[Comparison of the quick Gram stain method to the B&M modified and favor methods].

The Gram stain is an established method for bacterial identification, but the time needed to carry out this stain is 2-3 min. We attempted to shorten this time and stained a total of 70 clinical specimens isolated from using the Bartholomew & Mittwer (B&M) modified or Favor methods with a 3 s duration for washing and staining steps. Results were plotted and analyzed using a Hue Saturation Intensity (HSI) model. The range based on a plot of the two methods with the HSI model was presented as a reference interval. Our results indicated that 100% (35/35) of strains were Gram positive and 97.1% (34/35) were Gram negative for the quick B&M modified method. In the quick Favor method, 80.0% (28/35) were Gram positive and 68.6% (24/35) of strains were Gram negative. We propose that the quick B&M modified method is equivalent to the standard Gram staining method and is superior to the quick Favor method.

Recurrent mutation of the KIF21A gene in Japanese patients with congenital fibrosis of the extraocular muscles.

PURPOSE: To report recurrent mutation of the KIF21A gene in three Japanese families in which some members have congenital fibrosis of the extraocular muscles type 1 (CFEOM1), and to describe the clinical characteristics of the families. METHODS: Standard ocular examinations were performed on 18 normal and affected members of three unrelated families. To detect mutations, we determined the DNA sequence of exons 8, 20, and 21 and the splice sites of the KIF21A gene. RESULTS: All affected members had a heterozygous mutation of the KIF21A gene in exon 21 (R954W). Clinically, each patient had congenital bilateral ptosis, an infraducted primary position of each eye, and the inability to raise either eye above midline. CONCLUSIONS: The KIF21A gene mutation R954W was detected in the patients with CFEOM1 screened in this study, all of whom were Japanese, reflecting similar reports from Europe, America, the Middle East, and Japan. We suggest that mutations of the KIF21A gene contribute to the development of CFEOM1 regardless of ethnicity. We also found that the delimitation of the KIF21A gene mutation site enabled us to efficiently detect the KIF21A gene mutation despite the large number of KIF21A gene exons.

[Surgery for strabismus secondary to ethmoid sinus surgery].

PURPOSE: To review the outcome of surgery for strabismus due to ethmoid sinus surgery. CASES AND METHODS: The series comprised 13 cases, 1 of inferior rectus paresis, 1 of superior oblique paresis, 6 of medial rectus paresis, and 5 of medial rectus muscle palsy due to third nerve palsy. In the cases of paresis of the rectus muscle, resection of the rectus muscles was mainly performed. In the cases of palsy of the rectus muscle, transposition of the extraocular muscle with simultaneous recession of the lateral rectus muscle was performed. The major aim of surgery was to bring both eyes into alignment and to eliminate diplopia in the primary position. RESULTS: The mean preoperative horizontal deviation of 18.1 degrees of exotropia in the paresis cases was reduced to 1.4 degrees of exotropia after surgery. The mean preoperative vertical deviation of 3.8 degrees of hypertropia was reduced to 1.4 degrees of hypertropia postoperatively. The mean preoperative horizontal deviation of 35.6 degrees of exotropia in the palsy cases was reduced to 9.4 degrees of exotropia after surgery. The mean preoperative vertical deviation of 2.0 degrees of hypertropia was increased to 2.6 degrees of hypertropia postoperatively. Postoperatively, diplopia was absent in 11 cases with a slightly compensatory head posture. CONCLUSION: Surgery for strabismus due to sinus surgery induces improvements in eye position and diplopia.

Outcome of surgery for bilateral third nerve palsy.

PURPOSE: To review the outcome of surgery for bilateral third nerve palsy. METHODS: The series comprised 16 cases. The eye deviation in the primary position averaged -27.0 degrees horizontally. Surgery was aimed at bringing both eyes into alignment in the primary position by recession-resection of horizontal muscles. Transposition of the superior oblique was performed for complete third nerve palsy. Surgery was initially performed on the nonfixating eye. The fellow eye underwent further surgery for residual disorders. RESULTS: Within 6 months after surgery, the eye deviation in the primary position averaged -0.7 degrees horizontally. After longer follow-up, the eye deviation averaged -4.7 degrees horizontally. Postoperatively, diplopia in the primary position was absent in 11 and remained in 5 cases. CONCLUSION: Surgery for bilateral third nerve paresis or palsy achieved lasting cosmetic or functional improvements in the majority of cases.

[Outcome of surgery for bilateral third nerve disorder].

PURPOSE: To review the outcome of surgery for bilateral third nerve palsy. CASES AND METHODS: The series comprised 16 cases. The eye deviation in the primary position averaged -27.0 degrees horizontally. Surgery was aimed at bringing both eyes into alignment in the primary position by recession-resection of the horizontal muscles. Transposition of the superior oblique was performed for complete third nerve palsy. Surgery was initially performed on the nonfixating eye. The fellow eye received further surgery for residual disorders. RESULTS: Within 6 months after surgery, the eye deviation in the primary position averaged -0.7 degrees horizontally. After longer follow-up, the eye deviation averaged -4.7 degrees horizontally. Postoperatively, diplopia in the primary position was absent in 11 and present in 5 cases. CONCLUSION: Surgery for bilateral third nerve paresis or palsy induced lasting cosmetic or functional improvements in the majority of cases.