Cassini observes the active south pole of Enceladus.

Cassini has identified a geologically active province at the south pole of Saturn's moon Enceladus. In images acquired by the Imaging Science Subsystem (ISS), this region is circumscribed by a chain of folded ridges and troughs at approximately 55 degrees S latitude. The terrain southward of this boundary is distinguished by its albedo and color contrasts, elevated temperatures, extreme geologic youth, and narrow tectonic rifts that exhibit coarse-grained ice and coincide with the hottest temperatures measured in the region. Jets of fine icy particles that supply Saturn's E ring emanate from this province, carried aloft by water vapor probably venting from subsurface reservoirs of liquid water. The shape of Enceladus suggests a possible intense heating epoch in the past by capture into a 1:4 secondary spin/orbit resonance.

Cautery of the orbital septum during blepharoplasty.

PURPOSE: Application of a grid of electrocautery to the orbital septum to treat anteriorly prolapsed eyelid fat pads during blepharoplasty has been previously described. A review of patients who underwent this technique was performed to determine if this technique led to a higher incidence of postoperative eyelid retraction. METHODS: A retrospective case series of patients who underwent application of a grid of electrocautery to the orbital septum during blepharoplasty from 1979 to 1999 was reviewed. RESULTS: There were 1492 patients (3018 eyelids) who underwent an application of a grid of electrocautery to the orbital septum during this period. Five hundred twenty-nine patients (1036 eyelids) underwent upper blepharoplasty, 91 patients (174 eyelids) underwent lower blepharoplasty, 149 patients (596 eyelids) underwent combined upper and lower blepharoplasty, and 723 patients (1212 eyelids) underwent a combined upper blepharoplasty and ptosis repair. All patients were followed for at least 3 months. Follow-up ranged from 3 months to 20 years. No patient had postoperative eyelid retraction. CONCLUSIONS: The application of a grid of electrocautery to the orbital septum during blepharoplasty to treat anteriorly prolapsed eyelid fat pads is effective, safe, and does not lead to late postoperative eyelid retraction.

Io's thermal emission from the Galileo photopolarimeter-radiometer.

Galileo's photopolarimeter-radiometer instrument mapped Io's thermal emission during the I24, I25, and I27 flybys with a spatial resolution of 2.2 to 300 kilometers. Mapping of Loki in I24 shows uniform temperatures for most of Loki Patera and high temperatures in the southwest corner, probably resulting from an eruption that began 1 month before the observation. Most of Loki Patera was resurfaced before I27. Pele's caldera floor has a low temperature of 160 kelvin, whereas flows at Pillan and Zamama have temperatures of up to 200 kelvin. Global maps of nighttime temperatures provide a means for estimating global heat flow.

Involutional entropion and ectropion of the Asian lower eyelid.

PURPOSE: A clinical observation showed that involutional entropion of the lower eyelid in Asians may occur more commonly than ectropion. A review of surgical cases was performed to examine this hypothesis. METHODS: A retrospective review of the number of Asian lower lid involutional ectropion and entropion repairs was performed in three different clinical practice settings. These data were compared and statistically analyzed with similar data for non-Asian patients. RESULTS: The frequency of ectropion among Asians was significantly less than in non-Asians (chi-square, p < 0.001). Asian entropion repair represented 11.4% of the 604 eyelid operations performed on Asians, whereas Asian ectropion repair made up only 1.5% of cases. Non-Asian entropion and ectropion repairs were 3.7% and 6.2%, respectively, of the 1,849 eyelid procedures performed on non-Asians. CONCLUSIONS: Because of the normal anteriorly protruding position of the orbital fat within the Asian lower eyelid, Asians may be more predisposed than whites to the development of involutional entropion rather than ectropion. Removal of lower eyelid fat should be considered in entropion repair of the Asian lower eyelid.

Neuropsychological aspects of Wilson's disease.

A consecutive series of 34 patients with confirmed diagnoses of Wilson's disease (WD) was administered complete neuropsychological examinations upon admission to a university medical center for routine laboratory tests. Twenty-five patients with neurological and/or hepatic symptoms (symptomatics) revealed frequent and severe motor deficits and infrequent and mild cognitive deficits in contrast to nine patients with genetic findings of Wilson's disease but no symptomatic findings (asymptomatics). Somato-sensory tests were normal in all. One of the most intriguing findings was the absence of a significant correlation between the level of copper toxicity and the degree, nature, and frequency of associated neurological deficits in both symptomatic and asymptomatic patients. Fifty per cent of the present sample received psychiatric treatment, including hospitalization, for schizophrenia, depression, anxiety, and related disorders prior to confirmed diagnosis of WD. The present findings provide additional evidence that patients with the initial presenting psychological symptoms may be easily misdiagnosed and mistreated if the possibilities of Wilson's disease are not ruled out first.

Rhythmic auditory stimulation in gait training for Parkinson's disease patients.

Rhythmic auditory stimulation (RAS) was used as a pacemaker during a 3-week home-based gait-training program for Parkinson's disease (PD) patients (n = 15). Electromyogram (EMG) patterns and stride parameters were assessed before and after the test without RAS to evaluate changes in gait patterns. Data were compared with those of two control groups (n = 11), who either did not participate in any gait training or who participated in an internally self-paced training program. RAS consisted of audiotapes with metronome-pulse patterns embedded into the on/off beat structure of rhythmically accentuated instrumental music. Patients who trained with RAS significantly (p < 0.05) improved their gait velocity by 25%, stride length by 12%, and step cadence by 10% more than self-paced subjects who improved their velocity by 7% and no-training subjects whose velocity decreased by 7%. In the RAS-group, timing of EMG patterns changed significantly (p < 0.05) in the anterior tibialis and vastus lateralis muscles. Evidence for rhythmic entrainment of gait patterns was shown by the ability of the RAS group to reproduce the speed of the last training tape within a 2% margin of error without RAS.

