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Giemsa and fluorescence antibody (FA) staining were used to diagnose patients clinically suspected to be suffering from trachoma. A total of 52 controls i.e. individuals with refractive errors and no clinical trachoma and 173 cases suffering from different stages of trachoma were studied. FA was found to be 2.52 times more sensitive in confirming the presence of Chlamydia trachomatis compared to Giemsa staining. 28/52 (53.8%) and 4/52 (7.,69%) controls were also positive by FA and Giemsa staining, respectively, indicating sub-clinical infection without symptoms. Post treatment staining with both methods revealed that clinical cure of trachoma did not necessarily mean the absence of Chlamydia trachomatis in the conjunctival smears. As a corollary it can be deduced that mere presence of Chlamydia trachomatis in conjunctival epithelial cells may not cause clinical trachoma, certain host factors (local immunity etc.) may play an important role in clinical disease.

During a 14-year period, 397 radical hysterectomies and pelvic lymphadenectomies were performed for early invasive carcinoma of the cervix. Twenty-one patients were in stage IA2 with lymphatic/vascular channel permeation (5.2%), 340 in stage IB (85.6%) and 34 in early stage 2A disease (8.5%). Eighteen patients (4.5%) were pregnant. Adenocarcinoma comprised 26.9% of cases. The mean operative time was 4.14 h; the intraoperative blood loss was less than 1.51 in 77.3% patients. There was no operative mortality; one patient died 3 weeks after surgery from clostridium difficile enterocilitis. Eleven patients (2.7%) developed venous thrombosis; severe lymphedema occurred in four (1%). The incidence of uretero-vaginal fistula was 0.2% and that of vesico-vaginal fistula 0.5%. Ovarian metastases were noted in 4.3% of cases with adenocarcinoma. Sixty-six patients had positive nodes (16.6%). Five-year survival in patients with more than 2 positive nodes was 68%. The use of adjuvant chemotherapy in patients with 'high risk' factors resulted in survival rates approaching those without risk factors. Neo-adjuvant chemotherapy was used in 10 patients with large bulky tumors; the results were favorable. Recurrences occurred in 47 patients (11.8%); 36 patients have died (9.1%). Age did not appear to influence survival. The overall 5-year survival was 92.2%.

Two derivatives of the mesoionic thiazolo[3,2-a]pyrimidine-5,7-diones 1 were prepared and examined for in vivo antiprotozoan activity to study structure-activity relationships that might lead us to more active derivatives. Mesoionic compounds 1A and 1B were inoculated into Swiss Webster male mice with Trypanosoma musculi infection. The effects were measured by studying parasite populations during the course of patent period (days 9 through 15 post-infection). The injection of 200 micrograms of compound 1A along with 5 x 10(4) trypanosomes affected the level of parasitemia at both the peak and during days 9 to 13 post infection. Experimental animals that received drug 1A prior to and after infection with T. musculi developed significantly lower parasitemia as compared to the control animals at the height of parasite populations (day 11 of observation). The group that received the drug simultaneously with trypanosome infection had significantly lower parasitemias on day 11 and 13 of infection compared to the controls. The injection of 200 micrograms of mesoionic compound 1B along with 5 x 10(4) trypanosomes resulted in lower parasitemic levels in the prior treated and post inoculated groups on days 9 and 13 post-infection. Swiss Webster male mice treated with the test drug, compound 1B, simultaneously with an inoculation of parasites developed significant resistance against infection on days 9 and 11 post-infection. This trend was reversed for the rest of the observation period.

Oxytocinase (EC 3.4.11.3) activity was determined in 80 amniotic fluid samples obtained from 40 normotensive primigravidas (median age 27 years) and 40 primigravidas (median age 29 years) with pregnancies complicated by preeclampsia between 32 and 39 weeks of gestation. The enzyme activity was significantly lower in preeclampsia than in normal pregnancy with matched gestations (p < 0.01). Considering the possible involvement of vasopressin and angiotensin II in preeclampsia, it is suggested that the enzyme which degrades these pressor hormones may play a role in the pathogenesis of hypertensive pregnancy.

