The role of Müller's muscle reconsidered.

It is a traditional teaching that the levator aponeurosis is the main transmitter of the levator palpebrae muscle. However, there are several points that raise doubts in this fundamental concept of the levator aponeurosis as being the primary interconnecting mechanism in upper lid elevation. Despite the structural integrity of the levator complex, drooping of the upper eyelids is seen to develop in situations such as Horner's syndrome and in times of excessive fatigue and sleepiness. Amid the controversy in the literature regarding the specific role of the levator aponeurosis in the lid-elevating mechanism, we have observed that the levator aponeurosis fails to make constant attachment to the tarsal plate. This has led us to speculate on the possible role of the posterior lamella - Müller's muscle - as the primary transmitter of the levator muscle action to the tarsal plate.

Histopathology of apocrine bromhidrosis.

A histologic study of axillary skin taken from 20 Korean bromhidrosis patients and 10 normal Korean subjects without axillary odor was undertaken. Under light microscope, the skin specimens, stained with hematoxylin and eosin, were examined. Compared with the controls, the apocrine glands were numerous and the gland size large in the bromhidrosis skin. The decapitated epithelial cell-lined contracted glands were seen intermixed with the nondecapitated cell-lined distended glands in the bromhidrosis skin. By comparison, in the normal controls, the apocrine glands were atrophic and lined with flat epithelial cells and showed no decapitation. It appears that histologic change of apocrine glands may contribute more to bromhidrosis than bacterial decomposition of apocrine sweat. Surgical removal of apocrine glands may thus be the most satisfactory and logical method of treatment.

The double-eyelid operation without supratarsal fixation.

Among the considerations in the formation of the double eyelid, two factors are considered to be important. They are the levator insertion into the skin and the amount of soft tissue between the levator aponeurosis and the skin. The author assumes that the amount of soft tissue may be more importantly related to forming the double eyelid than the levator expansion. Based on this assumption, the author undertook a modified operation to create the double eyelid by removing excessive soft tissue without any fixation to the levator aponeurosis or the tarsal plate.

Malaria control with residual fenitrothion in Central Java, Indonesia: an operational-scale trial using both full and selective coverage treatments.

An operational-scale trial, using residual fenitrothion, for control of malaria was carried out in Central Java, Indonesia, from 1980 to 1982. Two areas, each comprising about 70 km(2) and a population of about 50 000, were treated with fenitrothion (40% water dispersible powder) at a target dosage of 2 g/m(2) for 3 cycles at 6-monthly intervals. One area was treated with full coverage (i.e., the interiors of houses and cattle shelters were sprayed to a height of 3 m) for 2 cycles, followed by a third cycle with selective coverage (i.e., the interiors of houses were sprayed with one 75 cm horizontal swath between 10 cm and 85 cm from the floor while the cattle shelters were sprayed to a height of 3 m). The other area was treated for 3 cycles with only selective coverage. While both treatment methods reduced malaria rates and vector populations to very low levels, the full coverage treatment was more rapidly effective and also reduced the Plasmodium falciparum index. However, the selective coverage treatment was 68% less expensive than full coverage and greatly reduced the degree of cholinesterase depressions among the spraymen. The trial also showed that a dosage of 1 g/m(2) with full coverage was nearly as effective as the 2 g/m(2) dosage.