Fecal endocrine profiles and ejaculate traits in black-footed cats (Felis nigripes) and sand cats (Felis margarita).

Information regarding the reproductive biology of black-footed cats (BFC) and sand cats (SC) is extremely limited. Our objectives were to: (1) validate fecal hormone analysis (estrogens, E; progestagens, P; androgens, T) for noninvasive monitoring of gonadal activity; (2) characterize estrous cyclicity, ovulatory mechanisms, gestation, and seasonality; and (3) evaluate male reproductive activity via fecal androgen metabolites and ejaculate traits. In both species, the estrous cycle averaged 11-12 days. In BFC (n=8), estrus lasted 2.2+/-0.2 days with peak concentrations of E (2962.8+/-166.3 ng/g feces) increasing 2.7-fold above basal concentrations. In SC (n=6), peak concentrations of E (1669.9+/-83.5 ng/g feces) during estrus (2.9+/-0.2 days) were 4.0-fold higher than basal concentrations. Nonpregnant luteal phases occurred in 26.5% (26 of 98) of BFC estrous cycles, but were not observed in SC (0 of 109 cycles). In both species, P concentrations during pregnancy were elevated (32.3+/-3.0 microg/g feces BFC; 8.5+/-0.7 microg/g feces SC) approximately 10-fold above basal concentrations. Fecal T concentrations in males averaged 3.1+/-0.1 microg/g feces in BFC and 2.3+/-0.0 microg/g feces in SC. Following electroejaculation, 200 to 250 microl of semen was collected containing 29.9 (BFC) to 36.5 (SC)x10(6) spermatozoa with 40.4 (SC) to 46.8 (BFC)% normal morphology. All females exhibited estrous cycles during the study and spermatozoa were recovered from all males on every collection attempt, suggesting poor reproductive success in these species may not be due to physiological infertility.

MR imaging of malignant uveal melanoma: role of pulse sequence and contrast agent.

To determine the most sensitive pulse sequence and to clarify the role of each pulse sequence in the MR diagnosis of uveal malignant melanoma, noncontrast T1- and T2-weighted, and postcontrast T1-weighted, spin-echo images were compared blindly and independently by two experienced observers. Thirty uveal malignant melanomas, preselected by ophthalmoscopy and sonography for size greater than 2 mm, were examined with a 1.5-T superconducting MR unit with an orbital surface coil. Fifteen tumor studies were done after the patient was injected with gadopentetate dimeglumine. Postcontrast T1-weighted images were the most sensitive in detecting melanomas, demonstrating tumors 2 mm in height accurately on axial planes and 1.6 mm in height on combined orthogonal planes. The contrast-to-noise ratio between melanoma and vitreous fluid was greatest on postcontrast T1-weighted images (average, 72.1), followed by noncontrast T1-weighted images (average, 32.9), and then by T2-weighted images (average, -21.2). Postcontrast T1-weighted images also proved useful in differentiating melanomas from subretinal fluid collections when combined with noncontrast images. We conclude that postcontrast T1-weighted images are most helpful in detecting small uveal melanomas and in differentiating melanomas from subretinal fluid collections.

Long term effect of apraclonidine.

AIMS: To evaluate the effect of the chronic use of apraclonidine 0.5% on the intraocular pressure (IOP) of patients with glaucoma; also, to study the side effect profile of this drug when used chronically. METHODS: All patients who had uncontrolled IOP, who were either already on glaucoma medications, or who were intolerant of other glaucoma medications were enrolled. A total of 185 patients were started on apraclonidine 0.5% two to three times a day in one eye. RESULTS: Follow up extended to 35 weeks. The mean difference in IOP between treated and control eyes was 2.1 (SD 5.0) mm Hg. A similar IOP lowering effect was obtained comparing IOP difference from baseline in the treated eye only. CONCLUSION: By the end of the follow up period, 46% of patients were still on the medication. The drug was stopped in 23% of patients because of side effects and in 31% of patients because of failure to lower IOP significantly.

Effect of respite care on dementia and nondementia patients and their caregivers.

The impact of a respite program on the cognitive and physical functioning of dementia and nondementia patients, and on the burden perceived by their caregivers, was assessed in a pretest-posttest design. A total of 55 caregivers were interviewed twice, 5 weeks apart. In the respite group, the caregiver's patient experienced a 2-week respite stay in a nursing home during the 5-week interval, whereas in the waiting-list comparison group, the patient experienced ongoing in-home care during the interval. We hypothesized that patient diagnosis (dementia vs. nondementia) would interact with respite exposure, with nondementia patients showing more improvement from respite than dementia patients. Regardless of diagnosis, however, positive effects from respite exposure were found for caregiver reports of the patient's memory and behavior.

