Treatment of experimental burn wound sepsis by postburn immunization with polyvalent Pseudomonas antigen.

1. Vaccination with a new heptavalent Pseudomonas aeruginosa antigen was found to reduce mortality rates from experimental pseudomonal burn wound sepsis. 2. Adjunctive use of the heptavalent vaccine improved survival of animals with pseudomonal sepsis which were treated with topical antibiotics. 3. Elevated antibody titers following vaccination could be correlated with survival in this model.

Molteno implants in children.

We report our experience with Molteno implants in 27 eyes of 20 children with glaucoma. Associated ocular findings included Sturge Weber syndrome (one patient), aniridia and retinoschisis (one patient), aphakia (seven patients, eight eyes), rubella syndrome (two patients), Peters anomaly (one patient), and Treacher Collins syndrome (one patient). Fifteen eyes received a single-plate implant, and 12 eyes received a double-plate implant in two stages. The patients' ages ranged from 2 months to 13 years (mean 47 +/- 55 months). The average number of previous glaucoma procedures was four per eye (range two to 10). The follow-up period ranged from 6 to 36 months (mean 20 +/- 9 months). The mean intraocular pressure before surgery was 34 +/- 4 mm Hg. The mean postoperative intraocular pressure was 19 +/- 11 mm Hg at 1 month and 19 +/- 6 mm Hg at 1 year (p < 0.001 at both times). After surgery nine eyes (33.3%) required no medication for control of intraocular pressure. Additional surgery was required in 12 eyes (44.4%). We believe the Molteno implant is a useful approach for children with glaucoma who fail to respond to standard medical and surgical treatments.

Penetrating neck wounds: a review of 218 cases.

A series of 218 patients with penetrating wounds of the neck is presented. The overall mortality rate was 8 per cent. One hundred seventy-five patients were explored promptly after admission; 60 per cent had structural damage present within the neck. Six of the patients without signs or symptoms to suggest injury beneath the platysma had injury demonstrated at exploration. Of 38 patients who were observed, only one developed a significant late complication. Thirty-four per cent of the patients had associated extracervical injuries; 38 per cent developed one of more complications during their hospitalization. Negative neck explorations were not associated with an increase in morbidity or prolonged hospital stay. In our hospital, early exploration of all wounds that penetrate the platysma appears to be the best approach for management of penetrating neck wounds.

Survey of optometry residency programs in the Veterans Administration.

A questionnaire was distributed to 10 optometry residency programs in the Veterans Administration (VA) Department of Medicine and Surgery. Results of the survey, including demographic, epidemiologic, and curriculum data are presented, with special emphasis upon the many similarities and few differences among these programs.

Arteritic and idiopathic ischemic optic neuropathy.

Ischemic optic neuropathy is a frequent cause of sudden visual loss in the older patient. There are two major causes of ischemic optic neuropathy; one, arteritic, due to an inflammatory process, and the other, idiopathic, possibly linked to hypertension. This paper presents four illustrative cases of ischemic optic neuropathy, one with an associated serous retinal detachment. The clinical appearance of the disorder, differential diagnosis of the two major types of ischemic optic neuropathy, and the pathogenesis and prognosis for vision are discussed. Currently accepted modes of treatment are also included.

Peripheral microcystoid retinal degeneration and retinoschisis.

Peripheral microcystoid retinal degeneration and degenerative retinoschisis represent two findings frequently made during indirect ophthalmoscopy of the peripheral fundus. Peripheral microcystoid degeneration, a benign condition, may represent a precursor to degenerative retinoschisis, a potentially sight threatening condition. Discussed are the epidemiology, histologic and clinical appearance, and possible pathogenesis of each. The normal progression of both conditions, together with the prognostic value of inner and/or outer layer holes in degenerative retinoschisis are addressed. Methods of following degenerative retinoschisis and modes of treatment of progressive cases are considered.

Characterization of cisplatin degradation as affected by pH and light.

The stability of cisplatin in 0.9% sodium chloride solution was studied. Cisplatin was reconstituted with sterile water for injection to achieve a concentration of approximately 1 mg/mL in 0.9% sodium chloride solution. The solutions were placed in flexible polyvinyl chloride containers, clear and amber glass flasks, and plastic syringes and stored at 22-25 degrees C in the dark or exposed to measured amounts of light and assayed periodically for up to 96 days. The initial pH of some of the solutions was adjusted. The stability of cisplatin in the solutions was determined by measuring the concentrations of cisplatin, trichloroammineplatinate(II) (TCAP), and trans-dichlorodiammineplatinum(II) (transplatin) with high-performance liquid chromatography and by measuring solution pH. The effect of adding ethylene oxide and other materials was also determined. TCAP was identified as the predominant degradation product of cisplatin in all the solutions. The rate of degradation was dependent on pH: In the dark, about 0.04% and 0.21% of the cisplatin degraded to TCAP per week at pH 4.3 and 6.3, respectively. The presence of ethylene oxide accelerated cisplatin degradation. Degradation also occurred during exposure to short-wavelength (350-490-nm) visible light. Storage in amber glass flasks offered more protection than storage in clear flasks. Isomerization of cisplatin to transplatin was not observed. The major degradation product of cisplatin was trichloroammineplatinate(II). Solution pH was the predominant factor affecting cisplatin stability.