Limbal allergic granulomatosis.

Four limbal diseases characterised by granuloma formation as part of an allergic response are discussed. A series of histological specimens from patients with Wegener's granulomatosis were re-examined. Genuine granulomatous disease at the limbus is rare, only occurring in two patients, whilst secondary, more non-specific limbal active chronic inflammation was more common.

Orbital and ocular micro-vascular corrosion casting in man.

The methods of preparation and examination of complete orbital and ocular vascular casts, suitable for the study of anterior segment vasculature, are described from our experience of 20 casts. The use of low viscosity methylmethacrylate produced complete vascular filling with few artefacts when injected into isolated orbital preparations from human cadavers 36-48 hours post-mortem, despite suggestions by previous authors that injection should be within 12 hours. Using scanning electron microscopy, arteries and veins are clearly distinguishable by their endothelial nuclear impressions.

Delayed suprachoroidal haemorrhage after glaucoma operations.

Delayed suprachoroidal haemorrhage occurred in 13 eyes in a consecutive series of 432 cases undergoing trabeculectomy or anterior chamber (A/C) tube drainage operations. Aphakia and vitrectomy were associated with an increased risk of haemorrhage, whilst advanced age, myopia, systemic hypertension and high preoperative intraocular pressure were not. Haemorrhage occurred more often after A/C tube drainage operations than after trabeculectomy.

Anterior segment vascular casting.

Vascular corrosion casting provides a permanent three-dimensional record of the deeper vasculature of the anterior segment whereas fluorescein angiography allows clinical examination of superficial vessels. Morphological findings on scanning electron microscopy of vascular casts of the anterior segment in sheep are presented and compared with that of man by casting techniques. Sheep illustrate the basic mammalian anterior segment vascular architecture but lack anterior ciliary arteries which connect with the deeper collateral arterial circles.

Medulloepithelioma (diktyoma).

Sixteen cases of medulloepithelioma are described. Clinical data and follow-up were available on 15. Four patients underwent iridocyclectomy initially; all later needed enucleation and one had an orbital recurrence.

Emphysema in the Blotchy mouse: a morphometric study.

Inheritance of the Blotchy allele at the X-chromosomal Mottled locus of mice results in changes in the lung which resemble emphysema. Previous studies using measurements of mean linear intercept have recognized emphysema in the hemizygous, Blo/Y, male and homozygous, Blo/Blo, female, but not in the heterozygous, Blo/+, female. The aim of this study was to develop a rapid, accurate method for analysis of emphysema and to establish whether it would identify emphysema in the heterozygote.

Spontaneous splenic rupture as complication of infective endocarditis.

A case is reported of spontaneously ruptured spleen occurring as a fatal complication of Group B streptococcal endocarditis, despite control of infection with antibiotics and early surgery.

Cerebral microembolism during cardiopulmonary bypass. Retinal microvascular studies in vivo with fluorescein angiography.

To observe microembolic events in the central nervous system during cardiopulmonary bypass, we subjected 21 patients undergoing elective coronary operations to retinal fluorescein angiograms 5 minutes before cardiopulmonary bypass was discontinued. Patients with diabetes or clinically evident cerebrovascular disease were excluded. Bubble oxygenation and nonpulsatile perfusion were used for bypass.

How to deal with a hospital outbreak of Legionnaires' disease.

The outbreak of Legionnaires' disease in Glasgow Royal Infirmary is discussed together with the problems such an outbreak poses to the microbiologist. The importance of early diagnosis is stressed. The outbreak was managed by a team drawn up from various disciplines within the hospital.

Posterior scleritis: a clinical and histological survey.

The clinical course of 47 patients with posterior scleritis is reviewed. Though clinical presentation varied widely, 73% of the patients presented with a visual acuity of 6/18 or less. Because the posterior scleritis was not always associated with pain or with anterior scleritis, the diagnosis was often not considered when the patient was first seen.

Endotoxaemia in multiple organ failure due to sepsis.

Patients with multiple organ failure secondary to intraabdominal sepsis are often blood culture negative despite exhibiting the features of septic shock. This study examined the possible central role of endotoxin in such patients. In 15 consecutive intensive care patients with the above clinical picture endotoxin was measured by a chromogenic limulus (LAL) assay; on admission and thereafter 4 hourly.