Serum alpha-1 acid glycoprotein levels were measured in 27 patients with idiopathic peripheral retinal vasculitis (Eales' disease) and 31 healthy subjects by single radial immunodiffusion technique. The levels were found to be significantly increased in both moderate and severe types of the disease. The serum levels of this protein paralleled the severity of the disease. The increased alpha-1 acid glycoprotein in serum showed a significant fall to near normal levels during the quiescent stage. Our observations support the hypothesis that idiopathic peripheral retinal vasculitis is an immune mediated disease. It is proposed that serum alpha-1 acid glycoprotein may be considered as a reliable parameter of the activity and the degree of severity of the disease, as well as an useful tool for monitoring the efficacy of treatment.

We determined the plasma levels of tissue plasminogen activator (t-PA), plasminogen activator inhibitor (PAI) activity and their antigen levels including urokinase plasminogen activator (u-PA) in 33 male and 27 female normal subjects. Males had mean t-PA activity of 0.50 iu/ml which was significantly lower (p less than 0.01) than the females 0.64 iu/ml. Males had higher (p less than 0.001) mean PAI activity (15.5 AU/ml) as compared to females 10.3 AU/ml. The respective mean levels of t-PA and PAI antigen were significantly higher (p less than 0.01) in males (8.1 ng/ml and 17.6 ng/ml) than in females (6.2 ng/ml and 12.1 ng/ml). The mean u-PA level in males was 1.54 ng/ml which was significantly higher (p less than 0.01) than in females with 1.02 ng/ml. In post-venous occlusion studies, females had a greater mean response of 8.6 fold in t-PA activity as compared to males with a mean of 4.5 fold increase. The mean t-PA antigen response in males was 2.0 fold increase as compared to 2.6 fold increase in the females. No significant responses were seen in both sexes in either PAI activity or antigen levels when compared with the resting state. In zymography studies, free t-PA, its inhibitor complexes and u-PA were demonstrated in the euglobulin fractions of stored plasma. This study demonstrates that significant differences in t-PA, u-PA and PAI exist between male and female subjects which should be taken into account when determining their levels in clinical conditions.

A rare case of histopathologically proved case of congenital cystic eye in a one day old girl is described. It was an unusually large cystic mass bulging forwards stretching the upperlid. There was no rudimentary eyeball in the orbit. The cystic eye's predilection for the left eye has been pointed out for the first time in this article.

Serum beta-2 microglobulin (beta 2-m) levels were measured in 12 patients with sympathetic ophthalmitis, 34 with neglected traumatic uveitis following penetrating injury and 36 healthy subjects by ELISA technique. There was no significant alteration of its level in patients with traumatic uveitis. However, its levels were significantly increased in patients with sympathetic ophthalmitis. They were high even in the early stage of the disease. Serum beta 2-m levels paralleled the severity of disease. It decreased significantly at the remission stage. Four patients came back with relapse of the condition and the level of serum beta 2-m was again found to be elevated in them. It is proposed that estimation of beta 2-m can be used as a diagnostic aid when the diagnosis of sympathetic ophthalmitis remains doubtful on clinical grounds. It is also suggested that a rise in serum beta 2-m in patients with traumatic uveitis following perforating injuries may point to the onset of sympathetic ophthalmitis. The extent of rise in its level may be considered a good parameter of the degree of severity of sympathetic ophthalmitis. It may also act as a useful tool to evaluate the drug efficacy in this disease and predict relapse.

A rare case of unilateral cryptophthalmos have unique findings is reported. The lateral part of the left eye was replaced by downward extension of the frontal hairline. The left upper eyelid, except in the lateral 4mm fully developed portion, was replaced by a fold adherent to the underlying disorganized globe (6.9 mm). The lower lid, however, was fully developed. Ocular and systemic features of cryptophthalmos have been reviewed. Predilection for the left eye in unilateral cases has been hinted for the first time.

