Plasminogen activators t-PA, u-PA and its inhibitor (PAI) in normal males and females.

We determined the plasma levels of tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI) activity and their antigen levels including urokinase plasminogen activator (u-PA) in 33 male and 27 female normal subjects. Males had mean t-PA activity of 0.50 iu/ml which was significantly lower (p less than 0.01) than the females 0.64 iu/ml. Males had higher (p less than 0.001) mean PAI activity (15.5 AU/ml) as compared to females 10.3 AU/ml. The respective mean levels of t-PA and PAI antigen were significantly higher (p less than 0.01) in males (8.1 ng/ml and 17.6 ng/ml) than in females (6.2 ng/ml and 12.1 ng/ml). The mean u-PA level in males was 1.54 ng/ml which was significantly higher (p less than 0.01) than in females with 1.02 ng/ml. In post-venous occlusion studies, females had a greater mean response of 8.6 fold in t-PA activity as compared to males with a mean of 4.5 fold increase. The mean t-PA antigen response in males was 2.0 fold increase as compared to 2.6 fold increase in the females. No significant responses were seen in both sexes in either PAI activity or antigen levels when compared with the resting state. In zymography studies, free t-PA, its inhibitor complexes and u-PA were demonstrated in the euglobulin fractions of stored plasma. This study demonstrates that significant differences in t-PA, u-PA and PAI exist between male and female subjects which should be taken into account when determining their levels in clinical conditions.

Immunoassay of human tear lysozyme.

We used a single radial immunodiffusion technique to determine the lysozyme content of human tears. The level in healthy subjects with this method was 1.3 mg/ml of tears. In patients with trachoma, the level was low, 0.9 mg/ml of tears. Detecting the reduction in lysozyme level in patients with trachoma proved the utility of this method.

Results of treatment in amblyopia associated with unilateral high myopia without strabismus.

Fifty-five patients with amblyopia in unilateral high myopia without strabismus were treated. Thirty-two (58%) had a visual improvement by two lines or more on the Snellen chart and 17 (31%) attained a final visual acuity of 6/12 or better. In patients with pretreatment corrected vision of 6/60 or better in the amblyopic eye treatment consisted of full-time occlusion of the good eye, in some cases supplemented by the after-image method of pleoptic exercises in the amblyopic eye. Overall improvement of vision in this group was 72.7%. Occlusion of the good eye combined with pleoptic exercises in the amblyopic eye had no advantage over simple occlusion of the good eye. In patients with pretreatment corrected vision worse than 6/60 in the amblyopic eye occlusion of the amblyopic eye was done and the after-image method of pleoptic exercises was instituted. Improvement of vision in this group was 36.3%. The study showed that it is worth the trouble to treat this disorder even after the age of 14 years and stresses the utility of pleoptic therapy in older patients with severe amblyopia.

Results of treatment of anisohypermetropic amblyopia without strabismus.

One hundred and two patients with anisohypermetropic amblyopia without strabismus were studied. Microstrabismus was excluded by detailed orthoptic examinations including visuscopy and Cüppers' bifoveal correspondence test. Treatment consisted in wearing correcting glasses and part-time or full-time patching of the nonamblyopic eye. In patients with dense amblyopia patching of the amblyopic eye was done and Cüppers' after-image method of pleoptic therapy was instituted as the initial procedure. When visual acuity improved sufficiently by this therapy, patching was used on the nonamblyopic eye. Sixty-five (63.7%) patients showed 2 lines or more improvement on the Snellen chart. Though young children (6 to 12 years) improved their visual acuity more often than those aged 13 to 20 years, a considerable number of patients (50.0%) in the older age group improved their visual acuity after therapy. The improvement in visual acuity was accompanied by improved stereoacuity in 49.0% of the patients. It is therefore suggested that every effort should be made to treat these patients even after the age of 12 years.

Immunoglobulin concentrations in human tears in ocular diseases.

