Diffusion weighted imaging identified brain areas involved in the emotional and motivational response to chronic pain that were impacted by paclitaxel treatment. Affected brain regions included the prefrontal cortex, amygdala, hippocampus, hypothalamus and the striatum/nucleus accumbens. This putative reorganization of gray matter microarchitecture formed a continuum of brain areas stretching from the basal medial/lateral forebrain to the midbrain. Resting state functional connectivity showed reorganization between the periaqueductal gray, a key node in nociceptive neural circuitry, and connections to the brainstem. Our results, employing different imaging modalities to assess the central nervous system effects of chemotherapy, fit the theory that chronic pain is regulated by emotion and motivation and influences activity in the periaqueductal gray and brainstem to modulate pain perception.

[Epibulbar tumours (author's transl)]. / Epibulbäre Tumoren.

After a classification in benign and malignant tumours and in pigmented and non-pigmented growth, attention is drawn to the fact that most of the tumours lie in the palpebral fissure and are benign. Leukoplakia is a clinical description but not a diagnosis. Both the benign and the malignant growths can be called Leukoplakia. The intra-epithelial epithelioma is often incorrectly diagnosed as Bowen's disease. This disease of the skin and the intraepithelial epithelioma of the limbus are histologically quite different, and therefore the term Bowen's disease is incorrect. Not all the various tumours occur with the same incidence, e. g. the squamous cell carcinoma occurs more often in some countries than in others. The malignant melanomas of the conjunctiva are not so malignant as in the caruncle or cornea. In the conjunctiva secundary melanomas can occur after penetration of an intraocular melanoma through the sclera; similary metastases can occur in the form of epibulbar tumours. In all cases the epibulbar tumour should be excised very carefully and a histological examination is necessary for the diagnosis.

Choristoma osseum orbitae. A clinicopathological case report.

A brief description is given of a congenital bone formation in the orbit lying on the surface of the outer canthus of the left eye, without any connection to the bulb.

[Congenital cataract in two families: Heredity and treatment (author's transl)]. / Die kongenitale Katarakt in zwei Familien.

A report is given on the inheritance of congenital cataract in two families. While in one family the males were mainly affected, in the second faimily the females were mainly affected with congenital cataract. In our experience an operation is only indicated if the visual acuity is no longer sufficient for day-to day living (less than 0.25).

[On the pathology of ocular malignant melanoma (author's transl)]. / Zur Pathologie okulärer maligner Melanome

From pertinent cases a contribution to the pathology of melanoma is published here. The histological structure of melanoma in the various eye tissues is dependent on the properties of the tissue in which the melanoma grows. By means of an example we have tried to throw light on the question of the differential diagnosis between a primary tumor and a metastatic deposit, although a single case cannot be used as proof. An intraocular degenerate melanoma and a melanomametastasis in the conjunctiva after a skin tumor are also demonstrated.

[Eduard Zirm (1863-1944)]. / Eduard Zirm (1863-1944).

Eduard Zirm (1863-1944) was the first ophthalmologist to perform a successful keratoplasty, in 1905. He submitted his report on the operation for publication in the "Graefe Archiv für Ophthalmologie" on July 9, 1906. The report appeared that same year. A brief historical survey is given here.

Cataract extraction after fistulizing operation.

Cataract extraction after a fistulizing operation poses many problems for the surgeon. No satisfactory solution has been found yet to these problems, although the procedure has become safer owing to new microsurgery techniques, so that the rate of success is higher than with previous techniques.

[Cataract extraction after a fistulizing operation (author's transl)]. / Die Kataraktextraktion nach fistelbildender Operation.

A report is given on a method for cataract extraction after fistulizing operation. The incision is made in a straight line on the cornea underneath the fistula, so that the two ends of the incision are in the limbal region. This corneo-limbla incision does not injure the fistula. The closure is performed under the microscope with a continuous suture. The results obtained support the security of this method.

[Vitrectomy after intracapsular cataract extraction (author's transl)]. / Vitrektomie nach intrakapsulärer Kataraktextraktion.

A report is given on transpupillar vitrectomy with the suction wedge for prolapse of the vitreous after intracapsular cataract extraction. From the results obtained this method can be recommended. In aphakic eyes with drawn up pupil the pupil should be cut out underneath after opening the anterior chamber. Also in this case vitrectomy must be performed before closure of the anterior chamber.

[Fluorometholon/tetryzoline in the treatment of conjunctival irritation]. / Fluorometholon/Tetryzolin zur Behandlung konjunktivaler Reizzustände.

The clinical efficacy of Efemoline eyedrops [fluourometholone (0.1%) + tetryzoline (0.25%)] and of fluorometholone 0.1% was investigated in a double-blind controlled clinical trial in 35 patients (63 eyes) in treatment of the upper bulbus area and postoperatively after surgery for cataract, glaucoma and strabismus. Both drugs were effective inflammation inhibitors. The superiority of fluorometholone + tetryzoline over fluorometholone was evident: subjective symptoms improved much more quickly. No tendency toward elevation of intraocular pressure was found. The combined preparation was compatible and produced no side-effects.