Robert Murphy

Plasma homovanillic acid and tardive dyskinesia during neuroleptic maintenance and withdrawal

Plasma levels of homovanillic acid (HVA), a dopamine metabolite, were examined in 19 psychiatric inpatients during maintenance treatment on neuroleptic medications. A significant positive correlation was found between the level of HVA and the severity of tardive dyskinesia (TD) in these patients. Seven patients had their medication discontinued for 12 days. In spite of a fall in neuroleptic levels to negligible values, plasma HVA levels remained essentially stable while scores on the Abnormal Involuntary Movement Scale (AIMS) fell only slightly. The data support the hypothesis that some forms of TD may involve a persistent increase in presynaptic dopaminergic activity.

Scleral outfolding for macular translocation

PURPOSE To report experimental study and clinical observation of scleral outfolding for macular translocation. METHODS In six human cadaver eyes, circumferential mattress sutures to create sclera infoldings were compared with radial-interrupted mattress sutures to create scleral outfoldings. In a 75-year-old man with macular degeneration and choroidal neovascular membrane, radial-interrupted mattress sutures were used for macular translocation. RESULTS In the human cadaver eyes, circumferential mattress sutures for scleral infolding created an average decrease in corresponding internal anteroposterior retinal contour of 0.36 mm. Radial-interrupted mattress sutures for scleral outfoldings created an average decrease in the corresponding internal anteroposterior retinal contour of 4. 61 mm. The statistical significance of the difference between infoldings of the sclera versus outfoldings of the sclera had a P value of.0001. CONCLUSIONS Initial experimental and clinical study suggests that radial-interrupted mattress sutures may generate more shortening of the internal scleral surface and greater macular translocation than circumferential mattress sutures. Additional studies are needed to evaluate the long-term effects of radial-interrupted mattress sutures and macular translocation for treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration.

Lex situs after Blue Sky: is the Cape Town Convention the solution?

English law is one of the leading systems of law selected by parties to govern aircraft leasing and financing transactions, on the basis that it is a robust, yet flexible, regime under which creditors have clear rights and remedies. However, the recent Blue Sky litigation has highlighted the complexity of the conflict of laws position in many aviation deals and the English High Courts decision has confirmed that a different approach is required to meet the commercial expectations of industry participants and to maintain English laws competitive position. The Cape Town Convention is an international treaty designed to facilitate the crossborder financing and leasing of aviation equipment, by reducing creditor risk and enhancing legal predictability. This article considers whether its ratification by the UK will resolve the issues arising out of the Blue Sky litigation and the extent to which supplemental measures are required.