Acquired strabismus following cosmetic blepharoplasty

The purpose of this study was to report on 12 patients with acquired strabismus following cosmetic blepharoplasty and to identify patterns of strabismus related to the surgical procedure. Clinical ophthalmologic examinations were performed to specifically clarify the type of strabismus. Operative reports of the blepharoplasty procedures were reviewed. Patients were followed for a minimum of 3 months after the blepharoplasty procedure before surgical intervention was considered. Operative findings at corrective strabismus surgery were noted and an attempt was made to correlate these findings with the clinical ophthalmologic examination and the blepharoplasty surgical procedure. Twelve cases of persistent vertical strabismus occurred following blepharoplasty procedures. Five patients had clinical findings consistent with the diagnosis of acquired superior oblique palsy; one of these five patients also showed signs of an acquired Brown syndrome. Seven patients developed an incomitant vertical deviation consistent with an inferior rectus paresis. Strabismus occurred after conventional lower lid, upper lid, and four-lid blepharoplasty with or without laser blepharoplasty. Acquired strabismus accompanied by persistent diplopia may occur as a complication of cosmetic blepharoplasty. Extraocular muscle damage resulting in either superior oblique muscle palsy or inferior rectus paresis was noted in these patients. In some cases, patients with inferior rectus paresis also showed mechanical restriction to upward rotation of the globe.     

The planar polarity gene strabismus regulates convergent extension movements in Xenopus

The signaling mechanisms that specify, guide and coordinate cell behavior during embryonic morphogenesis are poorly understood. We report that a Xenopus homolog of the Drosophila planar cell polarity gene strabismus (stbm) participates in the regulation of convergent extension, a critical morphogenetic process required for the elongation of dorsal structures in vertebrate embryos. Overexpression of Xstbm, which is expressed broadly in early development and subsequently in the nervous system, causes severely shortened trunk structures; a similar phenotype results from inhibiting Xstbm translation using a morpholino antisense oligo. Experiments with Keller explants further demonstrate that Xstbm can regulate convergent extension in both dorsal mesoderm and neural tissue. The specification of dorsal tissues is not affected. The Xstbm phenotype resembles those obtained with several other molecules with roles in planar polarity signaling, including Dishevelled and Frizzled-7 and -8. Unlike these proteins, however, Stbm has little effect on conventional Wnt/beta-catenin signaling in either frog or fly assays. Thus our results strongly support the emerging hypothesis that a vertebrate analog of the planar polarity pathway governs convergent extension movements.     

氟比洛芬酯用于小儿斜视手术的临床研究

目的观察氟比洛芬酯用于小儿斜视手术术后镇痛的有效性和安全性。方法将60例择期行斜视手术的息儿随机分为两组,每组30例。所有患儿均采用丙泊酚、瑞芬太尼靶控输注（TCI）全凭静脉麻醉方法。诱导采用丙泊酚效应室靶浓度为3μg／ml,瑞芬太尼血浆靶控浓度为3ng／ml,达预设浓度后静注维库溴铵0．1mg／kg,气管插管后行机械通气;麻醉维持为丙泊酚2～4μg／ml,瑞芬太尼3～4ng／ml,必要时追加维库溴铵。镇痛组于手术结束前15min缓慢静脉注射氟比洛芬酯1mg／kg（用生理盐水稀释至5m1）,对照组于麻醉拔管后缓慢静注生理盐水5ml,两组注射时间均为2rain。记录苏醒时间、拔管时间、恢复室停留时间,观察有无恶心、呕吐、嗜睡、躁动及呼吸抑制等不良反应的发生。观察术后1、2、4、8、12、24h的镇痛评分,同时记录各时点的平均动脉血压、心率、血氧饱和度。结果对照组患儿术后1、2、4、6、8h的MAP、HR值均较镇痛组高（P〈0．05）;两组术后12、24h的MAP、HR值比较差异无统计学意义（P〉0．05）。两组患儿术后各时点Spoz比较差异无统计学意义（P〉0．05）。对照组患儿的苏醒时间和拔管时间均较镇痛组延长（P〈0．05）。但两组患儿恢复室停留时间比较差异无统计学意义（P〉0．05）。对照组患儿术后1、2、4、6、8h的VAS值均较镇痛组高（P〈0．05）;两组术后12、24h的VAS值比较差异无统计学意义（P〉0．05）。对照组患儿术后躁动明显较镇痛组多（P〈0．05）。镇痛组患儿出现恶心、呕吐各1例,而对照组出现恶心2例,呕吐3例,但差异无统计学意义（P〉0．05）。结论氟比洛芬酯起效快,镇痛作用时间长,血流动力学稳定,苏醒期平稳,不抑制中枢,不影响患儿的麻醉苏醒,提高了患儿术后的舒适度。氟比洛芬酯用于小儿斜视手术安全、有效。     

