Viscocanalostomy: A glaucoma surgical technique - Videotape presentation

A surgical technique for decreasing intraocular pressure comprising a two-tiered approach to Schlemm's canal and the trabecular meshwork, was done in 660 heavily pigmented eyes in South Africans of colour and followed for ten years. The canal is opened and maintained with the instillation of viscoelastic, and a "clear window" is created over Descemet's membrane to facilitate continuous leakage of aqueous from the anterior chamber. The second tier is excised and the first tier is sutured tightly to the adjacent sclera, taking great care not to cauterise or injure the "collecting channels" on the surface. This technique was done on both primary and secondary glaucomatous eyes and offers excellent results and minimal complications (AU)

Agricultural practices affect arthritis

It has been suggested that boron deficiency in food may be a cause of some arthritis (Newnham 1979). Epidemiological studies were done to try to ascertain why some countries have more or less arthritis than other countries. Jamaica, Mauritius, Fiji and Israel were visited with a view to ascertaining the boron levels of locally consumed food as it was suspected that excessive use of soluble chemical fertilizers had damaged the soils of the sugar producing lands. Food grown on these soils were found to have low boron level. By contrast the food consumed in Isreal had high boron concentrations associated with a low incidence of arthritis. South African work has shown that people who eat mostly maize have more arthritis when eating processed maize grown with fertilizer. Brief references is made to the role of boron in human diets. There are bound to be geographical differences in dietary boron, but even in the USA levels have dropped considerably in 50 years. Arthritis is increasing, especially juvenile arthritis. The increased use of fertilizers and genetic selection of plants has led to a wide range of changes in the quality of foodstuffs and their nutrient content. The identification of the parallel loss of boron may reflect vital changes in trace elements and other nutrients (AU)

Variation in human aortic fatty streaks among geographic locations

Histological features of aortic fatty streaks were examined in male subjects aged 10-39 from Guatemala, Jamaica Negro, Durban Bantu, New Orleans Negro, New Orleans white, Lima and Santiago. These groups were selected from the 19 available in the IAP (International Atheroschlerosis Project) because they represented the greatest contrasts between the extent of fatty streaks in the young and raised lesions in the elders. Among these seven groups the extent of raised lesions in the older subjects was significantly but weakly correlated with the type of fatty streaks in the young as measured by lesion thickness, content of demonstrable lipid, numbers of foam and spindle cells. The severity of leukocytic infiltration and prevalence of foci of necrosis in fatty streaks however, correalted strongly with raised lesions (rank r=0.90). We interpret this to imply that the presence of leukocytes and of foci of necrosis in the fatty streak marks its propensity to progress into raised lesions. If this formulation is correct, then the presence of both features in the histology of fatty streaks could be used as a marker in future studies of factors bearing upon the emergence of raised lesions out of fatty streaks (AU)

The cape and Sir Henry Marshall

Much is known of men who have contributed little of permanence to the history of medicine, but comparatively little is known of men who have contributed much. Henry Marshall, who played a highly-significant part in military medicine, hygiene and sanitation, was one of the latter. (AU)

Fatty streaks in the coronary arteries and aorta

We have analyzed the extent of fatty streaks in the coronary arteries and aortae of young persons 10 to 39 years old from 19 geographic and ethnic groups. Fatty streaks in the aorta increase rapidly in succeeding age groups during the second decade of life, and in some groups during the third decade. There after they tend to diminish in extent or remain at approximately the same level. Fibrous plaques and other advanced lesions approach similar degrees of extent 20 years or more later. The extent of aortic fatty streaks in youth does not predict the extent of aortic raised lesions later in life on agroup basis. Fatty streaks in the second and the third decades of life, and show no tendency to regress at any age. The mean extent of coronary artery fatty streaks in young persons appears related to the mean extent of raised lesions in the same population at middle age in non-Negro groups. These data are consistent with the hypothesis that advanced atherosclerotic lesions develop by progression and transformation of fatty streaks. However, the degree to which the transformation takes place appears to vary among arteries and among racial groups. (AU)

Histologic characteristics of coronary artery fatty streaks

The histologic characterictics of a standard site in the left interior descending coronary artery of 304 males between 10 and 39 years of age from seven different populations were examined. These seven location-race groups were ranked in the same order as the ranking based upon mean extent of raised atherosclerotic lesions in the coronary arteries and aorta to establish the tendency of each group to develop advanced atherosclerosis. Muscloelastic intimal thickening in the earlier decades does not predict the likelihood to develop severe atherosclerosis. Amount of intimal lipid and degree of cellular infiltration do predict the disposition to develop severe atherosclerosis later in life. Therefore, increased intimal lipid and cellular infiltration characterize coronary artery fatty streaks that are associated with their conversion to fibrous plaques. Necrosis of lipid-containing cells may release intracellular lipid into the extracellular space and thereby incite cellular infiltration and sequelae. (AU)

Atherosclerosis in persons with selected diseases

Comparison has been made of measures of coronary and aortic atherosclerosis in autopsied persons having five selected diseases (lung cancer,stomach cancer, other cancer, cirrhosis of the liver, and tuberculosis) with similar measures in control cases. There appears to be a slight but not significant tendency for lung cancer to be associated with more severe atherosclerosis within age-location-race subgroups. The tendency is strongest in the abdominal aorta. None of the other four diseases appears to be associated with increased or decreased severity of atherosclerosis in comparison with the control groups.(AU)

Distribution of coronary and aortic atherosclerosis by geographic location, race, and sex

Cooperating pathologists in different countries collected 23,207 sets of coronary arteries and aortae, according to a standard protocol. A central laboratry staff stained the arteries with Sudan IV, and a team of pathologists graded the atherosclerotic lesions. A basal group of cases which died from accidents, infections, cancer, and selected miscellaneous causes was extracted in order to compare atherosclerosis among the different geographic, racial, and sex subgroups. Even the most homogeneous subgroups (same location, sex, age, and race) vary greatly in extent of advanced atherosclerotic lesions. The 19 location-race groups differ significantly in extent of raised lesions. The abdominal aorta and the left anterior descending coronary artery have more atherosclerosis than other arteries. Within most location-race groups, coronary arteries of men have more raised lesions than the coronary arteries of women. Aortae of men in some groups have slightly more, and in other groups slightly less raised lesions than the aortae of women. Negro groups show little or no sex difference in either the coronary arteries or the aorta. Ranking of the 19 location-race groups by raised atherosclerotic lesions is similar, regardless of lesion measure (fatty streaks excepted), sex, artery, or age group. New Orleans white and the Oslo group rank highest; Bogota, Sao Paulo Negro, Guatemala, and Durban Bantu groups rank lowest. With few exceptions, ranking these groups by raised lesions corresponds closely with ranking them by coronary heart disease mortality rate. (AU)