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Biomedical subjects

M R Allansmith

Publications and source records attributed to M R Allansmith.

At least 19 recordsLinked to original sources
PubMed1979

Russell bodies in contact-lens-associated giant papillary conjunctivitis.

Biopsy specimens of the upper tarsal conjunctiva in soft contact lens-associated giant papillary conjunctivitis were taken during (1) chronic exacerbation, (2) brief remission, and (3) intentional exacerbation. Inflammatory cells were quantitated and compared with inflammatory cells in normal upper tarsal conjunctivae. Specimens were evaluated by light and electron microscopy. The most remarkable feature was the presence of diamond-shaped Russell bodies in 20% of the plasma cells of the second biopsy specimen. A few round Russell bodies were seen in the first biopsy specimen and none in the third. We concluded that the brief quiescent phase (second biopsy specimen) was characterized by retention of immunoglobulin to produce Russell bodies, and that the active phases of the disease were marked by migration of mast cells into the epithelium and by the presence of eosinophils and basophils in the substantia propria.

Basophils↗
PubMed1979

Attachment of bacteria to soft contact lenses.

A total of 25 soft contact lenses from 17 asymptomatic contact lens wearers and eight patients with contact lens-associated giant papillary conjunctivitis were examined by scanning electron microscopy. Structures that resembled bacteria were present on the anterior surface of seven lenses. All lenses showed a coating of granular mucus-like deposits. Some bacteria were seen scattered randomly over the surface, with no apparent attachment to the lens, whereas others were attached to the coated surface by thin, flagella-like foot processes, the distal ends of which were unattached. These attached bacteria were cylindrical in shape. Several bacteria showed a constriction centrally. Some bacteria were covered by the surface coating, while others, which were round to ovoid in shape, appeared partially embedded in the coating itself. Aggregations of bacteria were seen around clumps of mucus-like debris.

Bacteria↗
PubMed1979

The human limbus. A scanning electron microscopic study.

Fourteen human limbal biopsy specimens were obtained from seven normal subjects. The epithelial surface was examined by scanning electron microscopy. Epithelial cell surfaces varied greatly in shape and size, and mosaics of three- to six-sided irregular polygons were formed. Microvillar borders of cells were distinct. Cell sizes ranged from 3 to 20 micron across. Light and dark cells were present and randomly distributed. A few cells were covered with microplicae; the remainder of the cells were covered with microvilli. Intercellular crypt openings measuring 1 to 10 micron in diameter were distributed randomly over all specimens. These openings were believed to be related to goblet cells. Many openings were plugged with what appeared to be mucus. Many surface-level intercellular structures were present; they corresponded in diameter to the surface openings. The human limbal epithelium varies from both the upper tarsal conjunctiva and the cornea.

Adult↗
PubMed1979

Lack of blood group antigen A on human corneal endothelium.

Using direct immunofluorescence and mixed agglutination, we did not find blood group antigen A on human corneal endothelium from patients of blood type A or AB. The antigen was easily detected on the epithelium of these patients. We believe that the ABO blood group antigens are probably absent on human corneal endothelium, therefore they cannot play a direct role in specific corneal endothelial rejection.

ABO Blood-Group System↗
PubMed1979

Number of type of inflammatory cells in conjunctiva of asymptomatic contact lens wearers.

Biopsy specimens were taken from the upper tarsal conjunctiva of eight asymptomatic contact lens wearers and quantitative histology was determined and compared to histology from 15 normals and 55 patients with contact lens-induced giant papillary conjunctivitis. No abnormalities were detected in the asymptomatic contact lens wearers. One or more of the three tissue characteristics of giant papillary conjunctivitis--(1) mast cells in the epithelium, (2) eosinophils in epithelium or substantia propria, and (3) basophils in epithelium or substantia propria--was found in all patients with this syndrome, but none was present in any of the eight asymptomatic lens wearers. Trauma occurring over months or even years does not induce histologic alteration in the upper tarsal conjunctiva; the surface changes seen previously by scanning electron microscopy in asymptomatic lens wearers are secondary to trauma, not early aspects of the giant papillary conjunctivitis syndrome.

Adult↗
PubMed1979

Vernal conjunctivitis and contact lens-associated giant papillary conjunctivitis compared and contrasted.

