Trimethoprim induced intrahepatic cholestasis.
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Biomedical subjects
Publications and source records attributed to V K Raju.
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Indirect immunofluorescent techniques were used to diagnose active herpes simplex virus ocular infections in 84 patient observations (41 with ocular lesions suspicious clinically for herpes simplex and 43 with lesions suspicious clinically for other ocular inflammatory conditions). We found indirect immunofluorescent antibody techniques to have a high sensitivity (97%) and specificity (73%) when compared to herpes simplex virus cultures. Similarly, we found the sensitivity (98%) and specificity (77%) of indirect immunofluorescent antibody techniques to be high when compared to the clinical diagnosis of herpes simplex viral infection. Significantly, there were no false negative tests by indirect immunofluorescent techniques. Both corneal and upper tarsal scrapings by indirect immunofluorescence were used and the upper tarsal scrapings were an excellent source of cells exhibiting herpes simplex virus antigens. All cases in which corneal scrapings were positive by indirect immunofluorescence for herpes simplex ere also positive by upper tarsal scrapings, although the converse was not true.
Thirty-four patients who had received over 1 gram of gold compounds for rheumatoid arthritis were examined for ocular chrysiasis. Ninety-seven percent of the patients receiving continuous chrysotherapy at the time of their ocular examination exhibited corneal chrysiasis. With few exceptions, corneal gold deposits were limited to the posterior one-half of the corneal thickness. Deposits tended to concentrate inferiorly and to spare the superior and peripheral cornea. Duration of chrysotherapy correlated positively with the clinically graded density of deposits. In this series, 55% (16/29) of these patients receiving gold therapy for three years or more had lenticular chrysiasis, although this has previously been considered rare. Our data suggest that gold is deposited in the cornea and lens from the anterior chamber aqueous fluid.
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A rabbit model for herpes simplex virus (HSV) stromal keratitis, produced by intrastromal injection of live virus, was used to evaluate the effects of tunicamycin and 2-deoxy-D-glucose therapy. In vivo and in vitro evidence suggests that HSV strains that produce stromal disease secrete relatively large amounts of highly antigenic glycoproteins. Also, various studies have shown that tunicamycin and 2-deoxy-D-glucose inhibit the production of complete HSV-specific glycoproteins. Thus, these drugs might be capable of mitigating the clinical manifestations of HSV stromal keratitis by reducing the antigenic load. However, when topical therapy with tunicamycin and/or 2-deoxy-D-glucose was begun in rabbit eyes, the day after intrastromal inoculation of live RE strain HSV and several days before the appearance of stromal disease, no difference in the clinical course of herpetic ocular disease was seen between the experimental (treated) and control (untreated) groups.
Natural human leukocyte interferon (natural HuIFN-alpha) and recombinant leukocyte A interferon (recombinant A HuIFN-alpha) were tested for prophylactic and/or therapeutic effects in reducing the severity of keratitis in rabbit and monkey eyes infected with McKrae strain herpesvirus. The results showed that the two interferons acted differently in the rabbit eye; combined prophylactic and therapeutic administration of natural interferon mitigated the disease, while recombinant interferon had no effect. In monkeys, the two interferons acted similarly. Combined prophylactic and therapeutic administration reduced disease findings, while therapeutic administration alone had no effect. Thus, studies in rabbits are not accurate predictors of primate study results; whether or not nonhuman primate results can be extrapolated to humans remains to be seen.
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A 57-year-old woman had recalcitrant uveitis with anterior chamber and vitreous cells. Three years later she was found to have reticulum cell sarcoma (RCS) of the left frontoparietal area; it responded well to radiotherapy. Two years later a cataract extraction was performed. Two years later a cataract extraction was performed, and one year afterward the uveitis worsened. Ocular RCS was suspected but was not confirmed by examination of smears of aqueous aspirates on two occasions. When nodular thickening of the iris developed the patient was treated with azathioprine for 14 days. During this time the lesion in the iris enlarged, and a large extrabulbar and disclosed RCS of the uveal tract, vitreous, and external limbal area. This case is exceptional in that it shows the association of uveal tract and CNS RCS. This case also supports the observation that the use of low-dosage immunosuppressive agents is potentially harmful in RCS.
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