Fourteen patients with tuberculosis of the orbit and lacrimal gland seen over a period of 20 years have been presented. The majority of them were between the ages of 4 to 15 years. Males were affected twice as frequently as females. Left side was affected four times as frequently as the right side. There were eight patients of periostitis of orbital margin, one patient of dacryoadenitis, three patients of tuberculoma of orbital tissues, and two patients of tuberculoma of maxillary sinus. One patient with periostitis had involvement of the greater and lesser wings of sphenoid in addition to the involvement of upper-outer orbital margin. Two periostitis patients had prolapse of the palpebral portion of the lacrimal gland. The clinical presentation and gross appearance of the tuberculoma of the lacrimal gland was similar to those found in benign mixed tumor. The patients with tuberculoma of orbital tissues presented as pseudotumors. The mimicry of tuberculoma of maxillary sinus to carcinoma has been mentioned. Associated tuberculous lesions were pulmonary in eight patients, cervical lymphadenitis in ten patients, intestinal in one patient, and caries spine in one patient. In two patients the disease developed in the absence of any other tuberculous lesion discovered in the body. The cases were cured by wide surgical removal of all the diseased tissues combined with antituberculous chemotherapy.

A case of acute suppurative dacryoadenitis caused by a cysticercus cellulosa in a male of 20 years is reported. The diagnosis was established by histopathologic examination of the cyst that escaped along with pus during drainage of the abscess. The abscess in the palpebral lobe of the lacrimal gland resulted from acute inflammation produced by the presence of an intact larva. There was no other focus of cysticercosis in the same eye, in the other eye, or anywhere else in the body. Postoperative recovery was uneventful and there were no sequelae. To our knowledge, this is the first case report of acute dacryoadenitis caused by a cysticercus cellulosa. As cysticercosis is still prevalent in the underdeveloped countries, it is to be kept in mind in the differential diagnosis of ocular and adnexal lesions in patients coming from these areas of the world.

One hundred and two patients with anisohypermetropic amblyopia without strabismus were studied. Microstrabismus was excluded by detailed orthoptic examinations including visuscopy and Cüppers' bifoveal correspondence test. Treatment consisted in wearing correcting glasses and part-time or full-time patching of the nonamblyopic eye. In patients with dense amblyopia patching of the amblyopic eye was done and Cüppers' after-image method of pleoptic therapy was instituted as the initial procedure. When visual acuity improved sufficiently by this therapy, patching was used on the nonamblyopic eye. Sixty-five (63.7%) patients showed 2 lines or more improvement on the Snellen chart. Though young children (6 to 12 years) improved their visual acuity more often than those aged 13 to 20 years, a considerable number of patients (50.0%) in the older age group improved their visual acuity after therapy. The improvement in visual acuity was accompanied by improved stereoacuity in 49.0% of the patients. It is therefore suggested that every effort should be made to treat these patients even after the age of 12 years.

We used a single radial immunodiffusion technique to determine the lysozyme content of human tears. The level in healthy subjects with this method was 1.3 mg/ml of tears. In patients with trachoma, the level was low, 0.9 mg/ml of tears. Detecting the reduction in lysozyme level in patients with trachoma proved the utility of this method.

Results of treatment of 9 cases of pure immature teratoma of the ovary seen at the University Hospital, Kuala Lumpur, are presented. Six patients were in Stage 1 and three in Stage 3. A majority of them had grade 2 or 3 tumors. Four patients in Stage 1 had the conservative surgery of salpingo-oophorectomy performed, the more radical procedure of total hysterectomy, bilateral salpingo-oophorectomy omentectomy, and tumor debulking where feasible being carried out in the others. Adjuvant chemotherapy consisted of either pulsed cyclophosphamide, VAC (vincristine, actinomycin D, and cyclophosphamide) or PVB (cis-platinum, vinblastine, bleomycin) regimes. Seven patients have survived for periods up to 9 years with no clinical evidence of disease.

Five patients illustrate various aspects of obstetrical defibrination in West Malaysia, resulting from exaggeration of changes in fibrinolytic-coagulation equilibrium that occur at delivery. Hypofibrinogenaemia and fibrinolysis may occur in association or either feature predominate. These patients are from a population in which a variety of genetic and environmental factors may interact, e.g. abnormal haemoglobins, cold agglutinins, viral and other infections, introducing additional complications.

