Evaluation of climatic factors on the yield and chemical composition of the essential oil of Myrocarpus frondosus.

The species Myrocarpus frondosus is native to southern Brazil, and it is known as cabreúva. It is a large tree, and its wood is used as a reservoir for distilled spirits, especially Cachaça. In this pioneering work, the essential oil was extracted monthly from the leaves of M. frondosus, for a period of 1 year. The essential oil was extracted by using hydrodistillation and the determination of the chemical composition of essential oil was performed by using the chromatographic techniques GC-FID and GC-MS. Thirty-three compounds were identified in the essential oil and bicyclogermacrene was the major compound. Through multivariate analysis, it was determined that ß-caryophyllene, limonene and terpinen-4-ol were directly proportional to climatic factors. The yield of the oil was directly proportional to temperature and radiation.

Family characteristics of 105 patients with bulimia.

The authors compared 105 patients who met DSM-III criteria for bulimia with 86 control subjects on measures of family environment and presence of eating disorders. Bulimic patients' perceptions of their families included low cohesiveness, a lack of emphasis on independent and assertive behavior, and a high level of conflict coupled with a low emphasis on open expression of feelings. Families of bulimic subjects had achievement expectations comparable to those of control families, but the former placed less emphasis on intellectual and recreational activities. The high disorganization of the families of bulimic subjects was associated with severity of symptoms.

Ptosis in the rat following topically administered 2% epinephrine.

Commercially available 2% epinephrine instilled twice daily in one eye of 15 rats resulted in ptosis after 4 weeks treatment. The ptosis was indistinguishable from that observed following topical treatment with 6-hydroxydopamine 20% and surgical sympathectomy. Ptosis in both epinephrine- and 6-hydroxydopamine-treated rats was associated with a statistically significant depletion of ocular norepinephrine, as determined by a sensitive catecholamine radio enzyme assay. Ultrastructural evidence of nerve terminal degeneration was present near the smooth muscle of Müller within the eyelid of rats treated with epinephrine. This study provides further evidence epinephrine administration can result in chemical sympathectomy as has been described following 6-hydroxydopamine.

Photosensitivity to sulfisoxazole ointment.

A 35-year-old man demonstrated sulfisoxazole diolamine-induced photosensitivity during treatment for staphylococcal blepharitis. This reaction was easily avoided by applying the ointment at bedtime and covering the eyelids during sun-bathing while in therapy. A drug-induced photosensitivity reaction should be considered in cases of staphylococcal blepharitis resistant to or aggravated by eyelid-margin therapy with sulfonamides.

Supersensitivity to topical epinephrine after long-term epinephrine therapy.

Two patients received long-term topical therapy with epinephrine in one eye. One week after cessation of therapy, the treated eye in each patient showed more sensitivity to epinephrine than the untreated eye. The possibility of denervation supersensitivity and some clinical implications of this observation are discussed.

The quantitative effect of 0.5% ketorolac tromethamine solution and 0.1% dexamethasone sodium phosphate solution on postsurgical blood-aqueous barrier.

Anterior chamber fluorophotometry was performed after the oral administration of fluorescein sodium in patients undergoing extracapsular cataract extraction and posterior chamber intraocular lens insertion before and after surgery. The administration of 0.5% ketorolac tromethamine solution (ketorolac solution) eye drops before and after surgery decreased the breakdown of the blood-aqueous barrier as compared with 0.1% dexamethasone sodium phosphate solution (dexamethasone solution) eye drops at each period, as measured by fluorophotometry. A single injection below Tenon's capsule of a short-acting corticosteroid had been given to each patient at the end of each surgical procedure. Slit-lamp observations of postoperative ocular inflammation were not different between treatment groups. Both ketorolac and dexamethasone solutions were well tolerated by patients. Ketorolac solution was more effective than dexamethasone solution in facilitating reestablishment of the blood-aqueous barrier after surgery, as measured by fluorophotometry, and was equal to dexamethasone solution as observed by slit-lamp observations. This study suggests that ketorolac ophthalmic solution may be effective and safe as a nonsteroidal anti-inflammatory agent for topical use after cataract surgery and intraocular lens implantation in place of topically administered corticosteroids.

