Topical insulin in neurotrophic keratopathy after resection of acoustic neuroma. / Insulina tópica en queratopatía neurotrófica tras resección de neurinoma del acústico.

CASE REPORT: A patient with a history of surgical resection of an acoustic neuroma presented with involvement of both the left facial nerve and the left trigeminal nerve. She initially consulted for exposure keratitis, but two weeks later presented with an infectious keratitis. After taking the corneal sample, she presented with persistent epithelial defect, which did not respond to medical management. Topical insulin was indicated, and a decrease in the area of the lesion was seen in the following 5 days. A therapeutic contact lens was also placed at that time and finally, two weeks after the initiation of insulin, the epithelial defect completely closed. DISCUSSION: This was a complex case due to the confluence of facial paralysis, neurotrophic keratitis, and infectious keratitis, which finally had a successful outcome. Topical insulin can be an effective adjuvant therapy in cases of neurotrophic ulcers that do not respond to standard therapy.

Transfer of radiocaesium from grass and silage to cows' milk.

The transfer of Cs137 from grass and silage to milk has been followed in detail for one farm in West Cumbria over the year following the deposition from the Chernobyl reactor accident. At this farm about 40% of the Cs137 in milk was attributed to the feeding of silage during the following winter. A wider study of an additional 14 farms showed considerable variations in the contributions from grazing and silage. The transfer quotient from silage to milk was comparable with the values measured for grass over the first few weeks and lower than values reached later in the grazing season.