Prostaglandins may be involved in human penile erection and erectile failure. To evaluate the possible role of prostaglandin metabolism in the penile tissue, the activity of nicotinamide adenine dinucleotide-dependent prostaglandin 15-hydroxydehydrogenase was assayed in the corpora cavernosa of the human penis. Km values (mean +/- SD) of the enzyme for PGE1, PGE2 and PGF2 alpha were 60.1 +/- 4.2, 17.7 +/- 1.5 and 16.1 +/- 1.2 microM respectively; Vmax values (mean +/- SD) were 0.219 +/- 0.062, 0.510 +/- 0.012 and 0.424 +/- 0.007 nmol/min/mg protein respectively. The implications of these findings in the erectile process are discussed.

Two new Cu-IUDs, the TCu-22OC and Multiload Cu250, were evaluated against the Cu7 in 1,199 subjects in a randomised, multicentric trial using a common study protocol. During the 2 years following insertion, cumulative first-segment rates for total use-related terminations showed no significant differences between the 3 devices; however, the Cu7 had a significantly higher termination rate for accidental pregnancy compared to the TCu-22OC and its expulsion rate was significantly higher than the ML Cu250. The rate of accidental pregnancy was higher and the expulsion rate lower with the ML Cu250 compared to the TCu-22OC but these differences were not significant. The results are discussed in relation to IUD design and their application in family planning.

The tear lysozyme content in 111 normal subjects and in 159 patients with various conjunctival diseases was determined by a single radial immunodiffusion technique. Tear lysozyme level in normal people was 1.33/mg/ml. (SI conversion: mg/ml = g/l.) The mean tear lysozyme levels in patients with chronic irritative conjunctivitis (0.97 mg/ml) and nutritional deficiency with epithelial xerosis (0.76 mg/ml) were significantly lower than in the normal controls. The mean tear lysozyme levels in tears from patients with vernal conjuctivitis (1.20 mg/ml), phlyctenular conjunctivitis (1.10 mg/ml), and acute bacterial conjunctivitis (1.48 mg/ml) were not significantly different from those in the normal controls. Superimposition of acute bacterial conjunctivitis on trachoma did not alter the low tear lysozyme level that existed before in these patients.

We wished to assess the contribution of the lens to the maintenance of the high level of lactic acid found in human aqueous humour. The lactic acid in aqueous humour was estimated by Pryce's modification of the Barker-Summerson method in 41 subjects who were divided into four groups: those with early cataract, those with advanced nuclear cataract, those with mature cataract and those with hypermature (morgagnian type) cataract. Statistical evaluation of the results showed that there was no significant difference in the lactic acid level between the four groups. We assume that the lens does not contribute significantly to the high concentration of lactate found in human aqueous humour.

The effect of holothurin (a marine biotoxin) on the resistance of mice to trypanosoma musculi was measured by studying changes in the parasite population in vivo. Swiss Webster (SW), Beige (BG), and Black (BL) mice treated with holothurin prior to and simultaneously with infection of trypanosomes had lower parasitemias than controls. Higher levels of parasitemia were observed in mice treated after infection with trypanosomes. The timing of administration of holothurin appeared to be an important factor in the observed effect. The minor variations in the parasitemia seemed to be related to the mouse strain.

The activity of NAD+-dependent PGDH was measured in the cytosolic fractions (100,000 x g) of uterine tissues obtained from transsexual, pregnant and non-pregnant women. The specific activity (mean +/- SD) of the enzyme at maximum velocity of the enzyme reaction in these three groups of women was 5.5 +/- 2.30, 0.53 +/- 0.27 and 0.54 +/- 0.25 mU/mg protein respectively using PGE2 as substrate, and with PGF2 alpha as substrate the respective values were 5.48 +/- 2.80, 0.49 +/- 0.41 and 0.51 +/- 0.30 mU/mg protein. These data suggest that, with either substrate, the uterine enzyme activity in the transsexuals was about 10-fold greater than in pregnant and non-pregnant women (p less than 0.001). However, the Km values of the enzyme for both PGE2 and PGF2 alpha were similar in all three groups, indicating the presence of same enzyme in the uterus of transsexual, pregnant and non-pregnant women. We speculate that PGDH activity was raised in the uterus of transsexual women because of the prolonged androgen therapy they received for the management of female-to-male transsexualism.