Amiodarone-induced lens opacities.

Amiodarone hydrochloride is a benzofurane derivative used for cardiac abnormalities. Its use is commonly associated with an asymptomatic keratopathy. Although lipid deposits have been observed with the electron microscope in the lens epithelium of one patient with a history of amiodarone therapy, lens opacities have not been reported in patients using this drug. Visually inconsequential, anterior subcapsular lens opacities in seven of 14 patients using moderate to high doses of amiodarone who were examined at the Veterans Administration Hospital in San Francisco are reviewed.

Quantitative assessment of postsurgical breakdown of the blood-aqueous barrier following administration of 0.5% ketorolac tromethamine solution. A double-masked, paired comparison with vehicle-placebo solution study.

Preoperative and serial postoperative anterior chamber fluorophotometry were performed after oral administration of fluorescein sodium in patients undergoing extracapsular cataract extraction and posterior chamber intraocular lens insertion. The administration of topical 0.5% ketorolac tromethamine solution before and after surgery markedly decreased the breakdown of the blood-aqueous barrier compared with vehicle-placebo solution administration at each time period, as measured by fluorophotometry. Corticosteroids were not given to any patients throughout the duration of the study. These fluorophotometric results correlated well with slit-lamp observations of postoperative ocular inflammation. Both ketorolac and vehicle were well tolerated by patients. No effects on intraocular pressure were seen with ketorolac administration. This study suggests that ketorolac ophthalmic solution is effective and safe as a nonsteroidal anti-inflammatory agent for topical use following cataract surgery and intraocular lens implantation.

Cyclo-oxygenase inhibitors in ophthalmology.

Cyclo-oxygenase inhibitors, which are formulated as ophthalmic eyedrop preparations, have recently become commercially available for use by ophthalmologists in the United States to inhibit intraoperative miosis during cataract surgery and to prevent postoperative inflammation. In addition, they are available worldwide as ocular antiinflammatory drugs and are used in the prevention and treatment of pseudophakic and aphakic cystoid macular edema. Understanding the rationale behind the use of these agents requires an understanding of the pathophysiology of the cyclo-oxygenase inhibitors. In this review recent advances in laboratory and clinical science are emphasized. The role of COIs during and following surgery is examined.

Fluorescein oropharyngoscopy.

To evaluate patency of the lacrimal system, fluorescein was instilled in the conjunctival cul-de-sac and the posterior oropharynx was examined with ultraviolet light. In 20 normal patients fluorescein was evident in one to 30 minutes. In cases of complete nasolacrimal duct blockage no fluorescein appeared after two hours.

Symblepharon in sarcoidosis.

A 38-year-old black man had developed sarcoidosis, confirmed by biopsy five years earlier. He then developed skin lesions and, at age 38, follicles and cicatrization of the upper and lower palpebral conjunctivae of both eyes. This patient had keratoconjunctivitis sicca, lacrimal gland enlargement, and cicatrization of the conjunctiva with symblepharon. Biopsies of the lacrimal gland, conjunctiva, skin, nasal polyps, and epididymis all showed sarcoidosis.

Local ocular hypotensive effect of topically applied acetazolamide.

Acetazolamide's usefulness in the treatment of the glaucomas is limited by the systemic side effects that often accompany its oral administration, and topical administration was initially thought to have no effect upon the intraocular pressures of human and rabbit eyes. Recent studies, however, have shown the usefulness of water-loading tests for screening drugs with potential antiglaucomatous activity. We found evidence that topical acetazolamide has the ability to lessen the increase in intraocular pressure after water-loading in pigmented rabbits and correlated this observation with low levels (0.0 to 0.7 microgram/ml) of plasma acetazolamide. Further, a separate study showed that 10% topical acetazolamide can enhance the ocular hypotensive effects of systemically administered acetazolamide in normal pigmented rabbits, suggesting that topically applied acetazolamide can have a local effect on intraocular pressure.

