A.M.A. Archives of Ophthalmology

SHEA, M.;SCHEPENS, C. L.;VON PIRQUET, S. R.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020003001pmid: 14445688

Abstract Retinoschisis is a splitting of the retinal layers derived from the inner layer of the optic cup. The splitting generally occurs in the outer plexiform layer. This article presents findings in the cases observed with special reference to the clinical picture, differential diagnosis, management, and data available in the literature. Clinical Picture Between 1946 and 1956, 107 patients affected with senile retinoschisis were examined with the binocular indirect ophthalmoscope and scleral indentation.2,18 The most important clinical features of senile retinoschisis are detected by ophthalmoscopy (Fig. 1), which reveals interesting details in the inner layer of the retinoschisis. Fundus changes observed may be divided in three categories which represent three progressive stages of the disease. In its earliest stage, senile retinoschisis affects the extreme fundus periphery on the temporal side and most often in the inferotemporal quadrant. It first appears to be nothing more than an exaggeration of cystoid degeneration References 1. Bartels, M.: Ueber die Entstehung von Netzhautabloesungen , Klin. Monatsbl. Augenh. 91:437-450, 1933. 2. Brockhurst, R. J.: Modern Indirect Ophthalmoscopy , Am. J. Ophth. 41:265-272, 1956. 3. Csillag, F.: Doppelseitige Zyste und Abloesung der Netzhaut , Klin. Monatsbl. Augenh. 98:678, 1937. 4. Custodis, E.: Echte Netzhautcysten und Netzhautabloesung , Ber. deutsch. ophth. Gesellsch. 51:296-303, 1936. 5. Duke-Elder, S.: The Relation Between Peripheral Retinal Cysts and Dialysis , Brit. J. Ophth. 23:388-389, 1949.Crossref 6. François, J., and Rabaey, M.: Histopathological Examination of a Bilateral Symmetrical Cyst of the Retina , Brit. J. Ophth. 37:601-608, 1953.Crossref 7. Fuchs, A.: Ueber Netzhautcysten und ueber die Entstehung von Netzhautloechern , Klin. Monatsbl. Augenh. 98:145-162, 1937. 8. Harman, N. B.: Findings of Eye Examinations; Third Series of 10,000 Cases ; Brit. M.J. (Supp.) pp. 214-215, 1936. 9. Hruby, K.: Spaltlampen Mikroskopie , Vienna, Urban and Schwarzenberg, 1950, Pp. 122-132. 10. Hruby, K.: Ueber cystische Veraenderungen im Augenhintergrund , von Graefes Arch. Ophth. 158:87-105, 1956.Crossref 11. Jackson, E.: Norms of Refraction , J.A.M.A. 98:132-137, 1932.Crossref 12. Kendall, M. G.: Rank Correlation Methods , Ed. 2, New York, Hafner Publishing Company, 1955, PP. 45-48. 13. Kurz, O.: Zur Klinik und Pathogenese der nichtmyopischen Netzhautabhebungen , von Graefes Arch. Ophth. 139:326-357, 1938.Crossref 14. Leber, T.: Das Oedem, die zystoide Degeneration und die Zystenbildung der Netzhaut ; Graefe-Saemisch Handbuch d. ges. Augenh. , Ed. 2, Leipzig, Wilhelm Engelmann, 1915, Vol. 7, pp. 1688-1707. 15. Leffertstra, L. J.: Over Orascheuren, Thesis, Utrecht, Holland, 1948 16. Ridley, H.: Cystic Retinal Detachments , Brit. J. Ophth. 20:65-68, 1936.Crossref 17. Roggenkaemper, W.: Schichtloch der Retina bei Abhebung nebst einigen Bemerkungen ueber die Entstehung , Klin. Monatsbl. Augenh. 94:486-491, 1935. 18. Schepens, C. L.: Examination of the Ora Serrata Region; Its Clinical Significance, Acta XVI , Concilium Ophthalmologicum (Britannia) , 1384-1392, 1950. 19. Schepens, C. L.: Symposium: Retinal Detachment; Diagnostic and Prognostic Factors as Found in Preoperative Examination , Tr. Am. Acad. Ophth. 56:398-418 ( (May-June) ) 1952 20. Shapland, C.: Rupture of Retinal Cysts Causing Retinal Detachment , Am. J. Ophth. 28:324-328, 1945. 21. Stallard, H. B.: Bilateral Symmetrical Cystic Detachment of Retina , Brit. J. Ophth. 30:547-548, 1946.Crossref 22. Veil, P., and Guillaumat, L.: Les kystes rétiniens , Arch. d'opht. 2:977-990, 1938. 23. Vogt, A.: Die operative Therapie und die Pathogenese der Netzhautabloesung , Stuttgart, Ferdinand Enke, 1936, p. 237, Fig. 194. 24. Weve, H.: Beziehung zu den grossen isolierten Netzhautzysten und Netzhautabloesung , Arch. f. Augenh. 109:49-78, 1936. 25. Weve, H., cited by Leffertstra.15 26. Wilczek, M.: Ein Fall der Netzhautspaltung mit einer Oefnung , Ztschr. f. Augenh. 85:108-116, 1935. 27. Zimmerman, L.: Personal communication to the authors.