A color Doppler analysis of nifedipine-induced posterior ocular blood flow changes in open-angle glaucoma.

PURPOSE: This pilot study used color Doppler imaging to investigate the effects of nifedipine on the posterior ocular blood flow of patients with glaucoma progression at normal intraocular pressures. PATIENTS AND METHODS: Eighteen patients, 11 men and seven women with a median age of 61.7 years, were imaged before and 6 weeks after the initiation of 30 mg of sustained-release nifedipine (Procardia XL; produced by either Pfizer or Pratt) daily. RESULTS: There was no statistically significant change in the blood velocity of the ophthalmic artery, central retinal artery, and main nasal and temporal short posterior ciliary arteries after treatment with nifedipine. CONCLUSION: The routine use of nifedipine in patients with normal tension glaucoma progression is not supported by this study.

Encapsulated filtering blebs after trabeculectomy with mitomycin-C.

BACKGROUND AND OBJECTIVE: To determine the frequency of encapsulated blebs after guarded filtration procedures with mitomycin-C. PATIENTS AND METHODS: The authors reviewed the charts of all patients who had undergone a guarded filtration procedure with mitomycin-C. There were 235 patients (283 cases) who had more than 1 month of follow-up. RESULTS: An encapsulated bleb developed in 7 eyes (2.47%) of 6 patients. Identification of bleb encapsulation occurred at a mean follow-up time of 29.7 +/- 14.6 days after surgery. The mean intraocular pressure at that point was 24.2 +/- 13.5 mm Hg in the affected eyes. Three eyes were treated medically, and needling was performed in 4 eyes. CONCLUSION: There is a low frequency of encapsulated bleb formation after guarded filtration procedures with adjunctive mitomycin-C.

Upper eyelid retraction from inferior rectus restriction in dysthyroid orbit disease.

Findings from orbital computed tomography scans have shown inflammatory enlargement of the levator palpebralis superioris complex to be a likely cause of eyelid retraction in dysthyroid (Graves's) ophthalmopathy. We have studied a subgroup of nine dysthyroid patients in whom the eyelid retraction occurs as a relative malposition of the globe and eyelid due to inferior rectus restriction. Our explanation of this phenomenon in nine patients is based on Hering's law. Increased innervation required for a fixating superior rectus muscle to overcome a severely restricted inferior rectus muscle causes an unrestricted levator muscle to open the eyelid abnormally wide relative to the globe. The retraction is best demonstrated with fixation of the involved eye. We have performed inferior rectus recession to correct this type of eyelid retraction in three of our patients.

Carbon dioxide laser in ophthalmic plastic and orbital surgery.

The CO2 laser cuts tissue by flash boiling extracellular or intracellular water molecules in contact with the beam. This vaporization sterilizes the tissue and seals capillaries. The CO2 laser seems most useful in ophthalmology to vaporize lymphangiomas and capillary hemangiomas and to provide hemostasis in patients with bleeding disorders. The cutting beam of the CO2 laser can be attached to the operating microscope to facilitate surgery deep within the orbit. The effectiveness of the CO2 cutting action depends upon water content of the tissue rather than tissue color as with argon and krypton lasers. Skin incisions show less scarring when made with conventional scalpel, but more precise surface cutting lasers may allow more precise microsurgical excision of eyelid tumors than can now be accomplished with a scalpel.

Intranasal procedures for successful lacrimal surgery.

Successful lacrimal surgery requires specialized knowledge of intranasal surgical anatomy. The clearance of the lower nasolacrimal duct relative to the inferior turbinate and the relationship of dacryocystorhinostomy and conjunctivodac-ryocystorhinostomy sites to upper nasal septum and anterior middle turbinate are not encountered in traditional cosmetic rhinoplasty or procedures for nasal airway obstruction. Intranasal procedures to facilitate lacrimal surgery are described.

Cluster headache after orbital exenteration.

A 56-year-old woman developed episodes of throbbing pain in the right orbit accompanied by ipsilateral nasal stuffiness and the feeling of ear swelling six months after orbital exenteration and ethmoidectomy for invasive, sclerosing basal-cell carcinoma. Extensive evaluation and treatment of her sinusitis failed to provide relief for her disabling symptoms. When treated by a neurologist with propranolol for cluster headaches, her symptoms subsided. To the best of our knowledge, this is the second patient with cluster headaches after orbital exenteration. Though no known causal relationship exists, these two patients document that orbital or ocular pain with cluster headaches is a referred or "phantom" pain and confirm the etiology of cluster headaches to lie outside the orbit.

