[Clinical characteristics and surgical treatment of idiopathic congenital nystagmus in 224 patients].

OBJECTIVE: To study clinical characteristics and surgical treatment of idiopathic congenital nystagmus (ICN). METHODS: A retrospective study was conducted in 224 patients with ICN in Tianjin eye hospital from July 2007 to February 2013. RESULTS: There were 224 patients, 158 (70.54%) males and 66 (29.5%) females, mean age was (11.6±8.4) years and (11.4±6.4) years separately. Horizontal nystgamus happened in 215 cases, 3 cases were vertical type and 6 cases were mixed. 214 cases were with no history of operation and 10 patients had ever underwent surgeries before. Furthermore, 151 patients combined with strabismus and refractive error, anterior segment or retinal disorders, which accounting for 67.4% of all the patients. 48 patients were associated myopia, 30 patients with hyperopia, 43 patients with strabismus. Among them, 153 cases of compensatory head position direction were horizontal with face turn, 43 cases (43/153, 28.1%) showed face turning to the left, 110 cases (110/153, 71.9%) showed face turning to the right. Surgeries were designed according to the compensatory head position and head retroversion angle. For 15 patients with double intermediate zones, the position which was often used with good visual function was chosen for operation design. As for the patients with nystagmus and strabismus, the transfer null zone to primary position for the dominant eye and strabismus surgery for the other eye was chosen. And for complicated patients with compensative head position, the dominant head posture were designed for surgery. CONCLUSIONS: ICN is dominated by male with variable clinical manifestations. Surgical choice for ICN depends on the direction of head position and if there is strabismus accompanying it.The aim of ocular muscle surgery is to transfer null zone to primary position. (Chin J Ophthalmol, 2016, 52: 574-578).

[Intravenous thrombolysis with domestic urokinase in 40 cases of acute myocardial infarction].

Thrombolytic therapy with intravenous domestic urokinase was carried out within 6 hours after onset in 40 cases of acute myocardial infarction from Feb. 1991 to Dec. 1992, the age of patients being 52.5 +/- 8.4 (37-74) years. The overall reperfusion rate was 65.0%; the reperfusion rate within 3 hours was 78.3% (18/23) and from 3 to 6 hours 47.1% (8/17) (P < 0.05). The incidence of reperfusion arrhythmia was 73.1%. Reinfarction occurred in 3 and acute allergy in 2 cases. 3 other cases developed ventricular fibrillation within 2 hours after onset. After prompt successful defibrillation, thrombolytic therapy was instituted and 2 cases had reperfusion. No marked bleeding and mortality were observed in all of our cases.

[Posterior cranial fossa arteriovenous malformations].

24 cases of AVMs posterior cranial fossa are reported. All these cases were confirmed by pathological examination or vertebral angiogram. There are 17 cases located in cerebellar hemisphere, 4 in vermis, 2 spread to brain stem, and 1 in fourth ventricle. Most of these patients are young adults, the mean age below 40 years. The most clinical manifestations were acute subarachnoid hemorrhage, increased intracranial pressure, ataxia, and cranial nerves palsy. 22 cases underwent surgical intervention, with 17 total, 3 subtotal, 2 partial resection of AVMs. After operation, 16 cases were good recovery, 3 free of symptom, and 3 death. In this article, the evaluation of some special clinical examinations and the operative approach for AVMs were discussed.

[Cryptococcal granuloma of the brain. Report of 7 cases].

7 cases of cryptococcal granuloma of the brain are reported. All were confirmed pathologically by autopsy or operation. The granuloma involved not only cerebral hemisphere but also the basal ganglion, hypothalamus, cerebellum and brain stem. It's clinical character and CSF examination are closely similar to the findings of tuberculous meningitis, and the larger toruloma is easy to be mistaken as brain tumor. The authors introduced several valuable methods of diagnosis of these patients. The indications of operation as well as medication are discussed also.