Effectiveness of ketorolac tromethamine 0.5% ophthalmic solution for chronic aphakic and pseudophakic cystoid macular edema.

The effect of ketorolac tromethamine 0.5% ophthalmic solution (a new nonsteroidal anti-inflammatory agent) treatment was compared to placebo treatment in patients with chronic, angiographically proven aphakic or pseudophakic cystoid macular edema (visual acuity less than or equal to 20/40 for six months) during a three- to four-month double-masked, randomized study. Twenty-six patients completed this study without significant ocular or systemic toxicity. The improved distance visual acuity observed in the ketorolac treatment group (8/13 patients) was statistically different from the improved vision observed in the placebo treated group (1/13 patients) (P = .005). No patient on a regimen of ketorolac therapy had a significant decrease in Snellen distance visual acuity while on treatment, but two patients in the placebo group demonstrated a decrease in visual acuity of two lines or more. Fluorescein angiography was consistent with changes in visual acuity.

Improvement in visual acuity in chronic aphakic and pseudophakic cystoid macular edema after treatment with topical 0.5% ketorolac tromethamine.

Ketorolac tromethamine 0.5% ophthalmic solution treatment was compared to placebo treatment in 120 patients with chronic aphakic or pseudophakic cystoid macular edema (six-month or more duration of distance visual acuity of 20/40 or less and angiographic evidence of cystoid changes) during a four- to five-month double-masked, multicenter study in which patients were randomly assigned. A statistically significant improvement in distance visual acuity (two lines or more) was observed in the ketorolac-treated group as compared to the placebo-treated group after 30 days (P = .038), 60 days (P = .017), and 90 days (P = .008) of treatment. This improvement in visual acuity remained statistically significant one month after cessation of treatment (P = .001). Nine ketorolac-treated patients and two placebo-treated patients demonstrated a decrease in visual acuity one month after treatment was discontinued. Seven of the nine ketorolac-treated patients experienced an improvement in visual acuity after retreatment as compared to none of the placebo-treated patients. This study offers evidence for a more optimistic outlook in the medical treatment of chronic aphakic and pseudophakic cystoid macular edema.

Habits, tics, and stuttering. Prevalence and relation to anxiety and somatic awareness.

This study examines the prevalence of nervous habits, tics and stuttering in 256 college students, as well as the relationship between these behaviors and self-reported general anxiety and awareness of bodily sensations. Improving on previous studies, this study strengthens the operational definition of a nervous habit by using a more stringent operational definition, giving what is arguably a more valid set of prevalence statistics. Participants were asked to complete self-report measures of general anxiety and somatic awareness. Relationships were found between number of nervous habits and tics that participants endorsed and their self-reported awareness of bodily sensations, as well as between number of habits endorsed and self-reported general anxiety. This article concludes with suggestions for future research in the area of nervous habits and motor tics.

Corneal melts associated with topically applied nonsteroidal anti-inflammatory drugs.