Two isoenzymes of oxytocinase activity were fractionated from human seminal plasma by acrylamide-agarose gel chromatography and partly characterized using S-benzyl-L-cysteine-p-nitroanilide (BCN) and L-leucine-p-nitroanilide (LN) separately as substrates. These isoenzymes appeared to be metallo-aminopeptidases with different elution volumes (90 ml and 150 ml), apparent molecular weights (unknown value and 300,000) and pH optima (6.8 and 7.0 with BCN and 7.2 and 7.4 with LN), but with similar substrate affinity and thermal sensitivity, and susceptibility to EDTA, divalent metal ions, L-methionine, polypeptide hormones and prostaglandins. A comparison of the enzymic properties with pregnancy-associated oxytocinases suggests that seminal oxytocinases are related more closely to amniotic fluid isoenzymes than to pregnancy serum, placental and uterine isoenzymes.

Fifty normal people and 50 diabetic patients were studied by means of an enzymatic method for the glucose content in the blood, tears, and urine before and after the peroral glucose load. In normal subjects the fasting glucose levels in the tears averaged 3.6 mg/100 ml (0.2 mmol/l) and in the diabetic patients it averaged 16.6 mg/100 ml (0.92 mmol/l). As in blood and urine, tear glucose levels are significantly higher in diabetic patients than normal persons both at fasting and after the peroral glucose load test. The fasting tear glucose level did not appear to be a satisfactory index for classifying a person as a diabetic or normal. It was found that after the peroral glucose load test a tear glucose level at 11 mg/100 ml (0.61 mmol/l) resulted in only 4.6% of the diabetics being missed, while 5.8% of the normal persons were misclassified as diabetics.

Serum C1q, C3, C4, and C5 components of complement levels were measured in 56 healthy subjects and 98 patients with trachoma. Serum C1q and C3 levels were found to be significantly low in stages II and III. There was no change in serum C4 and C5 levels in any of the stages. The levels of C1q and C3 complement components in serum in stages II and III returned to normal as the disease resolved following the medical treatment.

Immunoglobulin concentrations in human tears were determined in 165 patients with different eye diseases by a standard radial immunodiffusion method. IgA was present in all the samples in measurable quantity. The mean IgA values were significantly higher than the controls in patients with acute bacterial conjunctivitis, keratomalacia, corneal graft reaction, blepharoconjunctivitis, and acute keratoconjunctivitis. The values in the patients with vernal conjunctivitis, phlyctenular conjunctivitis, acute bacterial corneal ulcer, and acute endogenous uveitis were not significantly different from those in the controls. IgG could be detected in the majority of the samples but it was in measurable quantity in 18 samples. IgM could be detected in fewer samples. IgD was not detected in any of them. The study indicates that, whenever the immunoglobulin levels in tears are altered in diseased eyes, it is the IgA level that is predominantly altered and not the IgG level.

A case of fibroma arising from the anterolateral wall of a healthy lacrimal sac on the left side in a 22-year-old male is reported. There was no epiphora. The tumor presented as a painless, nonreducible swelling in the lacrimal sac region. It was excised off leaving a patent sac. The diagnosis could be established only on histopathologic examination. Postoperative recovery was uneventful and there was no postoperative epiphora.

