Biomedical subjects
Publications and source records attributed to R Held.
Binocular contrast inhibition can occur when the monocular contrast sensitivities are not equal. It has been reported in cases of monocular cataracts. Our case is an 18-year-old female with 3.50 D of hypermetropic anisometropia. She was not amblyopic but showed a typical binocular contrast inhibition.
To enhance the antimicrobial spectrum of the quinolones against anaerobic organisms and gram-positive bacteria, we investigated in two studies the parenteral combinations of ciprofloxacin (200 mg) and ofloxacin (200 mg) with metronidazole (500 mg) or clindamycin (600 mg) and the oral combinations of enoxacin (400 mg) and fleroxacin (400 mg) with metronidazole (400 mg), clindamycin (300 mg), or ornidazole (500 mg) (only with fleroxacin). The pharmacokinetics and serum bactericidal activities (SBAs) against 5 aerobic and 2 anaerobic species (total, 58 strains) were determined in two groups of 10 healthy volunteers by using a randomized crossover study design. The additions of metronidazole, clindamycin, and ornidazole did not affect the pharmacokinetics of the quinolones. The combination of clindamycin with ciprofloxacin, ofloxacin, and, to a lesser extent, fleroxacin resulted in an increase of the SBA against gram-positive strains (mean peak titers): Staphylococcus aureus, ciprofloxacin alone, 1:5.5; ciprofloxacin-clindamycin, 1:19.9; ofloxacin alone, 1:3.6; ofloxacin-clindamycin, 1:17.5; fleroxacin alone, 1:4.3; fleroxacin-clindamycin, 1:8.1; Streptococcus pneumoniae (fleroxacin and enoxacin were not tested), ciprofloxacin alone, 1:2.0; ciprofloxacin-clindamycin, 1:53; ofloxacin alone, 1:2.6; and ofloxacin-clindamycin, 1:49.2. The high SBA of quinolones against gram-negative bacteria was not affected by the combinations; however, relatively low activities against Pseudomonas aeruginosa were detected. In general, against anaerobic bacteria, low bactericidal activities were determined in both studies (mean peak titers ranged from 1:2.1 to 1:3.1; mean trough titers range from 1:2.0 to 1:2.9). In clinical settings with severe mixed infections, a parenteral therapy consisting of modern quinolones together with clindamycin or imidazole derivatives seems to be active and offers no obvious interactions.
A 35-year-old patient with systemic lupus erythematodes is presented. Two weeks after initiation of an immunosuppressive therapy with steroids and cyclophosphamide she developed a bilateral acute necrotising retinitis. Although the infiltration of the vitreous body was only slight the right eye developed a traction retinal detachment within a few days. A vitrectomy was performed but the situation was found to be inoperable due to central necrotic areas. Two days later serological specimen revealed an acute toxoplasmosis as the cause of the bilateral retinitis in this patient. A therapy with sulfadiazine and pyrimethamine was started immediately. Nevertheless two weeks later traction retinal detachment occurred also in the left eye. A reattachment of the retina could be achieved by vitreoretinal surgery.
A classic view of the relation between sensorineural activity and perception has assumed that the former is somehow transformed into the latter at some locus in the brain. This notion conflicts with the modern view that the activity of the nervous system is restricted to transmitting and processing information. It is suggested that the conflict may be resolved by considering perception as reflective activity rather than passive reception. This cognitive process entails information about the perceiving self and the general context and not merely the stimulus input. Some aspects of perception can be related to neuronal mechanisms and even to neuronal activity at specific loci. How is this done? By identifying the characteristics of the perceptual process and finding a necessary and sufficient neuronal mechanism that receives information about the stimulus input and can perform the implied computation. Examples are taken from the study of visual development in human infants.
Visual acuity, the most basic measure of developing pattern vision in human infants, has been used extensively for detecting anomalies of vision and oculomotor coordination. In the past 10 years much has been learned about the development of two hyperacuities, namely, vernier acuity and stereoacuity. These two acuities become superior to grating acuity after the third month and remain so throughout life. Compared to females, males show slower development of stereopsis and vernier acuity, but not grating acuity, during the third through sixth months. We have suggested that this may result from the neurotrophic effects of the early pulse of testosterone found in males. Measures of vernier acuity have proven effective in detecting meridional amblyopia in older children who had significant astigmatism in the first year and subsequently lost it. The susceptible period for acquiring meridional amblyopia extends from the second half of the first year to at least the end of the second year. Deviations from the typical oblique effect (equal acuity for vertical and horizontal edges; equal, but lower, acuity for left oblique and right oblique) may result from uncorrected astigmatism early in life.
A diagnostic vitrectomy was performed on three patients with posterior uveitis of unknown origin and whose vitrous body was markedly affected. In all cases, cells of high-grade B-cell lymphoma (earlier referred to as reticulum cell sarcoma) were identified by cytological analysis of the specimen. In addition to the ocular findings, one of the three patients showed clinical and radiological evidence of a tumorous mass in the area of the right thalamus at the time of diagnosis. This was interpreted as a cerebral manifestation of the lymphoma. Initially, the other two patients did not show any cerebral involvement. One of them, however, developed clinical symptoms 9 months after diagnosis, which were radiologically verified as tumor infiltration of the cerebellum and the diencephalon. Under radiation therapy, the ocular findings disappeared within a few weeks.
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Monkeys aligned a cursor bar with high-contrast square-wave gratings presented in a variety of orientations. Alignment time increased with increasing spatial frequency from 6 to 24 cycles deg-1 regardless of the orientation of the grating. At higher spatial frequencies, alignment tasks took longer for obliquely oriented gratings than for horizontal and vertical ones. Reducing grating contrast by blurring the image of the 24 cycle deg-1 grating also produced longer alignment times for the obliques. These data indicate that monkeys have an oblique effect similar to that found in humans, implying that the monkey is a useful animal model for investigating the development of meridional anisotropies.
Monocular acuities, in two infants with nonaccommodative comitant esotropia, were measured before and during occlusion therapy. The results indicate that strabismic amblyopia is present within the first year of life and that the infant visual system is remarkably sensitive to short periods of monocular occlusion during this time period.
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New techniques have permitted serial assessments of visual acuity in infants. Acuity measurements in infants with astigmatism did not reveal meridional amblyopia during the first year of life. Measurements in infants with esotropia showed marked differences in acuity of the two eyes as early as the first 6 months of life. Therapeutic occlusion of the non-deviating eye improves the acuity of the deviating eye but at the expense of the occluded eye. After discontinuing occlusion, rapid increases in acuity of the formerly occluded eye can occur.
Compared with children of school age, infants show ten times the incidence and considerably greater amounts of clinically significant astigmatism. The amount begins to decrease in the second semester of life, and the incidence declines during the third year. The unanticipated results bear on both the etiology and the neural sequelae of astigmatism.
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