Compartment syndrome of the arm and disseminated intravascular coagulation.

We present the case of a woman who had coagulopathy and sepsis and who developed compartment syndrome of the arm. We discuss recognition and treatment of arm compartment syndrome and review the literature regarding this condition.

Sarcoidosis of the pancreas: case report and review of the literature.

Sarcoidosis involving the pancreas is rare. Patients can present with symptoms that mimic pancreatic cancer. We report a case of a male patient with clinical and radiographic findings suggestive of pancreatic cancer as the initial manifestation of sarcoidosis.

Correlation of postoperative extraocular muscle suture adjustment with its immediate effect on the strabismic deviation.

PURPOSE: To determine if any relationship exists between the amount of adjustment using this surgical technique and resulting changes in the strabismic deviation. METHODS: A prospective database obtained between the years 1991 and 1996 was used to obtain retrospective clinical information and data for this study. We found in the database 172 postoperatively adjusted muscles in 159 patients who could be included in this study. All patients had their muscles adjusted postoperatively within the first 24 hours after surgery. Information retrieved specific to this study included the post-surgical, pre-adjustment strabismic deviation, the amount and direction of the adjustment and the resulting deviation immediately after this postoperative adjustment. Statistical analysis was performed on the total and individual muscles, as well as the direction of adjustment, comparing pre- to post-adjustment binocular deviations. RESULTS: There was a significant overall relationship between the millimeters of postoperative adjustment and the amount of change in the binocular deviation (p<.0001). This relationship was more linear under 3.0 mm of postoperative adjustment. The effect of the amount of postop' adjustment when advancing the muscle was significantly greater than when recessing the muscle (p<.0001). There was more effect per mm of postop' adjustment of horizontal muscles than vertical muscles (p=.004). CONCLUSIONS: There is a linear correlation of postoperative extraocular muscle adjustment when advancing an adjustable muscle but this correlation is more variable for adjustments over 3.0 mm. The effect of adjustment per mm is greater when adjusting horizontal than vertical muscles. There is a poor correlation for further recession. Prediction Equations are provided to enhance clinical results of this technique.

Ankyloblepharon filiforme adnatum in trisomy 18.

Ankyloblepharon filiforme adnatum (AFA) is a mild form of ankyloblepharon, in which there is partial thickness fusion of the central portion of the lid margins, sparing the canthi. Although it can be seen as an isolated sporadic congenital defect, it is important for pediatric ophthalmologists to be cognizant of its possible association with a number of anomalies. One infrequent, but nevertheless important association, is with trisomy 18. We present three cases of AFA in association with trisomy 18, and emphasize the need for clinicians to search for other abnormalities in a newborn presenting with AFA.

An alternative approach to the surgical management of exotropia--the unilateral lateral rectus recession.

Fifty-five patients with moderate angle exotropia of 15 to 20 prism diopters were surgically treated with a unilateral lateral rectus recession of 7.0, 7.5, or 8.0 mm. The mean age at surgery was 14.5 years. The mean preoperative deviation was 18.0 delta. The mean lateral rectus recession was 7.6 mm. At the initial postoperative follow up, all patients were either a small-angle exotropia or esotropia, or orthophoric. Twenty-eight of the 55 patients (51%) were orthophoric at their most recent follow up. Twenty-four patients (44%) were undercorrected, with 22 of these having residual exodeviations less than 8 delta. Three patients (5%) were overcorrected.