Remote fetal medicine consultation using stored ultrasound video images

Fifty-four (54) unrelated patients with Mediterranean Kaposi's sarcoma (MKS) and 8 patients members of 4 unrelated families with familial MKS were serotyped for HLA-A,B and DR antigens. The diagnosis was histologically confirmed and all patients were negative for anti-HIV antibodies. An increased frequency of HLA-B18 (44.4% vs 14.2% in the controls, p < 0.001, RR = 4.8) and HLA-DR5 (57.6% vs 37.2% in the controls, p < 0.025, RR = 2.29) was observed in the group of patients with MKS. Seven (7) of the 8 family members with FMKS possessed HLA-DR5, and the affected members in the 3 families shared a common haplotype which included HLA-DR5. These findings support the hypothesis that genetic factors linked to HLA-DR5 antigen may contribute to the pathogenesis of MKS.     

Ocular findings in patients with neutrophil dysfunction

Of 32 patients (19 females and 13 males, ranging in age from 2 to 44 years), nine had ocular problems related to neutrophil dysfunction. Four patients had blepharokeratoconjunctivitis and pannus formation. In one of these, severe visual loss secondary to corneal thinning and scarring occurred. Five patients had inactive chorioretinal scars without visual loss. Although some of the other 23 patients had minor ocular abnormalities, we could not demonstrate that they were related to the neutrophil dysfunction. However, none of the control subjects (20 patients with systemic lupus erythematosus and 20 randomly selected eye clinic patients) had lesions resembling those of the patients with neutrophil dysfunction. Fisher's exact test (one-tailed) gave the following values: P less than .03 for keratitis; P less than .01 for chorioretinal scars; and P less than .001 for keratitis and chorioretinal scars. Abnormal neutrophil function probably interferes with the control of normal eyelid flora and predisposes the eye to the development of marginal keratitis. Eyelid hygiene and topical administration of antibiotics and corticosteroids during inflammatory episodes may prevent the progression of corneal vascularization. The chorioretinal scars do not appear to be progressive.     

Ocular symptoms in association with antiphospholipid antibodies

OBJECTIVE: To describe the clinical and serologic findings of 50 antiphospholipid antibody (APA)-positive patients within a retrospective study. METHODS: Measurement of visual acuity, slit-lamp biomicroscopy, tonometry, fundus examination and perimetry. Laboratory tests were performed for detection of APA against thromboplastin and cardiolipin. Antinuclear antibodies (ANA), antibodies to dsDNA, antithyroidal and antiparietal antibodies were also tested. RESULTS: A combination of both transient and permanent visual disturbances was noticed in more than half of the patients. Transient visual disturbances included transient blurred vision, partial defects of the visual fields and amaurosis fugax. The most frequent permanent abnormalities were optic atrophy in 20 patients, due to AION in 9 cases, and disturbances of the choroidal circulation in 17 patients. Fourty-six patients had positive levels of thromboplastin APA; cardiolipin APA were found to be increased in 36 patients. CONCLUSIONS: We did not find a clear correlation between APA activity or the immunoglobulin classes in the individual and the severity of the ocular disease. The benefit from a therapy with the antiplatelet agent acetylsalicylic acid was evident in a reduction of the patients' transient visual disturbances and, in most cases, no further progression of permanent visual field defects was observed.     

Ocular tuberculosis

The frequency of tuberculous uveitis has extremely decreased in Japan. Anterior granulomatous or non-granulomatous uveitis, chorioretinitis and retinal vasculitis are common ocular manifestations, while tuberculoma, scleritis, keratitis and orbital tuberculosis are rare. The diagnosis of ocular tuberculosis is extremely difficult because ocular tuberculosis tends to be negative in chest x-ray or tuberclin skin test. To diagnose ocular tuberculosis clinically some ophthalmologists recommend subconjunctival tuberculin test or therapeutic isoniazide (INH) test. Recently, for confirmed diagnosis, polymerase chain reaction (PCR) technique has been used to detect mycobacterium in intraocular samples such as aqueous or vitreous humor. The mainstay of treatment is antituberculosis agents. Active retinal vasculitis or tuberculoma are generally responsive to corticosteroid therapy. Although ocular tuberculosis is rare, it must be considered as one of the possible causes of uveitis.     