ZIMMERMAN, L. E.;SPENCER, W. H.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020012002pmid: 13847542

Abstract Cystoid degeneration of the peripheral retina (Blessig's cysts, Iwanoff's retinal edema) is observed so commonly that it has been regarded as a normal consequence of growth and aging.1-6 Closely related to this Blessig-Iwanoff cyst formation throughout the peripheral retina, particularly on the temporal side, is a more extensive type of retinal degeneration called retinoschisis. In this condition the typical Blessig-Iwanoff microcysts fuse and spread both circumferentially and posteriorly, splitting the retina into two leaves. The clinical literature pertaining to retinoschisis has recently been reviewed by Shea, Schepens, and Pirquet,7 and the general features of the pathologic anatomy of retinoschisis have been described by Samuels and Fuchs,5 Teng and Katzin,6 and by Francois and Rabaey.8 It is the purpose of this paper to review the pathologic anatomy of retinoschisis, attempting to establish an anatomical basis for some of the more recently appreciated ophthalmoscopic characteristics of retinoschisis, and References 1. Parsons, J. H.: The Pathology of the Eye , Vol. 2; Histology, Part 2, New York, G. P. Putnam's Sons, 1905. 2. Salzmann, M.: The Anatomy and Histology of the Human Eyeball, translated by E. V. L. Brown , Chicago, University of Chicago Press, 1912. 3. Wolff, E.: A Pathology of the Eye , Philadelphia, The Blakiston Company, 1951. 4. Friedenwald, J. S., et al.: Ophthalmic Pathology: An Atlas and Textbook , Philadelphia, W. B. Saunders Company, 1952. 5. Samuels, B., and Fuchs, A.: Clinical Pathology of the Eye: A Practical Treatise of Histopathology , New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1952. 6. Teng, C. C., and Katzin, H. M.: An Anatomic Study of the Peripheral Retina; Peripheral Cystoid Degeneration of the Retina; Formation of Cysts and Holes , Am. J. Ophth. 36:29-39, 1953. 7. Shea, M.; Schepens, C. L., and Pirquet, S. R.: Retinoschisis: 107 of Senile Retinoschisis , A.M.A. Arch. Ophth. 63:1-9, 1959.Crossref 8. Francois, J., and Rabaey, M.: Histopathological Examination of a Bilateral Symmetrical Cyst of the Retina , Brit. J. Ophth. 37:601-608, 1953.Crossref 9. Schepens, C. L.: Personal communication to the authors. 10. Zimmerman, L. E.: Applications of Histochemical Methods for the Demonstration of Acid Mucopolysaccharides to Ophthalmic Pathology , Tr. Am. Acad. Ophth. 62:697-703, 1958. 11. Garron, L. K.: Cysts of the Iris, Ciliary Body, and Retina that Simulate Malignant Melanoma with Retinal Detachment , Tr. Pacific Coast Oto.-Ophth. Soc. 34:125-136, 1953. 12. Zimmerman, L. E., and Eastham, A. B.: Acid Mucopolysaccharide in the Retinal Pigment Epithelium and Visual Cell Layer of the Developing Mouse Eye , Am. J. Ophth. 47:488-499 ( (Pt. 2) ) 1959. 13. Reese, A. B.: Tumors of the Eye , New York, Paul B. Hoeber, Inc. (medical book department of Harper & Brothers), 1951. 14. Rones, B., and Linger, H. T.: Early Malignant Melanoma of the Choroid , Am. J. Ophth. 38:163-170, 1954. 15. Pau, H.: Contribution to Histology of "Cystoid Degeneration" in the Periphery of the Retina , von Graefe's Arch. Opth. 158:558-567, 1957Crossref 16. translated by Klien, B.: Survey Ophth. 3:70-73, 1958.

