The role of ultrasound biomicroscopy in surgical planning for limbal dermoids.

PURPOSE: Limbal dermoids usually involve corneal stroma and more rarely might extend into the anterior chamber. Depending on the size and amount of penetration of the lesion, different therapeutic approaches are indicated. Depth information is difficult to obtain by slit-lamp examination because the structure is opaque. We investigated the use of ultrasound biomicroscopic (UBM) examination for surgical planning in limbal dermoids. METHODS: The UBM (Zeiss Humphrey) with its 50-MHz probe was used for preoperative evaluation of the depth of penetration in two cases of infantile limbal dermoid. Histology specimens of the lesion corresponding to the UBM images were obtained. RESULTS: UBM was able to distinguish normal cornea from the more sonolucent lesion. Presence or absence of Descemet's membrane could be identified. Depth of involvement of limbal dermoids could be assessed. CONCLUSION: UBM is able to assess depth involvement of opaque corneal lesions such as limbal dermoids. Because planning of the surgical approach in these cases is facilitated by preoperative knowledge about the depth of penetration of these opaque lesions, UBM can be regarded as a helpful tool in the clinical management.

Comments on "An accelerated learning algorithm for multilayer perceptrons: optimization layer by layer".

This letter analyzes the performance of the neural network training method known as optimization layer by layer. We show, from theoretical considerations, that the amount of work required with OLL-Learning scales as the third power of the network size, compared with the square of the network size for commonly used conjugate gradient training algorithms. This theoretical estimate is confirmed through a practical example. Thus, although OLL is shown to function very well for small neural networks (less than about 500 weights per layer), it is slower than CG for large neural networks. Second, we show that OLL does not always improve on the accuracy that can be obtained with CG. It seems that the final accuracy that can be obtained depends strongly on the initial network weights.

A nonlinear discriminant algorithm for feature extraction and data classification.

This paper presents a nonlinear supervised feature extraction algorithm that combines Fisher's criterion function with a preliminary perceptron-like nonlinear projection of vectors in pattern space. Its main motivation is to combine the approximation properties of multilayer perceptrons (MLP's) with the target free nature of Fisher's classical discriminant analysis. In fact, although MLP's provide good classifiers for many problems, there may be some situations, such as unequal class sizes with a high degree of pattern mixing among them, that may make difficult the construction of good MLP classifiers. In these instances, the features extracted by our procedure could be more effective. After the description of its construction and the analysis of its complexity, we will illustrate its use over a synthetic problem with the above characteristics.

Chalazion-induced hyperopia as a cause of decreased vision.

This article presents three cases of decreased vision due to acquired hyperopia, which were caused by a chalazion of the upper eyelid. Through manifest refraction and computerized corneal topographic analysis, acquired hyperopia associated with central corneal flattening was revealed. These findings were responsible for the blurred vision that was reversed by chalazion resolution or removal. Although not usually considered a risk factor for refractive disorders other than astigmatism, chalazia of the upper eyelid can present as a decrease in vision associated with reversible central corneal flattening and acquired hyperopia.

Oral sarcoidosis with tongue involvement.

A case of oral sarcoidosis involving the tongue and buccal region is reported in a 56-year-old woman. Intraoral presentations of sarcoidosis are uncommon, and sarcoidosis of the tongue is particularly rare. In this case the tongue lesion was asymptomatic, and unusual clinical behavior. In this article, we review the clinical manifestations, diagnostic procedures, differential diagnosis and treatments of oral sarcoidosis.

Sperm from spinal cord injured men lose motility faster than sperm from normal men: the effect is exacerbated at body compared to room temperature.

PURPOSE: We investigated if sperm from spinal cord injured men lose motility and viability faster than sperm from normal men, and if there is an effect of temperature on these parameters. MATERIALS AND METHODS: Identical aliquots of fresh antegrade semen from 10 spinal cord injured men and 9 normal controls were stored at room temperature (23C) or body temperature (37C). Sperm motility and viability were measured at 0, 2, 4, 6 and 8 hours after semen collection. RESULTS: Sperm motility, particularly rapid linear motility, decreased faster in specimens from spinal cord injured men compared to normal controls. This effect was exacerbated at 37C. Heat did not affect the degradation of sperm motility in specimens from normal men. The percent of dead sperm in specimens from spinal cord injured men was significantly greater than that in normal men at all time points. However, the rate of cell death was not faster than normal with time or heat. CONCLUSIONS: When using sperm from spinal cord injured men for purposes of insemination or experimentation the rapid loss of motility must be considered, particularly when stored at body temperature.

