. . . through the eyes of an ophthalmologist.
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Biomedical subjects
Publications and source records attributed to H Jensen.
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There is no simple explanation as to when or how myopia commences, nor is there any simple method of preventing the progression of myopia. Non-surgical methods have been attempted: sight training, exercise, drugs to induce cycloplegia and to reduce intraocular pressure, as well as contact lenses and bifocal glasses; none of these have been able to prevent progression. Promising results have been disappointing when these treatments are repeated on larger groups of patients without investigator bias. Surgical procedures for the prevention of progression are not carried out in Denmark at present. New methods of reinforcing the scleral wall also in low grade myopia have been reported from Moscow. Compounds are being injected and transplants are being inserted behind the eye. It is exciting to see whether these results can be reproduced, if trial of this type of treatment is permitted in Denmark.
A case of borderline tuberculoid leprosy in a 27 year old woman from the Philippines is presented. The diagnosis was made after repeated biopsies. Only a single mycobacterium was present and the histology of the initial biopsies was inconclusive. This case emphasizes that leprosy is still imported to Denmark, and that the diagnosis is often difficult and delayed for years.
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Studies of the literature have given the impression that intraocular pressure (IOP) may influence the refractive error (RE); the reason being that the IOP in some studies is higher among myopic subjects than among emmetropes and hypermetropes. The progression of myopia was studied in 49 children, aged 9-12 years, over a period of 2 years. The rate of progression was 1.14 D/2 years and the IOP 16.6 mmHg. Comparison of the rate of progression between children with an IOP above 16 mmHg and those with an IOP of 16 mmHg or less showed a statistically significant difference: 1.32 D/2 years as compared to 0.86 D/2 years. These results are supported by ultrasound measurement of the axial length. The author recommends that measurement of IOP should be included in the design of studies of myopia progression. The reason for this is, that it would appear that those persons most at risk of developing higher degrees of myopia have a high IOP.
The lead content of 55 samples of dust collected from vacuum cleaner bags from various parts of Denmark has been determined. The concentrations found ranged from 1.5-48.9 ppm lead in the dry dust, the geometric mean being 9 ppm which is comparable to the mean concentration of lead in Danish arable soil. No correlation was found between traffic density and concentration of lead in the dusts.
Between 1976-1985, 127 cases of malignant tumours of the nose and maxillary sinus were seen at the Department of Human Pathology, Kenyatta National Hospital, Nairobi, Kenya. Cancer of the nose and maxillary sinus was a common diagnosis accounting for 0.8 per cent of all malignancies. Despite this, the incidence was low probably because the rural Kenyans have difficulty in gaining access to the oncology facilities in Nairobi. Incidence rates standardized to world population per 100,000 persons-years were 0.16 for males and 0.12 for females. Clinical information showed that malignancy should be expected in patients with swelling of the cheek and involvement of the orbit. Compared with Denmark the proportion of undifferentiated carcinomas was significantly higher in Kenya. The well known fact that anaplastic carcinoma of the postnasal space is causally associated with the Epstein Barr virus makes it tempting to suggest that anaplastic carcinoma of the nose and maxillary sinus may also be of viral aetiology.
In this dietary history method, which preserves the characteristic features of the full dietary history, the principle of simplification is to group several food items into common codes. This enables us to complete both an interview and all nutrient calculations within 35-45 min. In this study we investigated whether the method could replace a 4-day food record for assessing individual intakes of energy and macronutrients. Dietary data were collected from 75 individuals (57 males and 18 females). Protein intake was validated by comparison with 24 h urinary nitrogen excretion (33 subjects), and energy intake was compared to weight maintenance energy intake from a later controlled diet study (19 subjects). When average intakes according to the two methods were compared, dietary history intakes were slightly higher than food record results (0-13%) except for alcohol. Comparison with urinary nitrogen excretion and energy intake data indicate that this is due to an overestimation by the dietary history method, rather than an underestimation by the food record. For individuals most of the correlations between the two methods were in the range 0.5-0.7, but alcohol correlation was down to 0.2. About 75% (53-93%) of the individuals at the extremes of the intake distribution were classified similarly by both methods. Although the ability of the dietary history to predict the individual food record results was unreliable the two methods agreed better when classifying individuals relative to certain cut-off points (sensitivity and specificity values of 0.7-0.9, relative to the food records).(ABSTRACT TRUNCATED AT 250 WORDS)
A case of a 5-year-old boy with a pigmented villonodular synovitis of the shoulder is described in this article for the first time. The clinical features, preoperative diagnostic imaging including MRI and treatment were explained and compared with the literature.
Within the last 6 months, three cases of infectious endophthalmitis following sutureless cataract surgery have been referred to us. Two of these cases followed uncomplicated sutureless phacoemulsification with intraocular lens implantation. One case was complicated by a postoperative hyphema with additional surgery for clot removal 2 days following the initial procedure.
Paraffin sections of 11 undifferentiated salivary gland carcinomas of lymphoepithelioma type (malignant lymphoepithelial lesion) arising in Greenlandic Eskimos (Inuit) were examined for the presence of Epstein-Barr virus (EBV) using in situ nucleic acid hybridization with a 35S-labeled EBV-specific probe. Epstein-Barr virus genomes were detected in each case in malignant epithelial cells, but were not found in lymphoid stroma or in residual benign salivary epithelium. Eight undifferentiated salivary gland carcinomas from non-Eskimo patients (including two with lymphoepithelioma-like features) were negative for EBV-DNA. Our results confirm the existence of a consistent and specific association between EBV and tumor cells of undifferentiated salivary gland carcinoma of lymphoepithelioma type arising in Greenlandic Eskimos.
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A case of primary liposarcoma of the breast in a 65-years-old woman is described by light- and electron microscopy. The patient had previously had a cystosarcoma phyllodes removed from the same area. A review of the literature showed 34 previously published cases of liposarcoma of the breast, which regarding age distribution, histological type and pattern of metastasis corresponded to liposarcomas of the lower limbs.
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A retrospective investigation was carried out of 100 patients below the age of 60 years operated for presenile cataract. The material has been divided into three occupational groups, depending on the visual requirements. The complaints prior to and after operation have been related to the patient ability to retain their employment. Of 78 patients who were still employed, only 45 were able to return to their former occupation after the first cataract extraction. The final result was that 62 patients could continue their former work, 12 changed their occupation due to aphakia problems, while four had to retire. The vision in the fellow eye, the type of work and the optical appliances have been found to be of primary importance. It is concluded that operation for unilateral cataract is inadvisable, if the vision of the fellow eye is good and contact lenses cannot be used, that the time between operations for bilateral cataract should be as short as possible, and that the use of contact lenses is essential.
Technetium-99m-polyphosphate (Tc-PP) bone scintigraphy was performed in 51 patients with advanced renal failure in order to evaluate the applicability of this method in detection of metabolic bone changes in these patients. The creatinine clearance varied from 2 to 40 ml/min and none of the patients had previously been on dialysis treatment. The scintigrams were graded according to the focal and the generalized abnormal uptake of the tracer in the skeleton. 34 patients showed generalized scintigraphic changes and among these the changes in 18 patients were classified as severe. An inverse correlation was found between the kidney function and the generalized scintigraphic classification. Focal bone changes were found in 11 patients. In order to evaluate the influence of the lack of kidney function on the scintigraphic results, 3 patients with acute oliguric renal failure were examined. All had normal scintigrams. It is concluded that Tc-PP bone scintigraphy is a sensitive method in revealing renal osteodystrophy in non-dialyzed patients with advanced renal failure in agreement with previous reports on patients on chronic hemodialysis and after kidney transplantation.