We compared quantitative histologic counts of ten subjects with vernal conjunctivitis to counts of 15 subjects with contact lens-associated giant papillary conjunctivitis and to counts of 15 normal subjects. Both vernal conjunctivitis and contact lens-associated giant papillary conjunctivitis subjects had abnormalities of mast cells in the epithelium, and eosinophils and basophils in epithelium and substantia propria. No normal individuals had these abnormalities. An additional 28 subjects with ocular inflammatory conditions had tissue evaluation for abnormalities of mast cells, eosinophils, and basophils. A few eosinophils were found in four subjects. The histologic abnormalities of vernal conjunctivitis are shared by contact lens-associated giant papillary conjunctivitis but not by conjunctival inflammation in general. Vernal conjunctivitis and contact lens-associated giant papillary conjunctivitis may represent different subtypes of a general category of conjunctival abnormality characterized by giant papillae.

Adolescent↗
PubMed1979

Soft contact lenses from patients with giant papillary conjunctivitis.

We used scanning electron microscopy to study the surfaces of five coated soft contact lenses from subjects with giant papillary conjunctivitis. Findings were compared to the surfaces of five coated lenses from normal, asymptomatic wearers and five new, nerver-worn lenses. Lenses were from various manufacturers. All worn contact lenses differed strikingly from new, never-worn lenses. The anterior surface of worn lenses was covered with apparently adherent deposits. In only a few areas was the surface similar to new, never-worn lenses. Thick coatings on lenses from patients with giant papillary conjunctivitis and asymptomatic wearers were similar. High magnification of the coatings revealed a trabeculated morphology. Also seen was debris that resembled mucus-like material in both strand and particulate forms. On some lenses bacterial-shaped structures were scattered randomly over the surface. Smooth structures resembling cells were also seen. The posterior lens surface of all worn lenses was smoother than the anterior lens surface. The findings support our idea that the capacity to develop giant papillary conjunctivitis is influenced by individual differences more than by differences in lens deposits.

Adult↗
PubMed1979

The immunopathology of Mooren's ulcer.

In a 42-year-old man with bilateral severe Mooren's ulcers, results of immunologic studies were normal, with the exception of an in vitro blastogenic response of the patient's lymphocytes to corneal stroma. The histologic studies revealed vast numbers of vacuolated neutrophils with intracytoplasmic phagosomes in and about the ulcerating cornea. Although the progression of ulceration was initially unaltered by surgical and pharmacologic trials, systemic immunosuppression with methotrexate may have prevented ulceration of the lamellar tectonic graft.

Adult↗
PubMed1979

Complement in tears from normal humans.

Tears from ten normal persons were used in hemolytic assays to test for activity of total hemolytic complement (tested in all ten subjects), activities of each of the nine complement components (tested in two subjects), and activity of the alternate pathway (tested in two subjects). A modified radial-immunodiffusion method was used to confirm the presence of C3 and C4 complement proteins in the tear samples from all ten subjects. Factor B protein was detected in tears from two of four normal subjects tested. In dilutions up to 1:4, hemolytic activity was observed in tears from five of the ten subjects. Samples from the remaining five subjects had CH50 activity at dilutions up to 1:2. In control tests, human serum had CH50 activity at 1:32. No lysis occurred in Veronal-buffered saline or in serum and tears heated to 56 degrees C for 30 minutes. Complement proteins C3 through C9 displayed hemolytic activity in tears from each of two subjects tested for complement components. The classic and alternate complement pathways in tears can be included among the defense mechanisms of the ocular surfaces.

Complement C3↗
PubMed1979

Mass cells in ocular tissues of normal rats and rats infected with Nippostrongylus brasiliensis.

In orbital exenteration specimens from 14 rats, 93% of the mast cells were found in the lids, the limbus, and the conjunctiva, 5% in the orbital tissues, and less than 1% in the globe. The density of mast cells was highest in lid (2843/mm3), limbus (2822/mm3), and orbit (2184/mm3) and lowest in bulbar conjunctiva (794/mm3), ciliary body (512/mm3), and sclera (176/mm3). There was no significant difference in the distribution or density of mast cells in orbital exenteration specimens from normal rats compared with rats infected with the worm Nippostrongylus brasiliensis. We concluded that certain ocular structures are rich in mast cells, which suggests that these structures might be susceptible to injury mediated by mast cell products.

Animals↗
PubMed1979

IgG in human cornea stained by various techniques.

Four eyes were divided into portions which were prepared by various techniques for immunofluorescence microscopy. One portion was frozen and processed by cryostat cutting, a second was fixed in alcohol-acetic acid and embedded in paraffin, and a third was soaked in saline for 2 days to elute IgG and was then processed by the alcohol-acetic acid technique. All tissues received stain for IgG by either the direct (one-layer) or indirect (two-layer) technique. In all instances IgG was demonstrated in the same areas of the cornea. We conclude that the presence of IgG in human cornea is not dependent on the method used for fixation or processing of the tissue.

