Visual Field Defects in Deformational Posterior Plagiocephaly

Purpose: We sought to determine whether visual field abnormalities occur in infants with deformational posterior plagiocephaly and to assess whether there is a relationship between the severity and laterality of visual field abnormalities with the severity and laterality of skull deformity. Methods: A retrospective chart review was performed on 40 consecutive infants with deformational posterior plagiocephaly. Each was tested with standardized binocular arc perimetry in the horizontal plane. Sixteen patients also had 3-dimensional computed tomography of the skull. Hemifield asymmetry of ≥20 degrees and/or a decrease in hemifield values by ≥20 degrees from established normal patients was considered abnormal. Visual field data from study patients was plotted against previously published normative data. Graphs comparing visual field defects and laterality to cranial asymmetry also were generated. Results: Thirty-five percent of infants with deformational posterior plagiocephaly had constriction of one or both hemifields by at least 20 degrees from established normal patients. Hemifield asymmetry of 20 degrees or more was found in 17.5% of infants tested. There was a significant difference in the worse hemifield values measured in each patient and the standard visual fields obtained from normative data ( P = 0.036). There was no correlation between the laterality of the visual fields to the laterality of the defects. A correlation between severity of hemifield constriction and % asymmetry on computed tomography was noted ( P = 0.209). Conclusions: Deformational posterior plagiocephaly may affect visual field development but neither the laterality nor the severity of skull deformity is predictive of the severity of visual field defects

Elevation of Depressed Skull Fracture with a Cup of Breast Pump and a Suction Generator : A Case Report in Technical Aspects

Surgical elevation of the depressed bone is known to be the conventional treatment usually recommended for a simple depressed skull fracture in the adult or pediatric age. The authors introduce, however, a case of depressed skull fracture in an infant which was elevated by means of a cup of breast pump and a suction generator without surgical elevation. In our case, without surgery, a 'cup-shaped' depressed skull fracture in an infant was safely elevated with no neurological signs. This method is considered a simple, effective, safe, and alternative procedure in an infant with simple depressed skull fracture

Botrytis cinerea combines four molecular strategies to tolerate membrane-permeating plant compounds and to increase virulence

Abstract Saponins are plant secondary metabolites comprising glycosylated triterpenoids, steroids or steroidal alkaloids with a broad spectrum of toxicity to microbial pathogens and pest organisms that contribute to basal plant defense to biotic attack. Secretion of glycosyl hydrolases that enzymatically convert saponins into less toxic products was thus far the only mechanism reported to enable fungal pathogens to colonize their saponin-containing host plant(s). We studied the mechanisms that the fungus Botrytis cinerea utilizes to be tolerant to well-characterized, structurally related saponins from tomato and Digitalis purpurea. By gene expression studies, comparative genomics, enzyme assays and testing a large panel of fungal (knockout and complemented) mutants, we unraveled four distinct cellular mechanisms that participate in the mitigation of the toxic activity of these saponins and in virulence on saponin-producing host plants. The enzymatic deglycosylation that we identified is novel and unique to this fungus-saponin combination. The other three tolerance mechanisms operate in the fungal membrane and are mediated by protein families that are widely distributed in the fungal kingdom. We present a spatial and temporal model on how these mechanisms jointly confer tolerance to saponins and discuss the repercussions of these findings for other plant pathogenic fungi, as well as human pathogens