Optic Neuritis During Lactation: A Case Series.

BACKGROUND: Optic neuritis is a rare condition that can lead to sudden blindness and also could be a precursor to multiple sclerosis. When it occurs postpartum during lactation, it is called lactation optic neuritis. MAIN ISSUE: We present four cases of optic neuritis in lactating mothers, two of which had additional features of demyelinating disease upon neurological imaging. MANAGEMENT: All participants were treated with high dose intravenous steroids followed by 11 days of oral steroids, per the optic neuritis treatment trial, which led to complete recovery of vision. Two participants with demyelinating disease on magnetic resonance imaging scans were advised to wean, because of a need for immunosuppressive therapy later. CONCLUSION: Optic neuritis during lactation should be suspected following acute loss of vision. Prompt referral to an ophthalmologist is mandated for early diagnosis and treatment to prevent long-term co-morbidities.

Diplopia as the presenting feature of acute lymphoblastic leukemia.

PURPOSE: To report a rare case of acute lymphoblastic leukemia presenting with diplopia to an ophthalmologist. OBSERVATIONS: A 29-year-old male patient presented to ophthalmology department with sudden onset of binocular diplopia in left gaze. Magnetic resonance imaging of brain and orbits revealed a thickened left medial rectus, with enhancement of right sixth nerve, bilateral third and fifth nerves. Bone marrow biopsy revealed acute lymphoblastic leukemia (ALL) with a Burkitt-type chromosomal translocation-t(8; 14) and the patient was started on chemotherapy. CONCLUSION AND IMPORTANCE: This was a case of incomitant esotropia worse with left gaze due to left medial rectus infiltration mimicking a left sixth cranial nerve paresis. Diplopia can be the only presenting symptom of ALL and it can involve either an extraocular muscle or a cranial nerve.

The Chemical Shift Index method applied to resin-bound peptides.

The Chemical Shift Index (CSI) method proposed by Wishart et al. [Biochemistry (1992) 31, 1647-1651] to evaluate the secondary structure of peptides in aqueous solution uses as its reference the chemical shift values of each of the 20 natural amino acids (X) in a typical nonstructured sequence GGXAGG (17-20). In order to apply the CSI method to protected resin-bound peptides, we established a new database of chemical shift values for the same GGXAGG sequences in their protected form and anchored to a polystyrene resin swollen in DMF-d7. The predictive value of this new reference set in the CSI protocol was tested on different resin-bound peptides that were previously characterized by a full NOE analysis.