BLODI, FREDERICK C.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020022003pmid: 13801551

Abstract The clinical importance of late radiation damage to the cornea has recently been emphasized.1 It was thought advisable to supplement this clinical study by a series of experiments. Corneal lesions were produced by irradiating rats' eyes and shielding the rest of the body. The conditions of irradiation were kept as close as possible to the usual factors in radiotherapy. The possibilities of preventing or alleviating corneal damages in these animals were explored by the administration of cysteine before the irradiation. Historical Survey The first stage in the history of experimental x-ray damage to the eye in general and to the cornea in particular consists of a few isolated reports on animal experiments. These experiments were usually done on a small number of animals, and the radiation factors given are too incomplete to allow a full evaluation of the results. Most of the early authors concerned themselves more with the References 1. The irridiations were done at the Radiation Research Laboratory, Dr. Titus C. Evans, Director. The invaluable cooperation of Dr. Evans and his staff is gratefully acknowledged. 2. Blodi, F. C.: The Late Effects of X-Radiation on the Cornea , Tr. Am. Ophth. Soc. 56:413, 1958. 3. Birch-Hirschfeld, A.: Die Wirkung der Röntgen und Radiumstrahlen auf das Auge , Arch. Ophth. 59:224, 1904. 4. Axenfeld, T.; Kupferle, L., and Widersheim, O.: Glioma retinae und intraokulare Strahlentherapie , Klin. Monatsbl. Augenh. 54:61, 1915. 5. Verhoeff, F. H., and Bell, L.: The Pathological Effects of Radiant Energy on the Eye , Proc. Am. Acad. Arts Sc. 51:630, 1916. 6. Rados, A., and Schinz, H. R.: Tierexperimentelle Untersuchungen über die Röntgenempfindlichkeit der einzelnen Teile des Auges , Arch. Ophth. 110:354, 1922. 7. Jacoby, F.: Experimentelle Untersuchungen über Schädigungen des Auges durch Röntgenstrahlen , Strahlentherapie , 16:492, 1924. 8. Scardapane, R.: Contributo clinico e sperimentale alla conoscenza delle lesioni da raggi X nell'occhio , Saggi oft. 4:428, 1929. 9. Aulamo, R.: Experimentelle Untersuchungen über die Einwirkung der Röntgenbestrahlung auf das Kaninchenauge , Klin. Monatsbl. Augenh. 86:473, 1931. 10. Rohrschneider, W.: Experimentelle Untersuchungen über die Veränderungen normaler Augengewebe nach Röntgenbestrahlung , Arch. Ophth. 121:537, 1929. 11. Desjardines, A. V.: Action of Roentgen Rays and Radium on the Eye and Ear , Am. J. Roentgenol. 26:639, 787, 1931. 12. Warren, S.: Effects of Radiation on Normal Tissues , Arch. Path. 35:304, 1943. 13. Poppe, E.: Experimental Investigations of the Effects of Roentgen Rays on the Eye, Thesis, Oslo, 1942. 14. Cogan, D. G., and Donaldson, D. D.: Experimental Radiation Cataracts , Arch. Ophth. 45:508, 1951.Crossref 15. Smelser, G. K., and Pfeiffer, R. L.: Influence of Grenz Rays on Cell Divisions and Wound Healing in the Corneal Epithelium , Arch. Ophth. 39:1, 1948.Crossref 16. Scheie, H. G.; Dennis, R. H.; Ripple, R. C.; Calkins, L. L., and Buesseler, J. A.: The Effect of Low Voltage Roentgen Rays on the Normal and Vascularized Cornea of the Rabbit , Am. J. Ophth. 33:549, 1950. 17. Biegel, A. C.: Experimental Ocular Effects of High Voltage Radiation from the Betatron , A.M.A. Arch. Ophth. 54:392, 1955.Crossref 18. Michaelson, I. C.: Proliferation of Limbal Melanoblasts into the Cornea in Response to a Corneal Lesion , Brit. J. Ophth. 36:657, 1952.Crossref 19. Friedenwald, J. S.: The Influence of Ionizing Radiation on Mitotic Activity in the Rat's Corneal Epithelium , Bull. Johns Hopkins Hosp. 90:385, 1952. 