Funtabulously Frivolous Friday Five 255

Test to detect ocular leaks from the corneal, sclera or conjunctiva following surgery or trauma.

Installation of 10% fluorescein topically will fluoresce only when diluted further by a leak, hence the downward bright green under a cobalt light in a penetrating trauma. 

Named after the German ophthalmologist Erich Seidel (1882-1948)

A flourescein stained eye, showing the three classic signs of a full thickness laceration of the cornea, dilution of the dye at the site if injury, concentration of dye to the sides and top of the injury, and cascading of the down downwards with gravity.

• Seidel E. Weitere experimentelle Untersuchungen uber die Quelle und den Verlauf der intraokularen Safstromung: XII. Ueber den manometrischen Nachweis des physiologischen Druckgefalles zwischen Voderkammer und Schlemmschem Kanal. Archiv für Ophthalmologie. 1921;107:101-104.
• Cain W and Sinskey RM. Detection of Anterior Chamber Leakage With Seidel’s Test. Arch Ophthalmol. 1981;99(11):2013
• Lingam Vijaya et al Management of complications in glaucoma surgery. IndianJournal of Ophthalmology 2011;59(7):131-140
• Eye Wiki: Seidel Test

A relatively uncommon complication of fractures in locations of the body, such as the ankle, wrist elbow and foot, where skin adheres tightly to bone with little subcutaneous fat cushioning.

Fracture blisters are thought to result from large strains applied to the skin during the initial fracture deformation causing a cleavage injury at the dermo-epidermal junction.

Localized tissue hypoxia and cleavage injury are the main pathological mechanisms, thus the injury resembles the changes consistent with a second-degree burn rather than a friction blister.

Blisters are likely best left intact to preserve the sterile environment. Ideally treatment should occur before the blister forms and the current consensus is to wait for any blister formation to resolve before surgery is attempted.

• Uebbing CM et al. Fracture Blisters. West J Emerg Med 2011 Feb; 12(1):131-133

Anton Chekhov (1860-1904)

One of Russia’s most famous writers and often argued as one of the greatest short story writers, Anton Chekhov began his medical studies at the Moscow University Medical School in 1879. As a student, he wrote hundreds of short stories to support himself and his family.

Chekhov died at the age of 44 after a long affliction with tuberculosis. 

Schwartz RS. “Medicine Is My Lawful Wife” – Anton Chekhov, 1860-1904. N Engl J Med 2004; 351:213-214

Fava beans (broad beans).

Our young friend is experiencing Favism, an acute haemolytic anaemia caused by severe oxidative damage in patients with G6PD (Glucose-6-Phosphate Dehydrogenase Deficiency) whom eat Fava beans. 

Fava beans contain high levels of vicine and convicine, which after metabolism through the GI tract create high levels of divicine and isouramil in the erythrocyte. This creates high levels of hydrogen peroxide in the red cell.  In a cell replete with G6PD this superoxide species creates oxidate damage which lyses the cell.

G6PD deficiency is the most common enzyme deficiency worldwide, and may only present when precipitated by certain stressors in previously asymptomatic patients in whom there is no knowledge of the disorder.

G6PD deficiency is an X-linked disorder that is common in Africa, Asia, the Mediterranean, and the Middle East. It is the most common enzyme deficiency worldwide, with more than 300 known variants.

Luzzatto L and Arese P. Favism and Glucose-6-phosphate Dehydrogenase Deficiency. N Engl J Med 2018; 378:60-71.

Chinese Hamster Ovary.

Today, nearly fifty biologic drugs are produced using the CHO cell.  CHO cells have been a cell line of choice because of their rapid growth in suspension culture and high protein production

In 1948, the Chinese hamster was first used in the United States for breeding in research laboratories.

In 1957, Theodore T. Puck obtained a female Chinese hamster from Dr. George Yerganian’s laboratory at the Boston Cancer Research Foundation and used it to derive the original Chinese hamster ovary (CHO) cell line.

Dumont J et al. Human cell lines for biopharmaceutical manufacturing: history, status, and future perspectives. Crit Rev Biotechnol. 2016;36(6):1110-1122