Immunoglobulin concentrations in human tears were determined in 165 patients with different eye diseases by a standard radial immunodiffusion method. IgA was present in all the samples in measurable quantity. The mean IgA values were significantly higher than the controls in patients with acute bacterial conjunctivitis, keratomalacia, corneal graft reaction, blepharoconjunctivitis, and acute keratoconjunctivitis. The values in the patients with vernal conjunctivitis, phlyctenular conjunctivitis, acute bacterial corneal ulcer, and acute endogenous uveitis were not significantly different from those in the controls. IgG could be detected in the majority of the samples but it was in measurable quantity in 18 samples. IgM could be detected in fewer samples. IgD was not detected in any of them. The study indicates that, whenever the immunoglobulin levels in tears are altered in diseased eyes, it is the IgA level that is predominantly altered and not the IgG level.

Tear glucose levels in normal people and in diabetic patients.

Fifty normal people and 50 diabetic patients were studied by means of an enzymatic method for the glucose content in the blood, tears, and urine before and after the peroral glucose load. In normal subjects the fasting glucose levels in the tears averaged 3.6 mg/100 ml (0.2 mmol/l) and in the diabetic patients it averaged 16.6 mg/100 ml (0.92 mmol/l). As in blood and urine, tear glucose levels are significantly higher in diabetic patients than normal persons both at fasting and after the peroral glucose load test. The fasting tear glucose level did not appear to be a satisfactory index for classifying a person as a diabetic or normal. It was found that after the peroral glucose load test a tear glucose level at 11 mg/100 ml (0.61 mmol/l) resulted in only 4.6% of the diabetics being missed, while 5.8% of the normal persons were misclassified as diabetics.

Immunoassay of tear lysozyme in conjunctival diseases.

The tear lysozyme content in 111 normal subjects and in 159 patients with various conjunctival diseases was determined by a single radial immunodiffusion technique. Tear lysozyme level in normal people was 1.33/mg/ml. (SI conversion: mg/ml = g/l.) The mean tear lysozyme levels in patients with chronic irritative conjunctivitis (0.97 mg/ml) and nutritional deficiency with epithelial xerosis (0.76 mg/ml) were significantly lower than in the normal controls. The mean tear lysozyme levels in tears from patients with vernal conjuctivitis (1.20 mg/ml), phlyctenular conjunctivitis (1.10 mg/ml), and acute bacterial conjunctivitis (1.48 mg/ml) were not significantly different from those in the normal controls. Superimposition of acute bacterial conjunctivitis on trachoma did not alter the low tear lysozyme level that existed before in these patients.

Biological variations of lysozyme concentration in the tear fluids of healthy persons.

Concentration of tear lysozyme was measured in healthy Indian subjects of the same racial group aged 2 to 78 years by a single radial immunodiffusion technique. Variations in its concentration between the two eyes, during the day, over a period of time, in both sexes, and in different age groups were studied. The diurnal and age-related changes in the concentration of tear lysozyme were found to vary to an appreciable extent. The mean lysozyme concentration in tears was lower in the morning and higher in the evening. It tended to be low in children under 16, rose and attained a plateau in the age group 16-45 years and fell in later life, though still remaining higher than in the children.

Immunoglobulins in human aqueous humour.

The immunoglobulin concentrations in human aqueous humour from 44 patients aged 35 to 85 years with cataracts were measured by a standard immunodiffusion method. IgG was found in all the samples (mean level 7-0 mg/100 ml. IgD, IgA or IgM could not be detected. There was no significant difference in IgG levels in aqueous humour between the two sexes, in different age groups, and in the different types of cataracts.

Diagnosis and measurement of cyclodeviation.

A simple, convenient, and accurate method of detecting and measuring even the smallest degree of cyclodeviation with the help of two special major amblyoscope slides is described. Routine use of these slides in the investigation of all paralytic squints to detect and measure cyclodeviation is suggested. This will prove useful in the correct diagnosis and in the adequate management of a case of cyclovertical muscle palsy.