Paralytic strabismus as a manifestation of lyme borreliosis

Lyme disease is a multi-system organ disorder caused by Borrelia burgdorferi. Although ocular manifestations have been reported, these remain a rare feature of the disease. This report shows a 49-years old patient that has been bitten by a tick and as consequence of which developed symptoms of the Lyme disease. In 1998 the patient was hospitalized in our Eye Clinic due to operating treatment of the paralytic strabismus (abductal nerve paralysis), as a rare feature of the Lyme disease. Postoperative squint angle was significantly reduced, but without any temporal movement. Diplopia was still present, though slightly reduced with the use of prism eyeglasses. The improvement of the quality of life was achieved, as well as the patient's satisfaction.     

The management of chylothorax

Chylothorax is readily diagnosed from the characteristic qualities of the effusion. Treatment should initially be conservative, consisting of multiple aspirations followed, if necessary, by suction drainage. Approximately half of the patients will not respond to these measures, and direct ligation and division of the duct is necessary for cure. This operation is most readily carried out through the right chest, the thoracic duct being ligated just above the diaphragm. In cases in which the duct is surrounded by tumor, radiotherapy to the mediastinum is often successful in controlling the reaccumulation of chyle, but irradiation is generally not recommended until after a tissue diagnosis has been made by thoracotomy. Nutritional problems are often concomitants of chylothorax.     

The planar cell polarity gene strabismus regulates convergence and extension and neural fold closure in Xenopus

We cloned Xenopus Strabismus (Xstbm), a homologue of the Drosophila planar cell or tissue polarity gene. Xstbm encodes four transmembrane domains in its N-terminal half and a PDZ-binding motif in its C-terminal region, a structure similar to Drosophila and mouse homologues. Xstbm is expressed strongly in the deep cells of the anterior neural plate and at lower levels in the posterior notochordal and neural regions during convergent extension. Overexpression of Xstbm inhibits convergent extension of mesodermal and neural tissues, as well as neural tube closure, without direct effects on tissue differentiation. Expression of Xstbm(DeltaPDZ-B), which lacks the PDZ-binding region of Xstbm, inhibits convergent extension when expressed alone but rescues the effect of overexpressing Xstbm, suggesting that Xstbm(DeltaPDZ-B) acts as a dominant negative and that both increase and decrease of Xstbm function from an optimum retards convergence and extension. Recordings show that cells expressing Xstbm or Xstbm(DeltaPDZ-B) fail to acquire the polarized protrusive activity underlying normal cell intercalation during convergent extension of both mesodermal and neural and that this effect is population size-dependent. These results further characterize the role of Xstbm in regulating the cell polarity driving convergence and extension in Xenopus.     

The subtleties of error management

Error management theory is a theory of considerable scope and emerging influence. The theory claims that cognitive biases do not necessarily reflect flaws in evolutionary design, but that they may be best conceived as design features. Unfortunately, existing accounts are vague with respect to the key concept of bias. The result is that it is unclear that the cognitive biases that the theory seeks to defend are not simply a form of behavioral bias, in which case the theory reduces to a version of expected utility theory. We propose some clarifications and refinements of error management theory by emphasizing important distinctions between different forms of behavioral and cognitive bias. We also highlight a key assumption, that the capacity for Bayesian beliefs is subject to constraints. This assumption is necessary for what we see as error management theory's genuinely novel claim: that behavioral tendencies to avoid costly errors can rest on systematic departures from Bayesian beliefs and that the latter can be adaptive insofar as they generate the former.     

The economics of pest management

Abstract

When is a pest a pest? Children are at times called pests, while at other times we call them darlings. Possums were, not so long ago, considered a resource to New Zealand society, in that they provided skins and recreational opportunities. The annual report of the Auckland Acclimatization Society 1916-1917 stated.