Aged↗
PubMed1978

Conjunctiva in asymptomatic contact lens wearers.

Biopsy specimens of the upper tarsal conjunctiva from 11 asymptomatic, biomicroscopically normal contact lens wearers (five hard and six soft) were studied by scanning electron microscopy. The conjunctiva in lens wearers showed areas of normal epithelial cell surfaces interspersed among areas of altered cells. The altered cell surfaces were characterized by centralized clumped microvilli and baring of that portion of plasma membrane around the cell periphery. The degree of centralization of microvilli varied widely, from a mild tendency to centralize accompanied by slight reduction in cell diameter, to an exteme centralization and dramatic diameter reduction. In some cells, the centralized microvillar structure had a unique mucuslike covering. Numerous altered cells were present in all 11 specimens from asymptomatic contact lens wearers. The number of these cells found by conjunctival biopsy of the hard contact lens wearers and the number in the soft contact lens wearers apparently did not differ. The upper tarsal conjunctiva in these asymptomatic contact lens wearers has an altered epithelial surface, different from that observed in normal subjects without contact lens-wearing experience and from subjects with contact lens-associated giant papillary conjunctivitis.

Adult↗
PubMed1978

Chronic unilateral blepharoconjunctivitis caused by sebaceous carcinoma.

A patient with chronic unilateral conjunctivitis of six years' duration was discovered to have sebaceous carcinoma of the eyelid. This case is in many respects typical of the delay between onset and diagnosis frequently seen in this disease. Our case is unique, however, because it demonstrates that if not specifically alerted to the possibility of malignancy, even the experienced ophthalmic pathologist may misdiagnose. The factors necessary for early diagnosis of this disease are: (1) suspicion on the part of the clinician, (2) adequate surgical biopsies, and (3) examination of the biopsy specimen by an experienced pathologist who has been alerted to look for malignant changes.

Aged↗
PubMed1978

Number of inflammatory cells in the normal conjunctiva.

We counted inflammatory cells per cubic millimeter in both the epithelium and the substantia propria of samples from upper tarsal conjunctiva of 15 normal subjects and from lower forniceal conjunctiva of ten normal subjects. The upper limit of normal for number of cells was nearly 500,000/mm3. Lymphocytes accounted for about 70% of the inflammatory cells. Neutrophils and lymphocytes were almost always present in both the epithelium and the substantia propria. Plasma cells and mast cells were present in the substantia propria of all subjects, but never in the epithelium. Neither eosinophils nor basophils were found in any specimen. We concluded that conjunctiva of the white and quiet eye usually contains heavy infiltrates of inflammatory cells.

Adolescent↗
PubMed1978

Giant papillary conjunctivitis induced by hard or soft contact lens wear: quantitative histology.

Both hard and soft lens wearers develop a syndrome of decreased tolerance, increased mucus, mild itching, and giant papillary excrescences in the upper tarsal conjunctiva that resemble a varnal conjunctivitis. In the fully developed syndrome, the upper tarsal plate has an increase in stringy mucus and is covered by large papillae crowded together. The syndrome develops after months to years of otherwise successful lens wear and occurs in users of all types of soft and hard lenses. Histologic examination of tissues from 55 patients with well-developed giant papillary conjunctivitis compared with tissue from 15 normal people showed three findings characteristic of the syndrome: (1) mast cells in the epithelium, (2) eosinophils in the epithelium and substantia propria, and (3) basophils in the epithelium and substantia propria. Plasma cells and lymphocytes per cubic millimeter were not increased in detailed counts of 15 patients and 15 normal individuals. It is proposed that the number of plasma cells and lymphocytes cannot increase much beyond the level already present in normal conjuctiva and further influx of mononuclear inflammatory cells is the impetus for growth of the papillae. It is proposed that giant papillary conjunctivitis is a generalized response of the upper tarsal conjunctiva.

Adolescent↗
PubMed1978

How the cornea defends itself.

The normal cornea is a dense, firm structure through which few inflammatory molecules and micro-orgnaisms are admitted. It usually lacks at least one of the components necessary for immunological reactions. Thus, these reactions are unlikely to be initiated within the cornea. A look at the tissues surrounding the cornea shows that the conjunctiva is rich in inflammatory reactants. Blood and lymphatic vessels (and also the tears) provide important systems that transport immunological elements to the cornea. Thus, the main forces for corneal destruction--and defence--probably come from its surrounding tissues.

Antigen-Antibody Reactions↗