PURPOSE: Topically applied nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used to prevent miosis during cataract surgery, to treat ocular allergies, to prevent excessive postoperative inflammation following cataract surgery, and to treat cystoid macular edema following cataract surgery. They have also been used to control pain and photophobia following radial keratotomy and excimer laser photorefractive keratectomy. During August of 1999, severe complications following topical NSAID use including corneal melting, were reported by members of the American Society of Cataract and Refractive Surgery (ASCRS) responding to a survey distributed in letters from ASCRS to its members. The purpose of this report is to review 11 cases of corneal melting in patients treated with topical NSAIDs, with special attention to the observed toxicity and its relationship to dose and duration of treatment, coexistent disease and therapies, and the indication for treatment. The goal of this study is to identify factors useful in minimizing the occurrence of corneal toxicity. METHODS: The medical records and/or histories of 11 patients with corneal melting associated with the use of topical NSAIDs are reviewed, with special attention to the indication for treatment, the dose and duration of treatment, and coexistent diseases and medical treatments. In addition, the relationship between NSAID treatment and surgery and between NSAID treatment and onset and extent of corneal toxicity are described. RESULTS: Each of the 11 patients appeared to suffer severe corneal toxicity following the topical use of 0.5% diclofenac ophthalmic solution. Generic diclofenac (Falcon) (Alcon Laboratories, Inc, Fort Worth, Texas) was associated with 7 and Voltaren (Ciba Vision, Atlanta, Georgia) with 4 of these cases. Duration of treatment prior to corneal melting varied from 6 days to 17 months. Associated ocular and systemic diseases and their respective treatments complicate the analysis of these cases. In addition, the indication for treatment with topical NSAIDs was frequently unclear. CONCLUSIONS: The inconsistent and variable dose-toxicity relationships suggest that coexistent factors other than a simple drug toxicity are implicated, if not causative, in NSAID-associated corneal melting. These cases demonstrate the importance of making a clinical diagnosis before treatment and of following the clinical course of patients carefully during treatment.

Incidence of postoperative posterior capsular opacification following treatment with diclofenac 0.1% and ketorolac 0.5% ophthalmic solutions: 3-year randomized, double-masked, prospective clinical investigation.

PURPOSE: Laboratory studies in experimental animals suggest that use of nonsteroidal anti-inflammatory drugs decreases the incidence of posterior capsular opacification (PCO) following cataract surgery. Recently the incidence of PCO following cataract surgery and intraocular lens implantation was reported to be no different following postoperative treatment with diclofenac sodium 0.1% (Voltaren, Ciba Vision) or with dexamethasone 0.1% (Maxidex, Alcon). We studied the incidence of PCO in patients following treatment with diclofenac 0.1% and ketorolac tromethamine 0.5% (Acular, Allergan) ophthalmic solutions 3 years after cataract surgery and implantation of a foldable silicone intraocular lens. METHODS: A total of 120 patients underwent phacoemulsification and implantation of a foldable silicone intracular lens. Patients were treated with either diclofenac 0.1% ophthalmic solution or 0.5% ketorolac ophthalmic solution 4 times daily for 30 days in a double-masked, randomized fashion during the postoperative period. Patients were examined 3 years following surgery by a masked observer who determined which patients received YAG capsulotomies and graded any existing PCO. RESULTS: Each treatment group had 12% YAG capsulotomies 3 years following surgery. Although PCO was present more often with diclofenac treatment (25/62) than with ketorolac treatment (16/58), this difference is not statistically significant (P = .142). Patients tolerated both treatments well without a difference in toxic effects or tolerability. CONCLUSIONS: This study did not demonstrate a difference in the ability of diclofenac or ketorolac ophthalmic solutions to prevent PCO following cataract extraction and implantation of an intraocular lens. Both treatment regimens were equally well tolerated.

[Value of scintigraphic examination methods with 99mTechnetium in injuries of the epiphyseal cartilage (author's transl)]. / Der Wert szintigraphischer Untersuchungsverfahren mit 99mTechnetium bei Epiphysenfugenverletzungen.

The value of scintigraphic examinations of injuries involving the epiphyseal plate is to be seen to ensure the correct diagnosis of the lesions type I and type V according to Salter and Harris. Further on the results of these scintigraphic examinations allow a better planning of the therapeutic procedure. Experimental findings in rabbits succeeded to predict the seriousness and an early prognosis. The disturbances of the epiphyseal blood flow can be diagnosed by 99m Tc-O4 labeled erythrocytes and 99m Tc-O4 labeled albumin microspheres. 99m Tc-MDP skeletal scintigraphy gives the information at which time the repair is done and full weight bearing is possible.