Variability in cytokine and cell adhesion molecule staining in arthroscopic synovial biopsies: quantification using color video image analysis

OBJECTIVE: To investigate the variability in immunostaining for cytokines and cell adhesion molecules using multiple arthroscopically directed synovial biopsies from within a rheumatoid knee joint, quantitated by color video image analysis. METHODS: Needle arthroscopic biopsies were taken from multiple sites (4-7 sites) around a knee joint in 8 patients with rheumatoid arthritis (RA). In 5 patients, immunoperoxidase staining for the cytokines tumor necrosis factor alpha (TNF-alpha), interleukin 8 (IL-8), and IL-1beta as well as the IL-1 receptor antagonist protein (IL-1ra) was performed. In 3 patients, immunoperoxidase staining for the cell adhesion molecules E-selectin (CD62E), P-selectin (CD62P), intercellular adhesion molecule 1 (ICAM-1, CD54), and platelet endothelial cell adhesion molecule (PECAM, CD31) was performed. Immunostaining was quantified using color video image analysis. RESULTS: The overall probability of paired biopsies from the same RA knee joint being significantly different from each other due to sampling variation was at most 22% for cytokine staining (usually less than 10%). There were no significant differences between intrabiopsy and interbiopsy variability for cell adhesion molecule staining of the sublining and vessels. CONCLUSION: The variability in cytokine and cell adhesion molecule staining within any single biopsy usually reflects the variability between biopsies taken from different sites in the same rheumatoid joint when the immunostaining is quantified using color video image analysis. Therefore, only a small number of synovial biopsies are required to accurately determine the cytokine and cell adhesion molecule expression in a single joint.     

Ocular toxocariasis

Toxocara canis is a preventable cause of intraocular inflammation and visual loss ... caused by the larvae of toxocara canis usually occurring in children and young adults following accidental ingestion of the larvae from infected dogs. Treatment of ocular toxocariasis can include a combination of cryopexy and photocoagulation, with vitrectomy surgery utilized in the more serious cases.     

Ocular spherulocystosis

Spherulocystosis (myospherulosis), a rare entity, is characterised by histopathological changes of sac-like refractile structures in soft tissue and presents clinically as an inflammatory lesion. It is caused by trauma or is induced iatrogenically by the topical application of fat based ointments. A case of myospherulosis confined to the region of the lacrimal caruncle, which developed soon after topical antibiotic application for suspected conjunctivitis, in a 49 year old woman is reported. Though this lesion is uncommon, this report illustrates the importance of recognising this condition to avoid confusion with and treatment for fungal infection.     

Age differences in the ability of chimpanzees to distinguish mirror-images of self from video images of others.

To evaluate Heyes's (1994) claim that chimpanzees are incapable of using mirrored information to obtain otherwise unavailable information about the self, we exposed two different age groups of chimpanzees (3-year-olds and 7- to 10-year-olds) to mirrors and video images of conspecifics. Their reactions to these stimuli were videotaped and were later scored for behavioral indices of self-recognition by a trained observer who was blind to the purpose and conditions of the study. Some types of behavior (contingent facial and body movements) were clearly influenced by the type of stimulus that the chimpanzees were viewing but not by age; however, other behaviors (self-exploration) were affected by age in conjunction with the type of stimulus the animals were viewing. The results suggest that, unlike self-exploratory behavior, contingent facial and body movements may not, by themselves, be reliable indicators of self-recognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tibial torsion?

A longitudinal study evaluating the degree of rotation of the bimalleolar axis of tibia and fibula at birth, 6 month, 12 months and 24 months revealed a gradual statistically significant external rotation from a mean of 4 degrees at birth to a mean of 11 degrees at 24 months. There was no correlation with the sex or race of the child or with the age at which the child began independent walking. It is concluded that this external rotation is a part of normal growth and development of the infants' lower extremities.     

Ocular Ehlers-Danlos syndrome with normal lysyl hydroxylase activity

We report two brothers affected with what has been called either fragilitas oculi or the Ehlers-Danlos syndrome type VI. Previously reported cases of the Ehlers-Danlos syndrome type VI showed a deficiency of lysyl hydroxylase in cultured fibroblasts. Assays of cultured skin fibroblasts from these two boys yielded normal activity of this enzyme, suggesting that there are two variants of this disease.