| OCR Text |
Show longing the interval to recurrence and preventing regrowth of these tumors. ThOmJlS C. Spoor, M.D., F.A.C.S. • • • Neurological Manifestations of the Acquired 1mmuno- Deficiency Syndrome (AIDS): Experience at UCSF and Review of the Literature. Levy, R. M., Bredesen, D. E., and Rosenblum, M. L. J. Neurosurg. 62: 475-495, 1985. [Reprint requests to Mark L. Rosenblum, M.D., % The Editorial Office, Dept. of Neurosurgery, 1340 Ninth Ave., Suite 210, San Francisco, CA 94122.] The authors review the protean neurologic mani1. festations of acquired immunodeficiency syndrome (AIDS) in 366 patients. Central nervous system (CNS) complications included viral (subacute encephalitis [54], atypical aseptic meningitis [21], herpes simplex encephalitis [9], progressive, multifocal leukoencephalopathy [6], viral myelitis [3], and varicella zoster encephalitis [1]) and nonviral infections (ToxoplasmJl gondii [103], Cryptococcus neoformans [41], Candidil albicans [6], Mycobacteria [6], Treponema ptJllidum [21], Coccidioides immitis [1], Aspergillus fumigatus (1], and Escherchia coli [1]). Neoplasms included primary CNS lymphoma (15), systemic lymphoma with CNS manifestations (12), and metastatic Kaposi's sarcoma (3). Due to unpredictable manifestations and diverse etiologies of CNS lesions of AIDS, the authors suggest that biopsy of all space-occupying lesions be performed to obtain a tissue diagnosis prior to initiating treatment. ThomJls C. Spoor, M.D., F.A.C.S. • • • Superior Division Paresis of the Oculomotor Nerve. Guy, J., Savino, P. J., Schatz, N. J., Cobbs, W. H., and Day, A. L. Ophthalmology 92(6): 777-784, 1985. [Reprint requests to the Neuro-Ophthalmology Service, Department of Ophthalmology, University of Florida, Box J-284, JHMHC, Gainesville, FL 32610. (Dr. John Guy)] Guy et al. report here on five patients who have paresis of the superior division of the third cranial nerve (i.e., ptosis and paresis of elevation in abduction) on the basis of intracranial disease (aneurysm, tumor, etc.). As Dr. Neil Miller states in his discussion following the paper, such findings argue for topographical localization of nerve fibers in the third cranial nerve before anatomical division of the nerve in the anterior cavernous sinus. The point the authors make is that patients with isolated superior division third nerve findings cannot be presumed to have disease peripheral to the cavernous sinus. Lyn A. Sedwick, M.D. • • • Quantitative Office Perimetry. Keltner, J. L., Johnson, C. A., and Lewis, R. A. Ophthalmology 92 (7): 862-872, 1985. [Reprint requests to John L. December 1985 Literature Abstracts Keltner, M.D., Department of Ophthalmology, University of California, Davis, CA 95616.) Comparison of automated perimeters is complicated at best and impossible at worst. This article makes the task both easy and interesting in regard to certain subjective and objective criteria. The investigators compared six commercially available automated perimeters (Humphrey field analyzer, Squid, Octopus 500, Dicon 2000, Fieldmaster SO, and Digilab 350) on six normal patients, six patients with glaucoma, and six patients with neuro-ophthalmic visual field loss. Machine order was appropriately randomized and the results were tabulated in quickly absorbed tables, graphs, and grey-scale and numerical printouts of the actual fields obtained. Rather than focus on the picayune details that equipment salesmen "hype," this paper deals with such realistic factors as patients' response to each test (how difficult, how long, how stressful the pace, etc.) and technicians' assessment of ease of adjustment and monitoring of the patient. Also, variability of test times and test results (in normals) are discussed. Perhaps most interesting of all are the two pages that depict the actual printouts the clinician sees. Dr. William Hart discusses the paper and agrees with the authors that this study shows no one perimeter to outperform the others in all categories and that the "correct" perimeter depends on the specific needs of the clinician or practice. He also concludes, and one can easily agree, that this study will be "of great value to those currently in the process of making these decisions." Lyn A. Sedwick, M.D. • • • Lymphocyte Subpopulations in Graves' Ophthalmopathy. Felberg, N. T., Sergott, R. c., Savino, P. J., Blizzard, J. J., Schatz, N. J., and Amsel, J. Arch. Ophthalmol. 103: 656-659, 1985. [Reprint requests to Wills Eye Hospital, Ninth and Walnut Streets, Philadelphia, PA 19107 (Dr. Sergott).] Doctors Felberg et al. present information regarding T-Iymphocyte subsets in patients with thyroid ophthalmopathy. By grouping patients as Werner's class 1-2 (soft tissue and/or lid signs and symptoms), class 4-5 (extraocular muscles or cornea involvement), or class 6 (sight loss), they found that, compared to normals, patients with thyroid eye disease of classes 4-6 have significant alterations in numbers of T8 lymphocytes and T4!f8 ratio. Also, if patients are successfully treated with cortisone, this number and ratio return toward control or normal values. This paper is difficult to digest for the "T-cell naive," and review of earlier papers laying the groundwork for this one is really in order. Nevertheless, this work seems to be uncovering the new tip of the iceberg regarding immune mechanisms and thyroid eye disease. Lyn A. Sedwick, M.D. • • • Early Loss of Central Visual Acuity in Glaucoma. Pickett, J. E., Terry, S. A., O'Connor, P. 5., and O'Hara, M. Ophthalmology 92(7): 891-896, 1985. 279 |