Immunoglobulins in tear in trachoma patients.

Tear immunoglobulin concentrations have been measured in 100 healthy people and 62 patients in different stages of trachoma. In healthy people the average IgA level was 27-8 mg/100 ml. There was no significant difference in the IgA level in various age groups and between the sexes. IgG was detected in 92 samples, and it was less than 1 mg/100 ml. IgM in tears was detected in only one sample. IgD was not detected in any specimen. In tracoma cases, the mean IgA level was found to be significantly lower (22-0 mg/100 ml) than in healthy people. There was no significant difference in IgA level between different stages of trachoma, IgG, IgD, and IgM could not be detected in any sample from the trachoma cases.

Immunoglobulins in tears of normal Indian people.

Immunoglobulin concentrations in tears from 50 healthy Indians aged from 14 to 50 years were measured by a standard immunodiffusion method. The levels of IgA were substantial; those of IgG were very low; and IgD and IgM were not present. The mean IgA level was 24-6 mg/100 ml.

Serum complement components in patients with trachoma.

Serum C1q, C3, C4, and C5 components of complement levels were measured in 56 healthy subjects and 98 patients with trachoma. Serum C1q and C3 levels were found to be significantly low in stages II and III. There was no change in serum C4 and C5 levels in any of the stages. The levels of C1q and C3 complement components in serum in stages II and III returned to normal as the disease resolved following the medical treatment.

A randomised comparative evaluation of the copper 7, multiload copper 250 and T copper-22OC IUDs.

Two new Cu-IUDs, the TCu-22OC and Multiload Cu250, were evaluated against the Cu7 in 1,199 subjects in a randomised, multicentric trial using a common study protocol. During the 2 years following insertion, cumulative first-segment rates for total use-related terminations showed no significant differences between the 3 devices; however, the Cu7 had a significantly higher termination rate for accidental pregnancy compared to the TCu-22OC and its expulsion rate was significantly higher than the ML Cu250. The rate of accidental pregnancy was higher and the expulsion rate lower with the ML Cu250 compared to the TCu-22OC but these differences were not significant. The results are discussed in relation to IUD design and their application in family planning.

Radical hysterectomy and pelvic lymphadenectomy for early invasive cancer of the cervix - 14-year experience.

During a 14-year period, 397 radical hysterectomies and pelvic lymphadenectomies were performed for early invasive carcinoma of the cervix. Twenty-one patients were in stage IA2 with lymphatic/vascular channel permeation (5.2%), 340 in stage IB (85.6%) and 34 in early stage 2A disease (8.5%). Eighteen patients (4.5%) were pregnant. Adenocarcinoma comprised 26.9% of cases. The mean operative time was 4.14 h; the intraoperative blood loss was less than 1.51 in 77.3% patients. There was no operative mortality; one patient died 3 weeks after surgery from clostridium difficile enterocilitis. Eleven patients (2.7%) developed venous thrombosis; severe lymphedema occurred in four (1%). The incidence of uretero-vaginal fistula was 0.2% and that of vesico-vaginal fistula 0.5%. Ovarian metastases were noted in 4.3% of cases with adenocarcinoma. Sixty-six patients had positive nodes (16.6%). Five-year survival in patients with more than 2 positive nodes was 68%. The use of adjuvant chemotherapy in patients with 'high risk' factors resulted in survival rates approaching those without risk factors. Neo-adjuvant chemotherapy was used in 10 patients with large bulky tumors; the results were favorable. Recurrences occurred in 47 patients (11.8%); 36 patients have died (9.1%). Age did not appear to influence survival. The overall 5-year survival was 92.2%.

Normal pregnancy after successful treatment of choriocarcinoma with cerebral metastases. A case report.

Pregnancy after treatment of choriocarcinoma with cerebral metastases is uncommon. We treated a patient successfully with less-toxic chemotherapeutic agents than those advocated by others together with whole brain irradiation. She subsequently had two uneventful pregnancies.

