The double-eyelid operation without supratarsal fixation.

Among the considerations in the formation of the double eyelid, two factors are considered to be important. They are the levator insertion into the skin and the amount of soft tissue between the levator aponeurosis and the skin. The author assumes that the amount of soft tissue may be more importantly related to forming the double eyelid than the levator expansion. Based on this assumption, the author undertook a modified operation to create the double eyelid by removing excessive soft tissue without any fixation to the levator aponeurosis or the tarsal plate.

The role of Müller's muscle reconsidered.

It is a traditional teaching that the levator aponeurosis is the main transmitter of the levator palpebrae muscle. However, there are several points that raise doubts in this fundamental concept of the levator aponeurosis as being the primary interconnecting mechanism in upper lid elevation. Despite the structural integrity of the levator complex, drooping of the upper eyelids is seen to develop in situations such as Horner's syndrome and in times of excessive fatigue and sleepiness. Amid the controversy in the literature regarding the specific role of the levator aponeurosis in the lid-elevating mechanism, we have observed that the levator aponeurosis fails to make constant attachment to the tarsal plate. This has led us to speculate on the possible role of the posterior lamella - Müller's muscle - as the primary transmitter of the levator muscle action to the tarsal plate.

Histopathology of apocrine bromhidrosis.

A histologic study of axillary skin taken from 20 Korean bromhidrosis patients and 10 normal Korean subjects without axillary odor was undertaken. Under light microscope, the skin specimens, stained with hematoxylin and eosin, were examined. Compared with the controls, the apocrine glands were numerous and the gland size large in the bromhidrosis skin. The decapitated epithelial cell-lined contracted glands were seen intermixed with the nondecapitated cell-lined distended glands in the bromhidrosis skin. By comparison, in the normal controls, the apocrine glands were atrophic and lined with flat epithelial cells and showed no decapitation. It appears that histologic change of apocrine glands may contribute more to bromhidrosis than bacterial decomposition of apocrine sweat. Surgical removal of apocrine glands may thus be the most satisfactory and logical method of treatment.

Studies on Malayan filariasis in Bengkulu (Sumatera), Indonesia with special reference to vector confirmation.

In an endemic focus of Brugia malayi in Bengkulu, Indonesia the microfilariae rate was 25%. The microfilariae showed nocturnal periodicity. Domestic cats in the same area were found to harbour B. pahangi, with a microfilariae rate of 23%. In the study area, the most prevalent man-biting Mansonia mosquitoes were Mn.bonneae (41%), followed by Mn.annulata (27%), Mn.uniformis (25%) and Mn.dives (7%). More Mansonia mosquitoes were collected outdoors than indoors between 1800-2200 hours. Natural infections with infective larvae of Brugia spp. were found in Mn.bonneae, Mn.dives, Mn.uniformis, Mn.annulata, and An.nigerrimus. Experimental infection studies revealed that Mn.annulata, Mn.bonneae, Mn.uniformis, An.nigerrimus and An.peditaeniatus permit the development of infective larvae. Under experimental condition, the vectorial competence is high in Mn.bonneae, intermediate in Mn.uniformis and low in An.hyrcanus group. It is concluded that the principal vectors of periodic B.malayi in the study area in Bengkulu are four Mansonia species (Mn.annulata, Mn.bonneae, Mn.uniformis and Mn.dives), and that the potential vectors include two Anopheles species (An.nigerrimus and An.peditaeniatus). This is the first record of Mn.bonneae being a vector of periodic B.malayi in Indonesia.

A study of small mammals in the Ciloto field station area, West Java, Indonesia, with special reference to vectors of plague and scrub typhus.

From June 1977 to June 1978 a study of smal mammals was carried out in the Ciloto field station area, West Java, Indonesia by the WHO Vector Biology and Control Research Unit-II. The objectives of the investigations were to determine the diversity and density of rodent species, to find potential plague and scrub typhus vectors and to study their host-parasite relationships. In the 13 month period a total of 6 species of murids were identified; two species of campestral rats (R. tiomanicus and R. argentiventer), one species of peri-domestic (R. exulans), one species of domestic (R.r. diardii), and two species of forest rats (R. bartelsii and R. bukit). In addition, three species of insectivores (Suncus murinus, Hylomys suillus and Crocidura monticola), and one species of carnivore were found. Of the three habitats studies (mixed, ricefield and lalang), 10 species of small mammals were found in the mixed while four species of commensal murids were found in both the ricefield and the lalang. Of the four commensal murid species R. exulans had the highest density. R. tiomanicus was common but not abundant, and least common was R. argentiventer. R.r. diardii was occasionally found in the field. The mean litter size of gravid R. tiomanicus was 7.1, R. exulans 4.3, R. argentiventer 7.5 and R.r. diardii 9. Male R. tiomanicus, R. argentiventer and R.r. diardii with spermatozoa present in animals over 55 gm. Animals of less than 50 gm had no sperm. In R. exulans spermatozoa were present in specimens weighing 24-66 gm. No sperm were detected in those below 20 gm. The flea index of Xenopsylla cheopis and Stivalius cognatus as determined for R. tiomanicus was 0.3 and 2.3;l for R.r. diardii 2.2 and 1.7; for R. exulans 0.3 and 0.5; and for R. argentiventer 0.4 and 1.7 respectively. S. cognatus had a significantly higher density than X. cheopis among the campestral and peridomestic rats, but the density of X. cheopis was significantly in the domestic rat. Overall infestation rates were equally high in both mixed and lalang habitats, but low in the ricefield. Flea indices were highest in the mixed habitat, lower in lalang, and lowest in ricefield. The putative vector of scrub typhus (Leptotrombidium (L.) deliense) was quite prevalent on campestral rats, less so on domestic ones and least on peridomestic. Overall infestation rates were equally high in both mixed and lalang habitats and low in the ricefield. Chiggers load per animal was significantly higher in the mixed habitat, lower in lalang and lowest in the ricefield.