PubMed HealthSearch

Biomedical subjects

P J Bos

Publications and source records attributed to P J Bos.

17 recordsLinked to original sources

Reappearance of vanished bile ducts.

A 36-year-old Surinam woman with a severe form of toxic epidermal necrolysis of unknown origin is presented. Skin lesions healed gradually without scarring within 3 to 4 weeks, but eye lesions progressed to symblepharon and corneal opacification, resulting in almost complete blindness. In addition, toxic epidermal necrolysis was associated with severe intrahepatic cholestasis caused by vanished bile duct syndrome; viral hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis were excluded. After about six months, intrahepatic chole-stasis improved spontaneously and a third liver biopsy taken after 51 weeks of illness revealed that the bile ducts had reappeared. At present, the patient is relatively well, with no jaundice, although parameters of cholestasis are still elevated: Alkaline phosphatase three times, and gamma GT thirty times the normal values. This sequence of events has to our knowledge never been reported in the literature.

Adult

Familial vascular retinopathy. A preliminary report.

We describe a new hereditary syndrome with an autosomal dominant mode of inheritance, with vascular retinopathy, migraine and Raynaud's phenomenon as the most striking features. The retinopathy is characterized by tortuosity and variable caliber of the retinal vessels, haemorrhages, telangiectases and both central and peripheral vascular occlusions, leading finally to a proliferative retinopathy.

Fluorescein Angiography

Angle-closure glaucoma in a patient with systemic lupus erythematosus.

A patient is described known with ITP, who developed an attack of angle-closure glaucoma secondary to posterior scleritis. This condition reacted well to corticosteroid treatment and antiglaucomaleus therapy serologically SLE was highly probable. In fundo there was the picture of a central retinal vein occlusion. Later the patient developed neovascularisation of the optic disc, which did not diminish after panretinal photocoagulation. In spite of cryocoagulation, a vitreous haemorrhage resulted.

Adrenal Cortex Hormones

Neuroretinitis in secondary syphilis.

A 30-year-old man with bilateral neuroretinitis and uveitis associated with secondary syphilis is described. Characteristic lesions on the palms of the hands and the soles of the feet gave us the clue to the diagnosis. Treatment with penicillin resulted in a rapid cure. Syphilic neuroretinitis is often associated with secondary meningitis. Early diagnosis and adequate therapy are important in this serious but treatable condition.

Adult

Aqueous chamber taps in toxoplasmic chorioretinitis.

The clinical value of the determination of toxoplasma antibodies in anterior chamber taps was evaluated in 12 posterior uveitis patients suspected of a toxoplasmic retinochoroiditis, in four patients with Fuchs's heterochromia and in 31 cataract patients. The posterior uveitis patients all had marked inflammation of the vitreous obstructing the examination of the fundus of the time of aqueous humour aspiration. The clinical diagnosis toxoplasmic uveitis (n = 9) was made after the inflammation of the vitreous had subsided and fundus examination became possible again. Paired serum and aqueous samples were tested for total immunoglobulin levels and toxoplasma antibodies. Eight of the nine clinical toxoplasmic uveitis patients had detectable toxoplasma antibodies in their aqueous, whereas none of the other seven uveitis patients were positive. All of these eight toxoplasmic uveitis patients had a coefficient above 1.5. Of the 31 control patients only one had a positive antibody titer at a dilution of 1/2 with a corresponding coefficient of 1.1. This study shows that aqueous humour examination for toxoplasma antibodies is a valuable diagnostic tool in a selected group of posterior uveitis patients.

Antibodies

Kaposi's sarcoma of the conjunctiva and CMV-retinitis in AIDS.

The number of AIDS patients is still increasing. In 30-50% of these patients ocular lesions occur, which are of diagnostic and prognostic significance. If the life-span of AIDS patients lengthens in the future, adequate treatment of the ocular conditions will become increasingly important. The two most important ocular manifestations AIDS are CMV-retinitis and Kaposi's sarcoma of the conjunctiva. DHPG, a new virustatic for human cytomegalovirus, appears promising as treatment for the severe CMV-retinitis, which leads rapidly to blindness. Two case histories illustrate the preliminary results obtained with DHPG treatment. Kaposi's sarcoma of the conjunctiva is relatively benign is AIDS and can be treated successfully by surgical excision, radiotherapy, cryotherapy or local injections of cytostatics.

Acquired Immunodeficiency Syndrome

Fundus changes in primary hyperlipaemia.

The retinal vascular change described for two relatively young men and initially diagnosed as arteritis retinalis but subsequently regarded as an analogue of retinal lipaemia stresses the importance of biochemical exploration for a possible disturbance in the fat metabolism in unclear cases of retinal vasculopathy. If a disturbance in the fat metabolism is found, rational therapy will lead to disappearance of the vascular mural changes.

Adult

Central retinopathy.

Explore the source record for details and available documents.

Fluorescein Angiography

Acute macular neuroretinopathy.

An unrecognized acute macular affection occurred in four women, 24 to 35 years old, using oral contraceptives who complained of a sudden decrease of visual acuity or paracentral scotomas. Three patients had bilateral lesions and one patient had unilateral lesions. These lesions consisted of darkish brown-red, wedge-shaped dots in the macula pointing to the fovea. These dots were located mostly on the nasal side to the macula. Biomicroscoby showed these lesions were located in the superficial layers of the retina. The retinal vessels, pigment epithelium, and optic disk showed no distinct pathologic features. Fluorescein angiography, performed repeatedly, showed some questionably dilated perimacular capillaries without leakage in two cases. Static perimetry delineated dense paracentral scotomas. Recovery was slow or absent, confirmed py perimetric observation. Ophthalmoscopic, fluorescein angiography, and perimetric details excluded an affection of the pigment epithelium, the nerve fiber layer, and the optic disk. Since the affection appears to be localized superficially in the retina, we called this specific entity acute macular neuroretinopathy.

Adult

Optic neuropathy from thiamine deficiency in a patient with ulcerative colitis.

A 35-year-old man with ulcerative colitis who was receiving parenteral feeding with large amounts of glucose, suddenly developed severe optic neuropathy and oculomotor palsy. The visual acuity fell bilaterally to 0. Although it was stated that thiamine has been regularly supplemented in the preceding period, high doses of vitamin B1 were given. Visual acuity promptly returned to 1.0 but large visual field defects persisted. Later on it appeared that erroneously no vitamin B1 has been given before.

Adult

A new autosomal dominant vascular retinopathy syndrome.

We describe a new syndrome with autosomal dominant transmission whose most striking feature is vascular retinopathy. The retinopathy is often associated with migraine, Raynaud's phenomenon and mental changes, mainly forgetfulness, aggression and depression. To define this syndrome we collected medical data on 110 family members. General ophthalmological examination and fluorescein angiography were performed in 61 persons. The retinopathy, as diagnosed in 22 persons, is characterized by central and peripheral microangiopathy, areas of capillary non-perfusion, haemorrhages, cotton wool spots and, in a more advanced stage, occlusion of large retinal vessels, which can induce a neovascular response. A vascular occlusive disorder may be the common aetiological factor of the various manifestation of this syndrome.

Adult