16-year remission of rheumatoid arthritis after unusually vigorous treatment of closed dental foci.

This report describes a remission of rheumatoid arthritis (RA) of 16 years duration, apparently caused by the extraction of endodontically well-treated, healthy looking teeth. The only clue that the teeth were contributing to the disease pathogenesis in this case of RA was that the patient was able to reproducibly induce severe attacks of arthritis after prolonged, heavy pressure on some of his teeth treated with root canal fillings. After extraction, a small pus layer was found to cover the apices of the clinically healthy looking teeth.

Long term changes in human corneal endothelium following toxic endothelial cell destruction: a specular microscopic and fluorophotometric study.

Aims: To investigate the long term relation between corneal thickness, endothelial morphometric variables, and endothelial permeability in patients with endothelial cell counts under 900 cells/mm2 as a result of endothelial cell destruction after cataract surgery.

Methods: Eighteen patients developed the so called toxic endothelial cell destruction (TECD) syndrome following routine cataract surgery because of the intracameral injection of a toxic detergent residue. Ten patients with a mean (SEM) initial cell loss of 72% (2%) were followed for 4 years.

Iris nodules in Fuchs' heterochromic uveitis.

Four black patients with Fuchs' heterochromic uveitis had multiple nodules in the iris. The iris nodules were small, transparent, and scattered across the whole surface of the iris (Busacca's nodules) but increased in density toward the pupillary border. All four patients also had nodules at the pupillary border (Koeppe's nodules).

Rapid quantitative assays for corneal endothelial cell viability in vitro.

The Janus green photometric technique and the Mosmann's colorimetric MTT-assay to quantify corneal endothelial cytotoxicity were compared. Detergents, studied before by in vitro corneal perfusion, proved to be toxic at the 1% level in the Janus green assay with human corneas and at the 0.4% level in the MTT-assay with bovine endothelial cells.

Induction of autoantibodies to rat corneal protein 54.

Many studies have described the presence of circulating antibodies against corneal components in patients with corneal disease or uveitis, and in patients with skin or systemic disease with or without ocular involvement. The role of such antibodies in the underlying immunopathological process remains obscure. Here we describe the induction of autoantibodies against the rat cornea.

The effects of complement depletion on corneal inflammation in rats.

There are indications that complement activation may be involved in inflammatory processes of the cornea. To investigate the role of the complement system in experimental keratitis, rats were depleted of their plasma complement by treatment with cobra venom factor (CVF). intraperitoneal injection of CVF resulted in undetectable complement serum activity for 6 days when measured by a hemolytic assay.

Analysis of corneal inflammation following the injection of heterologous serum into the rat cornea.

The immunopathologic response following the injection of various antigens into the rat cornea was evaluated. This reaction, known as Wessely's phenomenon, was believed to be primarily triggered by antibodies and complement activation. The keratitis model was originally described in rabbits, using heterologous serum or purified proteins.

Elimination of immune precipitates from the rat corneal stroma: a histological study.

The pathogenesis of peripheral corneal lesions of immune aetiology, like Mooren's ulcer and catarrhal infiltrates, has been related to the formation or deposition of immune compkexes. The present investigation was undertaken to study the mechanisms involved in the elimination of immune precipitates from the cornea. Immune precipitates were induced by injecting human serum albumin (HSA) and rabbit anti-HSA serum into opposite sites of the rat corneal stroma.

The fate of antigen-antibody complexes in the rabbit cornea.

The mechanisms involved in the clearance of immune deposits in tissues are not yet clear. The cornea was chosen as a model to examine this question due to its avascularity and transparency. Bovine serum albumin (BSA) and rabbit anti BSA serum were injected at opposite sites into the corneal stroma of unsensitized rabbits.

Ocular inflammatory activity following different techniques of lens extraction and vitrectomy in rabbits.

The ocular inflammatory activity following different techniques of lens extraction and vitrectomy was studied in rabbits recovered from primary uveitis. Primary uveitis was induced by intravitreal injection of human serum albumin. After five to ten weeks, when the eyes were completely quiet, vitrectomy combined with lensectomy in one session or extracapsular lens extraction followed by vitrectomy was performed in different groups of rabbits.

Toxic endothelial cell destruction of the cornea after routine extracapsular cataract surgery.

Eighteen patients developed an acute corneal decompensation following normal intraocular surgery (cataract extraction in 17 patients), characterized by star-shaped endothelial folds, a twofold increase in corneal thickness, and a visual acuity of counting fingers during several postoperative days. In some cases, there was an additional iritis and transient hypotony. There was no effect of topical and/or subconjunctival corticosteroids on the course of the decompensation.

