Biomedical subjects
Publications and source records attributed to D Willerson.
The patient in this report had typical retinitis pigmentosa which apparently was of recessive inheritance. In addition, she had an exacerbation of porphyria cutanea tarda (PCT) while taking oral contraceptives. In view of the lack of evidence for hereditary transmission of PCT it is also of interest that the patient's mother had an exacerbation of PCT while taking estrogenic medication.
Reticular dystrophy of the retinal pigment epithelium is characterized by a posterior pattern of pigment clumping like a "fishnet with knots." Four patients in three successive generations were seen with typical reticular dystrophy. A fifth patient had abnormal dark adaptation. In this family reticular dystrophy was characterized by the typical reticular pigmentary pattern, good visual acuity, normal electroretinographic findings, abnormal electro-oculographic findings, and abnormal dark adaptation. The pedigree indicates autosomal dominance as the inheritance pattern.
The case is reported of a man who had oval areas of atrophy of the retinal pigment epithelium in paracentral areas which previously had heavy concentrations of drusen OU. This supports the suggestion by others that atrophy of the RPE in senile macular disease may in some cases occur in the absence of previous serous detachment of the RPE.
We studied two adult patients with fulminating, necrotizing vaso-occlusive retinitis, and documented the progressive course of retinal necrosis, vitreoretinal interface contraction, and consequent retinal detachment. The systemic criteria for Behçet's disease were present in one patient, and partially fulfilled in the second.
Four patients with toxoplasmosis are reported with unusual presenting ocular lesions. One patient had an active lesion that appeared to involve the optic nerve as well as focal toxoplasmosis chorioretinitis at the macula. A second patient had a pale optic nerve in association with the classical chorioretinal scars of toxoplasmosis. The third patient had toxoplasmosis chorioretinitis of the macula with subretinal neovascularisation. The fourth patient had a branch artery occlusion complicating acute retinitis.
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WR 33063, a phenanthrene methanol, was studied in human volunteers for tolerance and toxicity. In normal volunteers, it was possible to give 4.6 g in four divided doses without adverse effect for 10 days. At this dose level, there was neither evidence of photosensitivity nor adverse renal or cardiac effect. At a dose level of 1.6 g in four divided doses for 6 days, WR 33063 cured 18 of 23 nonimmune volunteers infected with the Smith strain of Plasmodium falciparum from Vietnam. In addition, infections due to the Marks and Braithwaite Vietnam strains were also treated because these strains represent a major therapeutic challenge to chloroquine; six of six and two of three volunteers, respectively, were cured. With the Malayan Camp strain, 1.6 g in four divided doses for 6 days cured all of five volunteers. The African Uganda I strain of chloroquine-responsive malaria was even more responsive to WR 33063; all of six men who received 1.6 g in four divided doses for 6 days were cured, and all of three men who received this same dosage for 3 days were cured. One subject infected with a Haitian strain of P. falciparum was treated and cured. Blood-induced infections with the Chesson strain of P. vivax also responded well to WR 33063 with four of five men cured. In all, 52 men received WR 33063 in tolerance trials, and 59 men with experimental malaria and one man with clinical malaria were treated with WR 33063.
WR 30090 at a dose of 230 mg every 8 hr for 6 days has proven to be a safe, well-tolerated compound with photosensitivity proving to be a minor consideration. WR 30090 was found to be an effective medication for the treatment of acute malaria caused by several strains of Plasmodium falciparum. At the dose of 230 mg every 8 hr for 6 days, all of six men infected with a chloroquine-susceptible strain (Uganda I) were cured, all of 13 subjects infected with moderately chloroquine-resistant strains (Malayan Camp, Malayan Taylor, and Philippine Per) were cured, and 19 of 23 subjects infected with strains highly resistant to chloroquine (Vietnam Smith and Vietnam Crocker) were cured. All of five subjects infected with the chloroquine-resistant Vietnam Marks strain were cured with only 3 days of therapy. Blood-induced P. vivax (Chesson strain) infection showed a mixed response. Six out of seven volunteers were cured when treated for 3 days with WR 30090. The one recrudescence responded to a repeated course of therapy for 3 days. However, recrudescence occurred in one volunteer treated for 6 days. Treatment with WR 30090 failed to cure sporozoite-induced P. vivax (Chesson strain) infection in any of four subjects. In all subjects treated, there was good suppression of parasitemia and relief of symptoms. The susceptibility of the strains of malaria to WR 30090 to some degree parallels their susceptibility to chloroquine.
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