20. Friedenwald, J. S.; Buschke, W., and Moses, R. G.: Comparison of the Effects of Mustard, Ultraviolet, and X-Radiation, and Colchicine on the Cornea , Bull. Johns Hopkins Hosp. 82:312, 1948. 21. Strelin, G. S.: Histologische Veränderungen im Hornhautepithel des Frosches nach totaler, bezw. partieller, Röntgenbestrahlung, Dokl. Akad. Nauk SSSR abstracted , Zentralbl. d. ges. Ophth. 56:298, 1952 22. 74:1283, 1950. 23. Cibis, P. A.; Noell, W. K., and Eichel, B.: Ocular Effects Produced by High Intensity X-Radiation , A.M.A. Arch. Ophth. 53:651, 1955.Crossref 24. Lane, L. A.: Radium in Ophthalmology , J.A.M.A. 88:232, 1927.Crossref 25. Hughes, W. F., Jr., and Iliff, C. E.: The Effects of Beta Irradiation on the Rabbit's Eye , Am. J. Roentgenol. 56:502, 1946. 26. McDonald, J. E., and Wilder, H. C.: The Effect of Beta Radiation on Corneal Healing , Am. J. Ophth. 40:170, 1955. 27. Lorenz, E., and Dunn, T. B.: Ocular Lesions Induced by Acute Exposure of the Whole Body of Newborn Mice to Roentgen Radiation , Arch. Ophth. 43:742, 1950.Crossref 28. Aurell, G., and Holmgren, H.: On the Metachromatic Staining of the Corneal Tissue and Some Observations on Its Transparency , Acta ophth. 31:1, 1953.Crossref 29. Gemolotto, G.: Ricerche istochimiche sul comportamento dei mucopolisaccaridi della cornea in un tipo di cheratite sperimentale , Arch. ottal. 59:185, 1955. 30. François, J. and Rabaey, M.: Recherches histo-chimiques sur le mucoide de la cornée , Ann. ocul. 186:90, 1953. 31. Aurell, G.: Healing Processes in the Cornea with Special Regard to Structure and Metachromasia , Acta ophth. 32:307, 1954.Crossref 32. Dunnington, J. H.: Tissue Responses in Ocular Wounds , Am. J. Ophth. 43:667, 1957. 33. Gunther, G.: Die Metachromasie der konservierten menschlichen Leichenhornhaut , von Graefes Arch. Ophth. 154:177, 1953.Crossref 34. François, J., and Rabaey, M.: Nouvelles recherches physico- et histo-chimiques sur le mucoide de la cornée , Acta ophth. 34:45, 1956.Crossref 35. von Sallmann, L.; Dische, Z.; Ehrlich, G., and Munoz, C. M.: Study on Penetration of Cysteine and Cystine into the Aqueous Humor of Rabbits and Its Relation to Early X-Irradiation Effect on the Eye , Am. J. Ophth. 34:95 ( (Pt. 2) ) 1951. 36. von Sallmann, L.: Further Efforts to Influence X-Ray Cataract by Chemical Agents , Tr. Am. Ophth. Soc. 49:391, 1951. 37. von Sallmann, L.: Experimental Studies On Early Lens Changes After Roentgen Irradiation , A.M.A. Arch. Ophth. 47:305, 1952.Crossref 38. François, J., and Beheyt, J.: Cataracte par rayons X et cysteamine , Bull. Soc. belge d'opht. 110:150, 1955. 39. Straub, W., and Krause, G.: Cystein als Strahlenschutz am Kaninchenauge , von Graefes Arch. Ophth. 159:667, 1958.Crossref 40. McDonald, J. E.: Cysteine Protection of the Cornea Against Beta Radiation , A.M.A. Arch. Ophth. 51:301, 1954.Crossref 41. Swanson, A. A.; Rose, H. W., and Taube, J. I.: Glutathione Protection in X-Irradiated Eyes , A.M.A. Arch. Ophth. 57:832, 1957.Crossref

APT, LEONARD;COSTENBADER, FRANK D.;PARKS, MARSHALL M.;ALBERT, DAN G.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020032004pmid: 13793987

