Search

A total of 103 cases with ocular involvement of Behcet's disease, seen over a period of 19 years (1970 to 1988), were collected from the ophthalmological departments of 6 major medical centers in Taiwan. The yearly number of patients who first visited these hospitals from 1979 through 1983 was about 5 cases and about 14 cases from 1984 to 1988. The domiciles of the patients were most commonly (51.5%) in Northern Taiwan. All 103 patients were Chinese, of which 78 (75.7%) were men and 25 (24.3%) were women; the male to female ratio was 3.1. Extraocular symptoms of Behçet's disease, major or minor, and their frequencies among these patients included; oral ulcers, 97.1%, skin lesions, 74.8%; genital ulcers, 61.2%; arthritis, 47.6%; gastrointestinal lesions, 14.6%; epididymitis, 5.8%; central nervous system lesions, 2.9%; vascular lesions, 1.9%; pulmonary lesions, 2.9% and urinary lesions, 4.9%. Fifty-one (49.5%) patients were of the complete type and 52 (50.5%) of the incomplete type. The peak distribution of ages at the onset of the ocular lesions, was from 20 to 40 years. As for visual prognosis, 37.9% of the 198 diseases eyes had a visual acuity of 0.5 or better, 9.1% between 0.5 and 0.1, 25.3% between 0.1 and 0.01 and 27.8% were 0.01 or worse. In 24 (12.1%) eyes, the vision was completely lost. In HLA studies, a significantly increased incidence of HLA-A26 (p less than 0.01) and HLA-B51 (p less than 0.001) was found.(ABSTRACT TRUNCATED AT 250 WORDS)

We reviewed the results of intraocular lens (IOL) implantation in the posterior chamber following extracapsular cataract extraction (ECCE) in 70 cataractous eyes with various types of endogenous uveitis, predominantly acute anterior uveitis, Fuchs' heterochromic cyclitis, Harada's disease, and Behçet's disease. During an average of 23.1 months' follow-up (range, 13 to 48 months) there was no exacerbation of the preexisting uveitis in any of the eyes. Postoperative visual acuity in all eyes was better than it was preoperatively, although further procedures were required in some eyes: a pars plana vitrectomy in one, a surgical peripheral iridectomy in one, and Nd:YAG laser capsulotomy in 10. Our results suggest that selected uveitis patients can tolerate and benefit from an ECCE and IOL implantation.

Paris formosana Hayata (Liliaceae) grown in the mountain areas of Taiwan, has been used as a folk remedy for snake bite, and as an anti-inflammatory or anti-neoplastic agent. The effects of formosanin-C, a diosgenin saponin isolated from Paris formosana, on immune responses and transplantable murine tumor were studied. In culture systems, formosanin-C (0.03-0.16 microM) displayed significant enhancement of the blastogenic response of human peripheral blood cells to phytohemagglutinin. Formosanin-C also significantly increased the 3H-thymidine incorporation of ConA-stimulated lymphocytes at concentrations of 0.1 and 0.01 microM. The responsiveness of the granulocyte/macrophage colony-forming cells (GM-CFC) to mouse fibroblast cells L929 conditioned medium was altered in the presence of 0.01 and 0.001 microM of formosanin-C. In addition, formosanin-C given intraperitoneally activated natural killer cell activity at doses of 1-2.5 mg/kg. An intraperitoneal injection of 2.5 mg/kg of formosanin-C markedly induced interferon production, the peak blood level of which was observed 24 h after formosanin-C injection. Growth of subcutaneously transplanted MH134 mouse hepatoma was retarded by intraperitoneal treatment with 1-2.5 mg/kg of formosanin-C. The activity of 5-fluorouracil against MH-134 mouse hepatoma was potentiated by intraperitoneal treatment with formosanin-C. These results suggest that formosanin-C might display antitumor activity in association with modification of the immune system.

A 54-year-old Chinese woman with miliary choroidal tuberculosis was followed for more than three years. She had had tuberculous meningitis for about one month before an ophthalmologic examination for blurred vision OU. There were 50 to 60 choroidal tubercles OU which were located mostly at the posterior poles including the macular areas. The meningitis and tubercular lesions resolved with antituberculous medications. In a series of fundus photographs and fluorescein angiograms, a macular subretinal neovascularization was noted in association with the tubercular lesions which resulted in disciform maculopathy. To the best of our knowledge, this case had the largest number of tubercles reported in this century, and the association of macular subretinal neovascularization with choroidal tuberculosis has never been reported.

The effects of training on a person's ability to perceive, interpret and utilize information presented via the tactile sense were examined by using a dual-channel electrocutaneous tracking approach. The electrocutaneous code studied was linear pulse rate encoding of information. The stimulus had a pulse width of 200 microseconds and a pulse rate between 2 and 50 pulses per second. Three tracking tasks--visual tracking, one-dimensional electrocutaneous tracking and two-dimensional electrocutaneous tracking--were performed by 20 subjects during eight to nine daily training sessions. The effects of this training regimen were found to be highly significant for both electrocutaneous tracking tasks (p less than 0.00005). The overall average improvement between successive training sessions was 21.6% for one-dimensional electrocutaneous tracking and 22.9% for two-dimensional electrocutaneous tracking. Furthermore, the rate of improvement was fastest during the initial training sessions with a slower rate of improvement seen in most subjects beginning with their fifth session. The cumulative effects of training were also reflected in the lesser amounts of practice and review required by the subjects with each succeeding test session. Results from this study can be used to estimate the amount and rate of improvement that one can expect using a typical training program for tactile sensory aids.

