Lenticonus in Alport's syndrome. A family study

A South Indian family with three well documented cases of Alport's syndrome with anterior lenticonus are reported. Clinical features of the syndrome including ocular and laboratory findings have been presented and discussed. Macular pigmentation, 5 cases, subcapsular opacity and nephrotic syndrome, one case each, observed in the present series are of great interest and are quite rare in patients with Alport's syndrome. Critical analysis of the family pedigree revealed autosomal dominance with incomplete penetrance as the possible mode of genetic transmission of the disease.

Trephine sections for cataract surgery

In 100 cases of senile cataract keratoplasty trephine was used for making lamellar cataract sections from the 3 to 9 o'clock position. The results are compared with sections made by keratome and scissors. The advantages achieved by performing the sections with the trephine are discussed. Complications due to defective wound healing are reduced to the bare minimum. There was no astigmatism in 41% of the cases. The sections were ab externo enabling preplaced sutures to be inserted.

Unilateral blindness following vidian neurectomy

A case with unilateral blindness is being reported, to arouse awareness in surgeons about the possibility of such a serious complication after Vidian neurectomy by the trans-septal route.

Lid rhinosporidiosis - simulating a tumor

A case of rhinosporidiosis is described with extensive primary involvement of the lids, bulbar and palpebral conjunctiva.

Blood pressure studies in black children

Blood pressure measurements were obtained under office conditions by auscultatory method, using appropriate cuff sizes, in 1,668 healthy black children (827 boys and 841 girls) ranging in age from 4 to 17 years. We found no significant difference between the mean systolic blood pressure of black children in our study and that of whites as reported in the literature. However, mean diastolic blood pressure was lower in black children. Some black children (3.6%) were found to have blood pressure more than 2 standard deviations above the mean for their age and should be closely observed for developing hypertensive cardiovascular changes.

Glaucoma-induced changes in the ciliary ganglion

Changes in ciliary ganglion cells are described after the experimental induction of glaucoma in rhesus monkeys. They appear within 12 hours in the form of peripheral displacement or extrusion of the cell nucleus and loss of Nissl granules.

Study of a kindred with thyroxine-binding globulin deficiency and oligomenorrhea

The finding of a low total thyroxine level in an oligomenorrheic woman uncovered a new family with thyroxine-binding globulin deficiency and oligomenorrhea. Thirteen of 17 family members had the deficiency of thyroxine-binding globulin, with heterozygous female subjects showing overlap of levels with normal subjects. Oligomenorrhea was frequently found but segregated separately from the thyroxine-binding globulin deficiency; of seven women with low levels, three had normal monthly menstrual cycles. Fertility was not impaired.

Dynamics of hypothermic heart muscle (heart-lung preparation)

The work performance of the hypothermic heart muscle and its possible relationship to ventricular fibrillation was studied in 42 canine heart-lung preparations. With lowering of temperature the work capacity of the heart declined proportional to the decline in heart rate. The maximum stroke volume remained uniformly high over a wide range of hypothermia, until arrhythmia interfered at temperatures around 22°C. Although the work capacity gradually decreased with lower temperature, it was found to be considerably higher than the work load the heart has to cope with in an intact animal at the same temperature. Spontaneous ventricular fibrillation occurred at the same temperature range in denervated heart-lung preparations as in intact hypothermic animals. No relationship was found between the onset of fibrillation and the work load of the heart prior to its onset. Myocardial mechanical failure is therefore not considered to be the cause of ventricular fibrillation in hypothermia. The increased blood viscosity at lower temperatures did not account for the marked prolongation of the ejection phase. Variations in stroke volume likewise did not effect significantly its duration. Epinephrine markedly shortened both ejection and relaxation phase of the hypothermic heart. Epinephrine had a marked inotropic effect upon the hypothermic heart, while the accelerator effect decreased with lowering of temperature. At 22°C or below, where sinus rhythm was no longer present, epinephrine induced ectopic impulse formation in multiple foci which led to ventricular fibrillation.