Serum C reactive protein in infective endocarditis.

C reactive protein (CRP) was measured serially in 29 patients with infective endocarditis. Twenty one patients were initially treated with antimicrobial drugs. In 13, serial measurement of CRP concentrations showed a progressive return to normal (less than 10 mg/l), which correlated with a satisfactory recovery.

Comparison between posterior polymorphous dystrophy and congenital hereditary endothelial dystrophy of the cornea.

Corneal discs from 10 cases of posterior polymorphous dystrophy (PPD) and 20 cases of congenital hereditary endothelial dystrophy (CHED) were compared and contrasted using light and electron microscopy. Secondary epithelial changes were similar in both diseases but spheroidal degeneration of stroma was seen more commonly in dominant CHED and not at all in PPD, when band, calcific, keratopathy was commoner. Changes at the level of Descemet's membrane showing failure to regulate growth were seen in recessive CHED whereas dominant CHED and PPD were both associated with development of a fibrillary posterior collagen layer (PCL).

Forty years of retinoblastoma; into the fifth age.

Forty years of research into retinoblastoma has seen wide-ranging changes in our knowledge of the histogenesis of this childhood tumour and in the treatment of the disease. These changes, and some of the more recent developments in the molecular biology of this tumour are reviewed.

The measurement of C-reactive protein and immune complexes in endocarditis caused by coagulase-negative staphylococci.

Coagulase-negative staphylococci are a major cause of early endocarditis following the insertion of prosthetic heart valves but rarely cause endocarditis in natural valves. From a 2-year prospective study we report seven cases: six with endocarditis related to prosthetic valves and one with endocarditis related to a natural valve. Each isolate of coagulase-negative staphylococcus was identified biochemically (six Staphylococcus epidermidis; one Staphylococcus hominis) and characterised by bacteriophage typing.

Endotoxaemia, fever and clinical status in immunosuppressed patients: a preliminary study.

A prospective study was performed in order to find out whether endotoxaemia assays are clinically relevant in neutropenic patients. In a group of 10 immunocompromised patients, serial haematological, bacteriological and clinical investigations were done in parallel with serial plasma endotoxin assays. The chromogenic modification of the Limulus amoebocyte lysate (LAL) assay for endotoxin used in this study had a sensitivity of less than 10 pg endotoxin per ml plasma.

Oncocytoma of the eyelid: a case report.

Oncocytic tumours of the eyelids are rare, only one previous case having been reported. This paper describes a second such lid tumour affecting the medial upper lid. We present the clinical features, surgical management, and histology of the lesion.

Rapid diagnosis of an outbreak of Legionnaires' disease at Glasgow Royal Infirmary.

In the last three months of 1985 there was an outbreak of legionnaires' disease at Glasgow Royal Infirmary affecting 15 patients and one surgeon; five patients died. Legionnaires' disease was first suspected when a second case of severe nosocomial pneumonia occurred in a high dependency unit. The application of the direct fluorescent antibody test to specimens obtained at bronchoscopy was responsible for the rapid diagnosis of legionnaires' disease, which led to the prescription of appropriate antibiotic treatment and the shutting down of the contaminated cooling tower, thereby containing the outbreak.

A chromosome study of three ovarian tumors.

The cytogenetic results of three different types of malignant ovarian tumors are reported. Their chromosomes were studied indirectly by using either peritoneal washings or ascitic fluids. Detected in the peritoneal washings from a treated case of serous cystadenocarcinoma with papillary involvement, stage III, was a clone of pseudodiploid cells.

Surgery of intraepithelial neoplasia, CIN, VAIN, and VIN.

The various surgical treatments of CIN, VAIN, and VIN have been discussed. The necessity for careful pretreatment, histological diagnosis and colposcopic mapping of the various conditions has been stressed. The relative risks of malignant progression of the various conditions have been discussed along with the various modes and methods of surgical therapy.

Congenital hereditary corneal oedema of Maumenee: its clinical features, management, and pathology.

The clinical and histological features of congenital hereditary corneal oedema in 23 patients are presented. The series includes cases of both recessive and dominant inheritance. Although the condition is present at birth or in early childhood, visual development appears to be little impaired, if at all.