The frequency of HLA-A, B and C antigen in 53 patients and HLA-DR, DQ and Dn antigen in 31 patients of Behçet's disease was studied. All patients were Chinese, and diagnosis was made according to the Japanese Research Committee on Behçet's disease. A significantly increased incidence of HLA-B51 (P less than 0.001) and a significantly decreased incidence of HLA-B16 (P less than 0.01) was found. No significant difference was found in HLA-DR, DQ and DN antigens.

Microorganisms isolated from seafood showed various degrees of sensitivity toward potassium sorbate (PS). At pH 7.0, PS concentration of 0.53% completely inhibited growth of Moraxella sp., while 2.73% was needed to inhibit Arthrobacter sp. Pseudomonas I sp., which was relatively resistant to PS (inhibitory concentration = 1.62%), was not affected by 0.3% PS after freeze-thaw treatment (-78°C for 8 min and 20°C for 20 min), but showed a delay in onset of logarithmic growth for up to 20 h after heating at 50°C for 5 min. The inhibitory effect of PS on sub-lethally injured Pseudomonas I was greater in basal medium (Minimum Broth, Davis) than in a rich medium (tryptone-peptone-extract, TPE). Alteromonas putrefaciens , which was sensitive to PS (inhibitory concentration = 0.74%), was also sensitive to freeze-thaw and mild heat. The lag period for quick-frozen cells was extended by 14 h in the presence of 0.05% PS. Heating at 45°C for 10 sec was sufficient to cause complete inhibition of growth by 0.05% PS in MBD, and 8 h delay in the onset of logarithmic growth in TPE. Selective and inhibitory effects of PS, therefore, could be further enhanced in frozen or heat-treated seafood.

A 28-year-old Chinese woman having sarcoidosis with ocular involvement was reported. She demonstrated bilateral hilar lymphadenopathy in a chest X-ray which was taken for a cough. Transbronchial lung biopsy revealed noncaseating epithelioid granulomas. Blurred vision occurred 8 months later when conjunctival follicle-like masses, granulomatous keratic precipitates, iridocyclitis, "snow-ball" vitreous opacity, and retinal periphlebitis developed in both eyes. Biopsy of the conjunctival follicle-like masses revealed noncaseating granulomas composed of epithelioid cells and multinuclear giant cells, typical of sarcoidosis. The ocular lesions waned under topical steroid treatment and vision improved. This is the only case with an ocular involvement among the 10 cases of sarcoidosis seen during the past 20 years at the Taipei Veterans General Hospital.

One hundred and seventeen consecutively detected Chinese patients, 100 males and 17 females, with HLA-B27-Positive acute anterior uveitis (AAU) were studied in the uveitis clinic at the National Yang-Ming Medical College and Veterans General Hospital during a 3-year period from January 1984 to December 1986. The ages of onset of uveitis ranged from 8 to 76 years and averaged 38.2, with most of them (63.8%) distributed between 30 and 59 years and a peak incidence in the thirties. Of the 137 uveitis attacks observed during the follow-up, 60.6% manifested as serous iridocyclitis and 39.4% highly fibrinous. Mutton-fat keratic precipitates were never noted. Of the 117 patients, 78 (66.7%) had recurrent uveitis attacks. The average interval between successive attacks was longer than 1.5 years in 50 (64.1%) of the 78 patients. All patients were unilaterally involved in an AAU attack. Of the 78 patients with recurrent uveitis attacks, 25.6% had an ipsilateral eye suffering from uveitis attacks and 74.4% had uveitis attacks involving either eye. In viewing the distribution of AAU attacks, a significant monthly variation was found (p less than 0.0001) with the highest incidence from December to March. Posterior synechiae and cataract were the most common two persistent ocular complications, which were present in 31.4% and 14.3% of the diseased eyes respectively. The visual prognosis was generally good with 90.3% of the diseased eyes having a visual acuity better than 0.5.2+ Among the 117 patients, 75.2% had an association with seronegative spondylarthropathies, which included ankylosing spondylitis (50.4%), probable ankylosing spondylitis (6.8%), Reiter's disease (12.0%), juvenile rheumatoid arthritis (4.3%) and psoriatic arthropathy (1.7%).(ABSTRACT TRUNCATED AT 250 WORDS)

Fresh bovine retinas were precipitated by ammonium sulfate, and further purified by the Sephadex G-200 column and the hydroxyapatite column. Through the SDS polyacrylamide gel electrophoresis and the isoelectric focusing gel electrophoresis, a single band of protein with molecular weight of 50,000 daltons, isoelectric point at 5.4-5.7, was identified as S-antigen. The yield of S-antigen from crude retina extract was 0.18%, higher than ever been reported. Guinea pigs were injected at the hind footpad with 5-30 micrograms of purified S-antigen which had been emulsified with an equal amount of complete Freund's adjuvant. There are severe uveitis findings in both clinical and pathological examinations. An experimental autoimmune uveitis animal model was successfully established. These results showed that it is an effective and rapid method for purification of retinal S-antigen.

