Ophthalmoplegia resulting from an intraorbital hematoma.

BACKGROUND: A case is described in which an intraorbital hematoma was found to complicate recovery from attempted aneurysm clipping 5 days into the postoperative period. The etiology, management, and complication avoidance are discussed. CASE DESCRIPTION: Five days after attempted surgical clipping of an internal carotid artery aneurysm via a frontotemporal craniotomy with orbital osteotomy, a patient underwent coiling of the aneurysm. Shortly after the endovascular procedure, the patient developed exophthalmos and ophthalmoplegia involving the right side followed by decline in her level of consciousness. An emergency computed tomography (CT) scan revealed an epidural hematoma with intraorbital extension. After evacuation of the hematoma, the patient recovered extraocular function and returned to her baseline mental status. CONCLUSION: Exophthalmos and ophthalmoplegia in a patient recovering from cranial surgery using skull base techniques warrants immediate attention, especially after endovascular procedures. Delay in intervention may result in loss of neurologic function or life. The authors discuss the relevant literature and management of this uncommon complication.

Chronic dermal studies of petroleum streams in mice.

During petroleum refining, a large number of products are generated which have varying chemical and physical properties. These are known in the industry as petroleum streams. In order to characterize their carcinogenic activity, a number of these commercially produced streams were administered to C3H/HeJ mice in chronic dermal bioassays. The bioassays were conducted using one of two study designs: the first set of test materials was applied for a lifetime and the second set for 24 months. In the lifetime study, the last mice in the test groups survived for periods of 31 to 32 months. Middle distillates, boiling in the range 115-390 degrees C, were found to decrease the lifespan of exposed mice compared to controls or streams of higher and lower boiling ranges. These middle distillate streams included straight run kerosine, hydrodesulfurized middle distillate, straight run middle distillate, light catalytic cracked distillate, and 90/10% and 70/30% mixtures of the last two. The middle distillate streams also proved to be active as carcinogens, with tumor incidence ranging from 16 to 67%. Light alkylate naphtha, heavy catalytic reformed naphtha, vacuum residuum, and unleaded gasoline did not demonstrate significant carcinogenic potency. Heavy thermal cracked naphtha, heavy catalytic cracked naphtha, and hydrotreated light naphthenic distillate were dermal carcinogens of low potency in this study. Administration of light catalytic cracked naphtha led to a low incidence of very late developing tumors with a mean latency of 118 weeks. Application of the 0.1% solution of catalytic cracked clarified oil in toluene did not result in a significant incidence of tumors, but the 10% solution caused almost 100% mortality and 100% tumor incidence in 12 months. There was no correlation between carcinogenic potency and the indices of irritation, alopecia, erythema, and scabbing. Only two of the streams tested, hydrotreated light naphthenic distillate and 10% catalytic cracked clarified oil, contain polynuclear aromatic hydrocarbons (PNAs) and may be presumed to be complete carcinogens. The middle distillates and heavy naphthas are nonmutagenic and essentially free of PNAs. Their activity may result from promotion of already-initiated skin sites. Where comparisons could be made, reducing the exposure period from a lifetime (29-32 months) to 24 months did not change the evaluations of stream carcinogenicity except in the case of light catalytic cracked naphtha where six of the seven mice that developed tumors did so after 24 months.

Alkane biosynthesis by decarbonylation of aldehyde catalyzed by a microsomal preparation from Botryococcus braunii.

The final step in the synthesis of n-hydrocarbons in an animal and a higher plant involves enzymatic decarbonylation of aldehydes to the corresponding alkanes by loss of the carbonyl carbon. Whether such a novel reaction is involved in hydrocarbon synthesis in the colonial microalga, Botryococcus braunii, which is known to produce unusually high levels (up to 32% of dry weight) of n-C27, C29, and C31 alka-dienes and -trienes, was investigated. Dithioerythritol severely inhibited the incorporation of [1-14C]acetate into these hydrocarbons with accumulation of the label in the aldehyde fraction in the B. braunii cells. Microsomal preparations of the alga synthesized alkane from fatty acid and aldehyde in the absence of O2. Conversion of fatty acid to alkane required CoA, ATP, and NADH, whereas conversion of aldehyde to alkane did not require the addition of cofactors. That the alkane synthesis involves a decarbonylation was shown by the production of CO and heptadecane from octadecanal. CO was identified by adsorption to RhCl[(C6H6)3P]3. The decarbonylase had a pH optimum at 7.0, an apparent Km of 65 microM, a Vmax of 1.36 nmol/min/mg and was inhibited by the metal chelators EDTA, O-phenanthroline and 8-hydroxyquinoline. It was stimulated nearly threefold by 2 mM ascorbate and inhibited by the presence of O2. A partial (28%) retention of the aldehydic hydrogen of [1-3H]octadecanal in the heptadecane was observed; the remaining 3H was lost to H2O. The microsomal preparation also catalyzed the oxidation of 14CO to 14CO2, with a pH optimum of 7.0. This accounts for the nonstoichiometry of CO to heptadecane observed. In vivo studies with 14CO showed that the label was incorporated into metabolic products. This metabolic conversion of CO, not found in the previously examined hydrocarbon synthesizing systems, may be necessary for organisms that produce large amounts of hydrocarbons such as the present alga. The mechanism of the decarbonylation and the nature of the decarbonylase remain to be elucidated.

Host response to bovine ocular squamous cell carcinoma.

Specific humoral and cellular immunologic responses to autologous and heterologous tumors were evaluated in 35 Hereford cows with ocular squamous cell tumors and in 6 healthy cows. Sera from 5 healthy cows and 23 ocular tumor-bearing cows were evaluated for antibody to tumor, using radioimmunoassay, passive hemagglutination, agglutination, and microagglutination assays with various soluble tumor antigen and whole tumor cell preparations. Antibody to tumor was detected in only 2 cows. Using the microagglutination assay, antibody to autologous and heterologous tumor cells was found in the sera of 2 cows inoculated intraocularly with purified, viable autologous tumor cells. Twenty-eight tumor-bearing cows and 3 healthy cows were evaluated for delayed-type hypersensitivity responses, using 5 tumor preparations; positive skin test responses were not observed.

Autotransplantation of bovine ocular squamous cell carcinoma and effects on primary tumor growth.

Autologous transplantation of ocular squamous cell carcinoma was done in 7 Hereford cows in 17 trials. Three preparations of tumor were used in orthotopic transplantation to 5 sites on the eye and eyelid. None of the transplants was successful. However, in 2 of 5 cows given autografts of a pure, viable tumor cell suspension, marked regression of the primary tumor was observed after transplantation.