[Increase of gamma-glutamyltranspeptidase in patients with compensated hypoalphalipoproteinemia and type IIa dyslipidemias]. / Elevación de gammaglutamiltranspeptidasa en pacientes con hipoalfalipoproteinemia y dislipemias tipo IIa compensadas.

Twenty-one asymptomatic patients presenting isolated elevations of gamma-glutamyltranspeptidase (GGT) were studied over the previous 10 years with all the findings being accidental. No other analytical alterations were demonstrated. Ingestion of alcohol, drugs or another type of toxic substance, diabetes, neurologic disease or neoplasm were discarded. Echography of the liver and the biliary tract was normal. In the first nine patients studied, liver biopsy was performed being normal or with minimum unspecific alterations. In two patients endoscopic retrograde cholangiography was carried out with no alterations being observed. Lipid study was performed in all the patients with alpha hypolipoproteinemia being found in 15 patients, compensated type II lipid profile in 5 and a normal lipid profile in one. To the author's knowledge there have been no reports of this lipid disorder causing elevations in GGT. However, on being the only abnormality found in these patients the authors believe that this may be the cause although the mechanism is unknown.

Quality of life 12 months after radical prostatectomy.

OBJECTIVE: To evaluate the impact of radical prostatectomy (RP) upon quality of life (QOL) in patients with prostate cancer. PATIENTS AND METHODS: Seventy-nine patients with prostate cancer were recruited to evaluate the impact of RP upon QOL. The patients comprised two groups: the first group (n = 51) was evaluated 12 months or longer after RP; and the second group (n = 28) was evaluated 1 month prior to RP. All patients completed two previously reported QOL measures: the Functional Living Index Cancer (FLIC) and Profile of Mood States (POMS), and a series of questions which evaluated bladder, bowel and sexual function. RESULTS: Comparison of patients before RP with those after RP at 12 month follow-up revealed significant (P < 0.05) deterioration in sexual function, continence and hardship scores following RP while tension scores improved significantly. Although 10 other subscale parameters were analysed, no other differences were observed. Of the 51 post-RP patients, 46 (90%) stated that given a choice they would have their surgery again. CONCLUSION: The results reported show that RP has minimal overall impact upon patient QOL. Although minimal voiding and bowel dysfunction was reported, many patients were dissatisfied with post-operative sexual function.

[Cryoglobulins in rheumatoid arthritis: exhaustive detection, immunochemical findings and clinical expression]. / Crioglobulinas en artritis reumatoide: detección exhaustiva, hallazgos inmunoquímicos y expresion clínica.

Cryoglobulins were measured in 29 patients (24 female, age 53.8 +/- 9.8 years) with rheumatoid arthritis (70% active). The cryoprecipitate was isolated, characterized and quantified. Cryoglobulinemia, always polyclonal or type III, was found in 83% of patients. The most frequent immunochemical isotypes found were IgG and A. Acrocyanosis was found in 50% and Raynaud phenomenon in 32% of patients with cryoglobulinemia. It is concluded that exhaustive detection of cryoglobulinemia in rheumatoid arthritis demonstrated a higher frequency than previously reported an is important for understanding pathogenesis of the disease.

[The determination of immunological parameters in splenectomized patients]. / Determinación de parámetros inmunológicos en pacientes esplenectomizados.

We studied 15 patients submitted to splenectomy. Humoral immunity was studied with protein electrophoresis and quantification of immunoglobulins; cellular immunity was studied by total and subpopulation lymphocyte counts and evaluation of phagocytosis. Increased levels of IgG, IgM and IgA, a decrease in circulating T-lymphocytes and an increased phagocytosis was seen after operation. These findings correlated to the presence of viral and parasitic infections postoperatively. Preoperative antipneumococcal vaccination prevented infections by this agent. Thus, appropriate preventive measures must be taken to deal with altered immunological responses after splenectomy.

Relevance of hemin for in vitro differentiation of Trypanosoma cruzi.

Simple culture conditions that allow good growth and high yields of trypomastigotes are described. The proportion of metacyclic trypomastigotes increases with the concentration of hemin in the culture medium, reaching a peak of 80% after 10 days with 20 mg hemin/liter.

Mixed (lichenoid and macular) cutaneous amyloidoses.

Between October 1972 and Paril 1974 a total of four patients suffering from lichen amyloidosus were admitted to the wards of the Department of Dermatology, University Hospital, Valladolid. All these patients also showed a macular amyloidosis associated with the lichenoid eruption. The authors emphasize that macular amyloidosis is quite commonly found as an associated and closely related condition in lichen amyloidosus.