Lymphomatoid granulomatosis is an angiocentric and angiodestructive lympho-proliferative disorder involving multisystems but rarely conjunctiva. We present a 62-year-old Chinese female with lymphomatoid granulomatosis who had an ulcerative conjunctival nodule. Conjunctival biopsy revealed pathological findings important for diagnosis and indicating progression of disease severity. To our knowledge, this is the first report to demonstrate pathological findings characteristic of lymphomatoid granulomatosis with conjunctival involvement.

The influence of potassium sorbate on growth of microorganisms in seafood was tested by treating English sole ( Parophrys retulus ) homogenate with 0, 0.1 and 1.0% potassium sorbate. Viable counts during 1.1-C storage revealed that 0.1% potassium sorbate delayed the onset of logarithmic growth of bacteria for 1 day compared to no delay for the untreated control. The generation time of 1.7 days and a maximum growth level of 10 9 cells per g were unchanged by the presence of 0.1% potassium sorbate. The 1.0% sorbate treatment extended the lag period to 6 days. The generation time was increased to 2.1 days and the maximum level of growth reached was 10 7 cells per g on the 14th day. Tests of the microbial flora of the fish revealed that Pseudomonas spp., which comprised 17.1 %of the total at 0 day, increased to 96.0% of the microbial population in 14 days at 1.1 C for the untreated sample. During the same period the Pseudomonas population reached 100% for the 0.1% sorbate-treated sample, and to 98.2% for the 1.0% sorbate-treated sample. Potassium sorbate at the concentrations employed, therefore, did not seem to alter the typical microbial spoilage pattern.

A review of 240 consecutive Chinese patients with endogenous uveitis seen over a 3-year period was made in Taiwan. The frequency of major types of uveitis was 110 cases (45.8%) of acute anterior uveitis, 43 cases (17.9%) of Behçet's disease, 22 cases (9.2%) of Harada's disease, 10 cases (4.2%) of peripheral uveitis, 6 cases (2.5%) of virus-induced uveitis and 5 cases (2.1%) of Fuchs' heterochromic cyclitis. Only 1 case (0.4%) of sarcoidosis was found. Of the 110 cases of acute anterior uveitis, 80.9% presented with HLA-B27 antigen. The incidences of types of endogenous uveitis in Chinese differ from those in Caucasians, Japanese and Negro races in the USA.

Clinical manifestations and immunogenetic aspects of Behçet's disease were investigated in the Veterans General Hospital of the National Yang-Ming Medical College, Taiwan. Diagnosis of Behçet's disease was made according to the diagnostic criteria proposed by the Japanese Research Committee of Behçet's disease. Fifty-three patients including 33 men and 20 women have been diagnosed as having Behçet's disease in the past 10 years; 20 cases with the complete type and 33 cases with the incomplete type. About half of these cases were diagnosed in the past 2 years, predominantly by ophthalmologists. Of the 53 cases, ocular lesions were found in 35 cases, 25 men and 10 women. The ages of the onset of the ocular lesions ranged from 10 to 50 years, with the peak distribution between 20-30 years. Bilateral involvement was seen in 24 men and 8 women, and a total of 67 eyes were affected; 37 eyes (55.2%) had the final visual acuity of 0.1 or lower. Immunogenetic study revealed that the incidence of HLA-B51 was significantly higher in the patients than in the normal population.

Retinal S-antigen is thought to play an important role in the immunopathogenesis of uveitis. To investigate the role of S-antigen in human uveitis, an immunopotent bioactive S-antigen and a sensitive enzyme-linked immunosorbent assay (ELISA) were developed to determine the anti-S-antigen antibody contents in experimental autoimmune uveitis (EAU) and human uveitis. The bovine S-antigen was isolated by ammonium sulfate precipitation, Fractogel TSK HW-55 gel filtration and hydroxylapatite absorption chromatography. A test by SDS polyacrylamide electrophoresis showed that it was a highly purified protein. The purified S-antigen evoked EAU in 60% of eyes of guinea pigs even at the dose of 1 microgram. ELISA was developed to determine the contents of serum immunoglobulin G antibody against S-antigen. In the serum of S-antigen immunized rabbit, the antibody was measurable up to 1:160,000 in dilution. The antibody content appeared on the 10th day following inoculation and rose gradually until the 22nd day when the maximal antibody content was observed. Regarding human uveitis, the anti-S-antigen antibody was higher in 31 patients with Behçet's disease and 8 with Harada's disease than in normal controls although statistical significance existed only in the former (p less than 0.02). In this study, the method to purify the bovine retinal S-antigen proved relatively rapid and efficient. The ELISA developed herein appeared sensitive and well reproducible in the detection of anti-S-antigen antibody. The results showed that retinal autoimmunity may play a role in the pathogenesis in EAU and human uveitis.