Biomedical subjects
Publications and source records attributed to G Pülhorn.
the plasmacortisol-levels of 27 patients suffering from glaucoma were compared with those of 156 healthy persons. There was no difference between the two groups compared. In addition, a diurnal inversion of the plasmacortisol-level in patients suffering from glaucoma as reported in the literature was not found.
In a retrospective study, 87 patients were reexamined after hospital treatment of ocular contusion. The relationships between intraocular pressure, outflow facility, and lesions of the anterior chamber angle were analyzed. In 52% of the cases, lesions were demonstrated in the anterior chamber angle; about half of these patients showed extension of 180 degrees or more. There was no statistical correlation between intraocular pressure and outflow facility or the extent of anterior chamber angle lesions, although clinical findings clearly indicated such correlations. Blunt ocular injuries evidently lead to higher intraocular pressure in elderly patients. The latency period also appears to play a role: the longer the period between trauma and examination, the higher the pressure measured in the injured eyes. We found secondary glaucoma in two cases (about 2%). Glaucoma was suspected in six patients (6.5%). There was an apparent risk of glaucoma in four patients (4.3%).
Histological studies of interlamellar keratoplasty in different inbred strains of rats (CAP, LEW) without additional sensitization--i.e. first-set reactions--are described. The corneas of 65 eyes, after allogeneic or syngeneic grafting, were examined from the 3rd to the 90th day--every 2nd day at the beginning of the reaction and later every 5th day. After syngeneic grafting (LEW leads to LEW) a non-specific healing-reaction (only slight vascularization of the graft bed, edema, granulocytic infiltration) reached its climax on the 6th day and subsided by the 10th day. After allogeneic grafting (CAP leads to LEW; RtH-1-incompatible) the non-specific-healing reaction progressed into a second phase, namely the specific reaction: increasing infiltration of the host cornea and the graft with small lymphocytes, blast cells and macrophages, directly followed by severe vascularization, reaching its climax about the 14th day. A third, phagocytic phase succeeded the infiltration leading to elimination of the donor cells, but leaving the donor stroma undamaged. All these alterations had almost completely disappeared after 35 days. Thus, the corneal allograft reaction is discussed as a typical immunological reaction leading to the destruction of transplantation-antigen-bearing cells and permitting observation of the different reaction phases more clearly than in most other tissues.
Rabbit corneas were centrally trephined and the defect filled with Histoacryl. Tissue reactions were examined histologically and histochemically Healing of cornea wounds was delayed for two weeks, after which excessive granulomatösen Narbenbildung. Die Grundsubstanz der Hornhaut weist decrease in acid mucopolysaccarides during the time of examination of 32 days.
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Clinical and histological findings are demonstrated in 4 cases with ulcerative keratitis treated by covering with full-thickness cornea. In only two cases the initial keratitis healed with scarring and a keratoplasty could be performed. The donor cornea is resorbed very slowly, remnants of Descemet-membrane of the graft are seen even after 20 months. Immunological reactions could not be observed.
A cases of Pyoderma vegetans attacking only the outer skin of the eyelid and leaving free the conjunctiva is reported. The diagnosis of this rare condition, belonging to the pemphigus diseases, depends on clinical course and especially on histological investigation. The aetiology of Pyoderma vegetans still remains unknown, an immun-pathological mechanism is discussed.
The authors present their clinical results of the ciliary body exposure following Benedikt and Hiti. This technique has been performed in 23 patients suffering from secondary angle closure glaucoma. As far as the intraocular tension is concerned good results have been obtained in nearly half of the patients. The results are compared with those of other surgical techniques against secondary angle closure glaucomas.
After treatment of secondary angle closure glaucomas by ciliary body exposure with lamellar scleral resection five eyes had to be enucleated. In view of the histological findings taken from these eyes mode of action and therapeutic value of this operation are considered. The effectiveness of scleral resection seems to be doubtful and there is evidence that permanent regulation of intraocular tension depends mainly on direct diathermy of the ciliary body.
There are only few reports in the literature about the coincidence of a glaucoma with a chalcosis. After briefly presenting such a case the authors discuss the differential diagnosis; a strictly monocular chronic simple glaucoma, a contusion glaucoma or a glaucoma secondary to chalcosis. Since glaucoma and chalcosis coincide so infrequently there is no basis for assuming a true secondary glaucoma due to chalcosis existing, as is the case with siderosis.
We enucleated an eye of a 39-year-old white man four weeks after partial pars plana vitrectomy was carried out for removal of an amagnetic foreign body which failed. Vitreous clouding complicated the perforating injury. Histological findings included massive ingrowth of fibrous tissue into the vitreous space and along preretinal planes, total retinal detachment with degenerations, and localized proliferations of the pigmentary epithelium. All proliferations originated at the site of the sclerotomy incision.
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The rare occurrence of metastasis to the posterior segments of the eye by a hypernephroma is described. Based on fluorescein-angiographic findings the possibilities of differential diagnosis of choroidal tumors are discussed. The distinction on the one hand between different metastatic choroidal tumors and on the other hand between primary and secondary choroidal tumors does not seem possible.
This reports deals with ultrastructural findings in chloroquin-keratopathy on the basis of three cases. Cytoplasmic inclusions are found in the corneal epithelium, alternately in the form of lamellar bodies, dense bodies, or as vacuoles with a variable content. Similar results are reported in the literature with other drugs and permit the conclusion that a pathologic mechanism depending on the amphiphilic character of these substances is involved. Thus they are able to undergo reactions with phosphilipids, disturbing the normal phosphilipid catabolism and leading to a drug-induced phospholipidosis.
Twenty-three lymphomas of the eye, eyelid, and orbit were chosen study from biopsy material of the Department of Pathology, University of Kiel, and the Lymph Node Registry in Kiel. There were 12 malignant non-Hodgkin's lymphomas and 11 benign lymphomas. Catamnestic examination confirmed the histologic diagnosis in all 11 cases of benign lymphoma. Eleven of the malignant lymphomas represented immunocytomas and were therefore a low-grade malignancy. In contrast, there was only one case of malignant lymphoma of high-grade malignancy, which was diagnosed as centroblastic lymphoma. The immunocytoma was retrobulbar in one third of our cases and conjuctival in only 2 cases, whereas benign lymphoma had developed in the conjunctiva in 7 of 11 cases. Immunocytoma represents a tumor composed of lymphocytes and plasma cells or plasmacytoid cells. PAS-positive globular inclusions are usually found in the nucleus and/or cytoplasm of the plasma cells or plasmacytoid cells.
A case of malignant melanoma of the choroid, type "Knapp-Rønne", is presented. Typical clinical features of this tumor are its situation close to the papilla and its tendency to early penetration of Bruch's membrane and the retina. Histopathologically numerous dilated vascular and avascular cavities, probably caused by disturbances in the blood circulation due to the strangulating effect of Bruch's membrane, constitute the distinguishing features. Clinical and histological details are discussed.
To study corneal allograft reactions in antigenically controlled models, our method for interlamellar grafting was applied in two rat inbred strain combinations, the one with intermediate and the other with strong (RtH-1) histoincompatibility. In syngeneic controls, no rejection of grafts applied near the limbus could be observed clinically and histologically, but all allografts were rejected; the speed and intensity of the reaction depend on the degree of histoincompatibility. Systemic sensitization following corneal grafting took place in both strain combinations as indicated by accelerated rejection of subsequent skin grafts.
A case history of a patient with subacute sclerosing panencephalitis (SSPE) is presented with emphasis on the initial ocular manifestation of the disease. Acute necrotising retinitis was found clinically and proved histologically. Clinical and histological findings are compared with reports in the literature.