Two doses of Streptozotocin (50 and 100 mg/kg body weight) were administered to two groups of pregnant gilts at d 80 of gestation to determine the influence of two levels of maternal diabetes on the gilts, their developing progenies and the body composition of the pigs. All the experimental animals received 1.82 kg of gestation diet/day throughout gestation. Serum glucose concentration increased to hyperglycemic levels in low-dose and high-dose groups; insulin concentrations decreased (P less than .01) in the high-dose, but not in the low-dose group (P greater than .05). Maternal free fatty acids (FFA) increased (P less than .05) in both treatment groups when compared with the control. However, birth weight of the litter and litter size were not affected. The liver weight increased (P less than .01) in the progeny of high-dose but not the low-dose group. Total liver DNA and RNA were not altered by the treatments, however; total liver protein and protein:DNA ratio increased (P less than .01) in the progeny of high-dose gilts. Pigs from high-dose and low-dose groups showed increases (P less than .01) in liver glycogen concentrations and percentage liver lipid. Body chemical composition data showed increases in percentage dry matter and percentage lipid (P less than .05 and P less than .01, respectively) in the progeny of high-dose but not in the low-dose group. It was concluded that streptozotocin administered to gestating gilts increased the maternal nutrient supply to the developing pigs, which resulted in higher energy status of the pigs at birth.

Six cases of adnexal cysticercosis, (1 in the lacrimal gland, 3 orbital, and 2 palpebral) have been reported. In the lacrimal gland it presented as a painless, translucent cyst which closely simulated a simple dacryops. In the orbit, two of the cases presented as an acute abscess in the upper and inner quadrant. However, one of them initially presented and existed as a case of simple ptosis for a period of 8 months. The third orbital case appeared as a painless cyst in the upper and outer quadrant. In the lid the larva presented as a subcutaneous nodule in one case and in the other it was lodged in the orbicularis oculi muscle. The cyst was surgically removed in all cases and the diagnosis was confirmed by histopathological examination. Lodgement of cysticercus cyst in the lacrimal gland and in the orbicularis oculi muscle is reported for the first time.

One hundred seventy-two consecutive cases of pure anisometropic amblyopia have been studied. Of them 167 were anisohypermetropic and five of them were anisomyopic. The majority of the cases (65.1%) were teenagers. A difference of 1 to 2 diopters between the two eyes formed the single largest group comprising 28.5% cases. Amblyopia was dense and the fixation was foveal in majority of the cases. Statistical analysis of the data revealed that the age at presentation has no relationship to the degree of anisometropia. The higher the age at presentation the greater is the depth of amblyopia. A higher degree of anisometropia is associated with a more severe degree of amblyopia. Persons with a lesser degree of anisometropia are more likely to have fixation at or near the fovea than persons with higher degree of anisometropia. There is a significant association between the age at presentation and the eccentricity of fixation. The farther the fixation is from the fovea the greater is the loss of vision.

The clinical findings in a 16-year-old boy with unilateral isolated pupillary paralysis in a case of herpes zoster ophthalmicus is described because of the extreme rarity of the condition. The condition appeared to be due to a partial third nerve lesion affecting only the fibers subserving the light and near reflexes.

The first case of intraocular sparganosis presenting as endophthalmitis is reported with a live plerocercoid larva of Spirometra lodged in the anterior chamber of the eye of a man in India. The larva was identified histologically.

Four cases of granuloma pyogenicum involving the palpebral conjunctiva are reported. Two of them reported with bloody tears; the lesion was pedunculated and arose close to the upper fornix in one patient and from the subtarsal sulcus of lower lid in the other. The remaining two patients presented with large, flat, wing-like masses arising from the upper tarsal conjunctiva. In all four cases the lesion was painless and each developed without antecedent inflammatory or traumatic episode. They were treated with complete surgical excision and thorough fulguration of the base by diathermy. There was no recurrence in any of them after three to six years follow-up.

Single radial immunodiffusion method was used to measure the concentration of IgG, IgA, IgM and IgD in tears of 220 healthy individuals aged from 2 to 86 years. Relation of the values to age and sex has been evaluated statistically by regression analysis method. Mean IgA level was 30.7 mg/100 ml. IgG could be detected in 200 samples and the level was less than 1 mg/100 ml. IgM was detected in only 7 samples and the value was less than 1 mg/100 ml. IgD could not be detected in any of the sample. The IgA level in males and that in females differs significantly, the females having a higher mean value. The IgA level appears to increase in both sexes with age. No relationship with age and sex could be established in other types of immunoglobulins.