Toxic effects of detergents on the corneal endothelium.

Eighteen patients developed a toxic endothelial cell destruction syndrome following normal intraocular surgery, caused by a detergent residue originating from irrigating cannulas. The residue occurred after the concentration of a detergent solution has been increased from 0.4% to 4%, in combination with insufficient cleaning of the cannulas.

Cataract extraction in patients with chronic posterior uveitis.

The surgical management of cataract in patients with chronic posterior uveitis is described. Of 41 eyes, 88% acquired improvement of the visual acuity 4 months postoperatively, which then remained stable in most of the cases during a follow-up of one year. The type of cataract extraction, extracapsular or intracapsular, did not influence these results, nor did the implantation of an intraocular lens.

The influence of vitrectomy and lensectomy on experimental uveitis.

A secondary immune response in the rabbit eye can be provoked by intravenous injection of the antigen, previously injected intravitreally. The inflammation process consists of iris hyperemia, pericorneal redness and cellular and proteinous exudates in the anterior chamber and vitreous. The influence of vitrectomy combined with lensectomy or preceded by extracapsular lens extraction on the character of the secondary immune response has been studied in the rabbit eye.

Aqueous humor analysis as a diagnostic tool in toxoplasma uveitis.

Analysis of local toxoplasma antibody production to confirm a suspected clinical diagnosis of toxoplasma chorioretinitis is a valuable diagnostic tool. Determination of toxoplasma antibodies in the blood of the patient is of limited use. When blood toxoplasma tests are negative this indicates that toxoplasma as a causative organisms in the pathogenesis of uveitis is unlikely.

Risk factors for ocular sarcoidosis.

We reviewed 121 consecutive patients with biopsy-proven sarcoidosis who visited the sarcoidosis clinic of the University Hospital in Amsterdam, to determine the risk factors for the development of ocular manifestations. Of 121 patients 52 (43%) were black. Ocular disease developed in 50 (41%) patients and was more common in female and in black patients.

Factors influencing the quantitative determination of tear proteins by high performance liquid chromatography.

HPLC analysis of human tears allows tear protein profiles to be obtained within ten minutes. A tear protein profile normally consists of 4 major peaks: IgA, lactoferrin, protein G and lysozyme. Although it is a rapid method, the use of High Performance Liquid Chromatography in the (quantitative) determination of proteins in tears is influenced by various factors.

Analysis of human tear protein profiles using high performance liquid chromatography (HPLC).

Using high performance liquid chromatography (HPLC) the tear protein profiles were measured in controls, patients with Sjögren's disease, questionable dry eye (idiopathic dry eye), idiopathic chronic conjunctivitis and the corneal melting syndrome. Qualitative comparison of the protein profiles of patients with Sjögren's disease, corneal melting and IgA deficiency shows a marked difference in the heights of various peaks as compared to the profiles of the control group. The total protein content of tears in controls and in patients with idiopathic chronic conjunctivitis is age dependent and appears to increase until the age of 40 and to decrease afterwards.

Aqueous chamber taps in toxoplasmic chorioretinitis.

The clinical value of the determination of toxoplasma antibodies in anterior chamber taps was evaluated in 12 posterior uveitis patients suspected of a toxoplasmic retinochoroiditis, in four patients with Fuchs's heterochromia and in 31 cataract patients. The posterior uveitis patients all had marked inflammation of the vitreous obstructing the examination of the fundus of the time of aqueous humour aspiration. The clinical diagnosis toxoplasmic uveitis (n = 9) was made after the inflammation of the vitreous had subsided and fundus examination became possible again.

Expression of HLA antigens in paraffin sections of uveal melanomas.

Expression of histocompatibility (HLA) antigens on tumor cells may influence the recognition of these tumor cells by the immune system. Immunological recognition may influence tumor growth and patient survival. Although HLA class I and II antigens are known to be present on several tissues in the eye, their presence on ocular tumors had not yet been demonstrated.

Quantitative determination of S-antigen in human ocular tissues, aqueous humour and serum.

Retinal S-antigen is thought to play an important role in the immunopathogenesis of uveitis. To investigate whether S-antigen is a sequestered antigen confined to the retina, a sensitive ELISA was developed to determine the levels of this protein in various human ocular tissues, aqueous humour and serum. The ELISA was performed by incubating S-antigen-containing samples with solid-phase bound immunospecific rabbit anti human S-antigen F(ab')2 fragments and then incubating the bound S-antigen with mouse anti bovine S-antigen serum and the bound mouse antibodies with peroxidase-labelled rabbit anti mouse IgG; the peroxidase activity is developed with ABTS.