Ethnicity and intergenerational perceptions of family solidarity.

Intergenerational interaction between matched pairs of older parents and their middle-aged offspring were explored in this research, comparing Mennonites and non-Mennonites. Middle-aged respondents replied to a mailed questionnaire, and their parents were interviewed. Five dimensions of family solidarity were compared between the generations, with the result that middle-aged offspring typically report less family solidarity than do their parents. These results are explained in terms of the concept of the "developmental stake."

Orbital pseudotumor of the levator muscle.

A 58-year-old white man with chronic progressive external ophthalmoplegia developed proptosis and an improvement in his ptosis from a mass in the superior orbit. A biopsy showed the mass to consist of an inflammatory mass of the levator palpebrae superioris muscle. As the inflammatory mass responded to periorbital and systemic steroids, the ptosis recurred. Inflammatory pseudotumor of the levator muscle is extremely unusual and has not been reported previously in patients with chronic progressive external ophthalmoplegia.

Magnetic resonance imaging of choroidal melanoma with and without gadolinium contrast enhancement.

Choroidal melanoma is the most common intraocular tumor and is uniquely suited for evaluation by magnetic resonance imaging (MRI) because of the paramagnetic effect of the melanin molecule. The authors performed T1-, T2-, and proton-density-weighted MRI on 34 patients with choroidal melanoma. Nineteen patients received gadolinium contrast, T1-weighted images were superior in both detecting and delineating tumors, showing increased contrast-to-noise ratios over other images. Gadolinium contrast further increased this ratio. These images are presented as evidence that gadolinium-enhanced MRI is valuable in the evaluation of choroidal melanoma.

The financial abuse of mentally incompetent older adults: a canadian study.

ABSTRACT This article reports the results of a pilot study on the financial abuse of mentally incompetent seniors. The objectives of the study were to: (1) establish the incidence of suspected financial abuse among the clientele of the Office of Public Trustee, Province of Manitoba, (2) identify the characteristics of mentally incompetent older adults most at risk, and (3) identify indicators of financial abuse. Approximately 20% of the cases opened in a one year period were under suspicion of abuse. Findings were consistent with those of other research projects on elder abuse, in general, showing an over-representation of women over the age of eighty as victims of financial abuse. Unpaid personal care home bills when money should have been available was the most common indicator. In addition to providing a list of indicators of financial abuse that are of potential use to professionals, devising prevention programs, practical implications for service providers are presented.

Orbital metastasis from cutaneous melanoma.

Although orbital extension from ocular melanoma occurs frequently in advanced cases, orbital metastasis from cutaneous melanoma has been reported but eight times previously. We have reported two such cases. One of the patients had three previous primary melanomas; the other had metastasis to the cauda equina. Both patients died when orbital involvement developed years after the initial lesions. Ours are the first cases to include CT and MRI findings in metastatic orbital melanoma.

Magnetic resonance imaging of orbital lymphangioma with and without gadolinium contrast enhancement.

BACKGROUND: Lymphangioma is a vascular tumor of the orbit with a propensity for recurrent hemorrhage. These tumors may be difficult to diagnose in young patients who present with sudden proptosis due to hemorrhage into a previously unrecognized lesion. Magnetic resonance imaging (MRI) should be ideally suited for evaluating lymphangioma due to the unique ability of MRI to characterize hemorrhage because of the paramagnetic qualities of hemoglobin. METHODS: The authors performed T1-, T2-, and proton density-weighted MRI on 12 patients with orbital lymphangioma. Six patients underwent MRI with gadolinium-DTPA contrast enhancement. The MRI studies were performed using a 1.5 Tesla super-conducting magnetic resonance unit, except for 3 early studies performed with a 0.5 Tesla unit. All studies were performed with orbital surface coil imaging. Computed tomography (CT) was performed in 10 patients. RESULTS: Tumor was visible on MRI in all 12 patients. Magnetic resonance imaging delineated clearly the internal structure of subacute and chronic hemorrhagic cysts, and differentiated between these tumors because of the different paramagnetic qualities of subacute hemorrhage compared to chronic hemorrhage. In two patients, MRI detected large tumor feeding vessels by the flow void phenomenon unique to MRI. Computed tomography did not detect these vessels. Gadolinium-contrasted T1-weighted MRI did not further delineate or characterize the tumor. CONCLUSION: Magnetic resonance imaging is the modality of choice for imaging orbital lymphangioma because of its unequalled differentiation of hemorrhagic cysts, and its unique ability to detect tumor feeding vessels by the flow void phenomenon.