Anatomy of the terminal nerves in the upper eyelid.

Anatomic dissections on human cadaver heads were performed to determine the anatomy of the terminal nerves in the upper eyelid. Vertically oriented nerves, which are commonly identified in a preseptal location in the upper eyelid, were determined to be sensory nerves, most commonly originating from the supraorbital nerve (V1). Facial nerve (VII) dissections were also performed, with specific attention paid to the temporal branch. The facial nerve innervates the orbicularis muscle on its deep surface, both at the most temporal aspect of the muscle as well as along the supraorbital rim. No motor fibers could be traced into the upper eyelid and no anastomosis was noted between the temporal branch of the facial nerve (VII) and the supraorbital nerve (V1).

Development of a computerized alcohol screening instrument for the university community.

An anonymous, self-administered alcohol screening instrument, suitable for faculty, students, and staff, combines two already existing alcohol screening questionnaires, the CAGE and the AUDIT. The composite instrument, Alcohol Screening Instrument for Self-Assessment (ASISA) was developed at the University of Michigan with the university's extensive computer networking capabilities in mind. It was designed as a "frontline" self-identification screening questionnaire to help individuals determine whether or not their current drinking practices are problematic or if they have the potential for becoming problematic. The ASISA is not a replacement for an in-depth alcohol evaluation; its aim is to encourage members of the university community to take a closer look at their drinking patterns and seek a comprehensive clinical assessment if indicated by the scores received on the ASISA.

Self-compression plates for orbital rim fractures.

The development and principles of self-compression plating, as well as a series of patients treated with this technique, are described. The use of such plates has specific advantages over other techniques for disorders encountered by the oculoplastic surgeon. The indications for plating were displaced trimalar fracture, displaced trimalar fracture with orbital rim fragment, and comminuted orbital rim fracture. Results were good; no complications have been observed to date. Comparison of compression plating to other methods for repair of orbital fractures is made. Self-compression plating with Vitallium plates is an effective modality for the treatment of a broad spectrum of patients with orbital rim fractures.

Ptosis surgery in the Asian eyelid.

There are many characteristic features of the Asian eyelid that differ significantly from those of the Occidental. The most noticeable of these are fullness of the upper eyelid and a low or absent upper lid crease. The patient may desire the preservation of these distinctive features during ptosis surgery. The surgical techniques of ptosis repair and the preservation of the typical Asian eyelid features during ptosis repair have not previously been described in the literature. This study describes the histologic differences between the Asian and Occidental upper eyelid, and the application of this anatomic knowledge to surgical techniques of ptosis repair with special emphasis on the preservation of the Asian eyelid features.

Patient generated dysphoria in psychiatric residents.

Caring for patients can induce intense emotions in psychiatrists. Although clinical experience suggests that such feeling can become a source of stress for the psychiatrists, particularly the first year resident, and interfere adversely with patient care, research in this area has been lacking. We studied a group of psychiatric residents in order to identify what patient conditions or characteristics induce the greatest dysphoria and adversely affect the quality of patient care. Serious medical illnesses induced the greatest dysphoria.

Team management of failure to thrive.

A multidisciplinary team approach to treatment of failure to thrive in infancy and early childhood permits the simultaneous consideration of nutritional, medical, and psychosocial risk factors associated with this complex syndrome. The registered dietitian works with the physician, nurse, and social worker to provide an integrated evaluation of nutrition history, feeding patterns, medical status, social situation, developmental level, and interactional qualities of the child with failure to thrive. Nutritional management of failure to thrive emphasizes: (a) ongoing assessment of nutritional status and rate of catch-up growth, including regular collection of anthropometric measurements; (b) provision of energy and protein in amounts sufficient to meet requirements for catch-up growth; and (c) concrete, individualized nutrition instruction. Long-term follow-up at regular intervals in coordination with other members of the failure-to-thrive team provides the opportunity to reinforce nutrition instruction and to reassess and adapt meal plans to meet the growing child's changing nutritional needs.

Evaluation of ECG changes in dentists treating awake patients.

Twenty-eight male dentists were evaluated with 24 hour ambulatory ECG while working on awake patients. Only one of the participants showed any sign of stress induced arrhythmias after a patient fainted. The remainder of the subjects were indistinguishable from previously studied normal populations.

Childhood depression. Developmental considerations.

Childhood depression is becoming a more commonly recognized diagnosis in the pediatric population. The American Psychiatric Association purposes that the criteria for adult and childhood depression are the same. We question that position and emphasize the developmental aspects of depressive symptoms providing diagnostic guidelines for depression at five different stages from infancy through adolescence. Case examples are included to highlight the distinctive presentation of depression at each developmental stage. Specific treatment recommendations include psychotherapy, mobilization, and pharmacotherapy.

Effects of the silicone tube on the canaliculus: an animal experiment.

A silicone tube is often passed through a fellow normal canaliculus in the treatment of a lacerated canaliculus in order to form a loop in the medial canthus and unite the ends of the tube in the nose. The histopathologic effects of the tube on the canaliculus and the constant frictional trauma caused by movement of the tube with blinking are not known. We intubated both normal and lacerated canaliculi of dogs to determine whether any damage occurred to the normal canaliculus and whether the inflammatory response following surgical repair of canalicular lacerations was prolonged or altered by the tube. We found no significant damage to the normal canaliculus and no increase in the surgical inflammation. Following the repair of a laceration, the canalicular epithelial layer healed along the silicone tube in spite of the constant frictional trauma. These findings support the safety of the use of the silicone tube in the treatment of canalicular disorders.