Iridocorneal adhesions in patients with the Marfan syndrome.

Marfan syndrome is an autosomal dominant connective tissue disorder characterized by skeletal, cardiovascular, and ocular anomalies. Ectopia lentis is the most common ocular manifestation. We report an ocular sign not previously described in Marfan syndrome, iridocorneal adhesions secondary to anterior lens subluxation. Three patients with the Marfan syndrome had iridocorneal adhesions on slit-lamp examination. One patient developed adhesions following treatment with pilocarpine. She underwent pars plana vitrectomy and lensectomy in both eyes due to progression of the iridocorneal adhesions. Treatment with miotics rotates the lens-iris diaphragm anteriorly and may contribute to the formation of such adhesions. The two other patients remained stable and did not received lensectomy or vitrectomy. Careful slit-lamp examination of the anterior segment should be conducted in patients with dislocated lenses.

Effect of splenectomy on acute inflammation.

It is becoming increasingly evident that platelets play a significant role in the inflammatory process. Heterogeneity has been demonstrated among platelets, and evidence has been presented that the spleen retains the youngest and hemostatically most effective platelets. The present study was designed to determine what effect splenectomy, by removing a special population of platelets, would have on acute inflammation as manifested by carrageenan-induced murine foot pad edema. Swiss white mice (25 +/- 2 g) were anesthetized and subjected to splenectomy (Group A, n = 13) or to celiotomy only (Group B, n = 15). One week later, carrageenan (0.1 cc of 1% solution) was injected into the right hind foot pad of each animal. The mice were killed 3.5 hr later, and both hind paws amputated at the tibio-tarsal joint and weighed individually. The change in weight of the experimental hind paw relative to control was expressed as edema index for each animal. The inflammatory reaction, as manifested by carrageenan edema, was significantly (P less than 0.001) decreased in those animals subjected to splenectomy. The mean edema index in Group A was 62.8 per cent compared to 80.9 per cent in Group B. The results of this study indicate that splenectomy decreases inflammation as manifested by carrageenan-induced edema. Splenectomy eliminates a population of platelets having greater functional capabilities than those found in the peripheral circulation and impairs the organism's ability to respond to injury.

Biochemical and morphologic changes in hepatocytes from the shock injured liver.

It has been proposed that the isolated hepatocyte is an excellent model for the study of cellular changes during and after hemorrhagic shock. To investigate this proposition the biochemical and morphologic changes in the isolated hepatocyte of shock injured rats were documented. Use of the isolated hepatocyte allows direct measurement of intracellular biochemical changes which we find corroborates the results of basic shock studies done on rats using liver slices, perfused liver or specimens taken at biopsy. Morphologic changes in the shocked liver of the rat are noted using transmission electron microscopy (TEM) and scanning electron microscopy (SEM). The results are correlated with the biochemical changes. SEM of the isolated hepatocyte reveals marked swelling immediately after shock with some scattered blebs. The cells show some recovery at two hours with near complete normality restored at 24 hours. TEM of tissue and isolated cells reveal vacuolization and mitochondrial changes in the early post shock period with return to normality at 24 hours after shock. The shock injured hepatocyte is a reasonably faithful representative of the events which have taken place in the liver from which it is isolated. It can be used as a model for treatment in vivo or as a device for comparison of the effects of different environments in vivo or in vitro.