Effects of maternal streptozotocin-diabetes on fetal growth, energy reserves and body composition of newborn pigs.

Two doses of Streptozotocin (50 and 100 mg/kg body weight) were administered to two groups of pregnant gilts at d 80 of gestation to determine the influence of two levels of maternal diabetes on the gilts, their developing progenies and the body composition of the pigs. All the experimental animals received 1.82 kg of gestation diet/day throughout gestation. Serum glucose concentration increased to hyperglycemic levels in low-dose and high-dose groups; insulin concentrations decreased (P less than .01) in the high-dose, but not in the low-dose group (P greater than .05). Maternal free fatty acids (FFA) increased (P less than .05) in both treatment groups when compared with the control. However, birth weight of the litter and litter size were not affected. The liver weight increased (P less than .01) in the progeny of high-dose but not the low-dose group. Total liver DNA and RNA were not altered by the treatments, however; total liver protein and protein:DNA ratio increased (P less than .01) in the progeny of high-dose gilts. Pigs from high-dose and low-dose groups showed increases (P less than .01) in liver glycogen concentrations and percentage liver lipid. Body chemical composition data showed increases in percentage dry matter and percentage lipid (P less than .05 and P less than .01, respectively) in the progeny of high-dose but not in the low-dose group. It was concluded that streptozotocin administered to gestating gilts increased the maternal nutrient supply to the developing pigs, which resulted in higher energy status of the pigs at birth.

Lactic acid in human aqueous humour.

We wished to assess the contribution of the lens to the maintenance of the high level of lactic acid found in human aqueous humour. The lactic acid in aqueous humour was estimated by Pryce's modification of the Barker-Summerson method in 41 subjects who were divided into four groups: those with early cataract, those with advanced nuclear cataract, those with mature cataract and those with hypermature (morgagnian type) cataract. Statistical evaluation of the results showed that there was no significant difference in the lactic acid level between the four groups. We assume that the lens does not contribute significantly to the high concentration of lactate found in human aqueous humour.

Tuberculosis of the orbit and lacrimal gland: a clinical study of 14 cases.

Fourteen patients with tuberculosis of the orbit and lacrimal gland seen over a period of 20 years have been presented. The majority of them were between the ages of 4 to 15 years. Males were affected twice as frequently as females. Left side was affected four times as frequently as the right side. There were eight patients of periostitis of orbital margin, one patient of dacryoadenitis, three patients of tuberculoma of orbital tissues, and two patients of tuberculoma of maxillary sinus. One patient with periostitis had involvement of the greater and lesser wings of sphenoid in addition to the involvement of upper-outer orbital margin. Two periostitis patients had prolapse of the palpebral portion of the lacrimal gland. The clinical presentation and gross appearance of the tuberculoma of the lacrimal gland was similar to those found in benign mixed tumor. The patients with tuberculoma of orbital tissues presented as pseudotumors. The mimicry of tuberculoma of maxillary sinus to carcinoma has been mentioned. Associated tuberculous lesions were pulmonary in eight patients, cervical lymphadenitis in ten patients, intestinal in one patient, and caries spine in one patient. In two patients the disease developed in the absence of any other tuberculous lesion discovered in the body. The cases were cured by wide surgical removal of all the diseased tissues combined with antituberculous chemotherapy.

Paradoxical movements of the eyelid and eyeball.

Two cases of ptosis with paradoxical eye and lid movements have been reported. One of them was congenital, where there was narrowing of palpebral aperture on abduction and pseudo-Graefe phenomenon on looking down. The other case was acquired following head injury. Here there was narrowing of palpebral aperture on abduction and widening of palpebral aperture on adduction. Besides there was absence of elevation of the globe in looking up. The pseudo-Graefe phenomenon of lid retraction was present only on looking down and in and not on looking down and out. Probable causes of such associated movements have been mentioned.