Abstract Introduction For several years we have recognized an unusual eye reaction in some children after eye muscle surgery. The reaction appears unexpectedly, most often about one week after the operation. It is characterized by discomfort and itchiness of the eye, chemosis and hyperemia of the conjunctiva, and edema of the eyelids. The symptoms usually subside in 12 to 48 hours. At times the eye signs appear within 24 hours after operation. In these cases the reaction frequently is more intense and may persist for a week if untreated.We have been unable to relate the reaction to infection, to the amount or type of operation, or to the use of local eye medication.To study the possibility that the eye reaction was due to an unusual response to catgut, simultaneous observations were made of eye reaction and the cutaneous response to catgut inserted at the time of operation in 219 References 1. Babcock, W. W.: Catgut Allergy , Am. J. Surg. 27:67, 1935.Crossref 2. Hinton, J. W.: Allergy as an Explanation of Dehiscence of a Wound and Incisional Hernia , Arch. Surg. 33:197, 1936.Crossref 3. Kraissl, C. J.: Intrinsic Factors Altering the Absorption of Catgut , Surg. Gynec. & Obst. 63:561, 1936. 4. Fallis, L. S.: Postoperative Wound Separation , Surgery 1:523, 1937. 5. Kraissl, C. J.; Kesten, B. M., and Cimiotti, J. G.: The Relation of Catgut Sensitivity to Wound Healing , Surg. Gynec. & Obst. 66:628, 1938. 6. Whipple, A. O., and Elliott, R. E.: The Repair of Abdominal Incisions , Ann. Surg. 108:741, 1938. 7. Bellas, J. E.: The Influence of Sutures upon Operative Wounds , Ann. Surg. 112:112, 1940. 8. Langston, H. T.: The Problem of Catgut Sensitivity and Its Relation to Wound Healing , Ann. Surg. 115:141, 1942. 9. Muller, F.: Singular complicacas de um caso de amputacao do colo uterino , An. Clin. ginec. Fac. med. Univ. São Paulo 3:195, 1949. 10. Orbach, E. J.: Allergenic Tissue Reaction of Catgut, an Aid for the Obliteration of Varicose Veins , J. Internat. Coll. Surg. 22:707, 1954. 11. Marchesani, O.: Ueber Catgutanaphylaxie , Ber. ophth. Ges. 49:233, 1932. 12. Gratia, A. and Gibson, O.: Le Phenomene d'Arthus au catgut , Mem. Acad. Roy. Méd. Belg. (No. (2) ) 25:1, 1934. 13. Vaccaro, H. and Cabezas, V. J.: Alergia al catgut y produccion de adherencios , Rev. méd. Chile 70:750, 1942. 14. Hopps, H. C.: Role of Allergy in Delayed Healing and in Disruption of Wounds , Arch. Surg. 48:438, 1944. 15. Morone, C.: Fenomeni allergici sperimentali de catgut e loro expressioni moriologiche , Ann. ital. Chir. 24:558, 1947. 16. Basso, R.: Reazione dei tessuti in animali sensibilizzati al catgut in occasione di intervents chirurgico , Policlinico (sez. chir.) 57:351, 1950. 17. Moriconi, L.: Ricerca di proprieta antigena del catgut , Rass. int. Clin. Terap. 14:2, 1933. 18. Frugoni, P.: Sulla supposta allergia da catgut , Arch. ital. Chir. 43:334, 1936. 19. Pickrell, K. L. and Clay, R. C.: Wound Disruption and Catgut Allergy , Surgery 15:333, 1944. 20. Sewell, W. R.; Wiland, J., and Craver, B. N.: A New Method of Comparing Sutures of Ovine Catgut with Sutures of Bovine Catgut in Three Species , Surg. Gynec. & Obst. 100:483, 1955. 21. Sewell, W. R., and Craver, B. N.: The Comparative Antigenicity in the Guinea Pig of Sutures from Ovine Submucosa and Bovine Sersosa , Ann. Surg. 142:980, 1955.Crossref 22. Van Winckle, W., Jr.; Sewell, W., and Wiland, J.: Mechanism of Absorption and Antigenicity of Absorbable Collagen Sutures , J. Am. Geriatrics Soc. 3:572, 1955. 23. Mauer, P. H.: Antigenicity of Oxypolygelatin and Gelatin in Man , J. Exper. Med. 100:497, 1954.Crossref 24. Mauer, P. H.: Antigenicity of Gelatin in Rabbits and Other Species , J. Exper. Med. 100:515, 1954.Crossref 25. Grabar, P.: VI Congresso Internazazionale Microbiologia, Rome, Sept. 6-12, 1953, 1, 475 26. Watson, R. F.; Rothbard, S., and Vanamee, P.: The Antigenicity of Rat Collagen , J. Exper. Med. 99:535, 1954.Crossref 27. Dunham, C. L., and Jenkins, H. P.: Surgical Gut (Catgut) Tubing Fluid as a Tissue Irritant , Ann. Surg. 118:269, 1943.Crossref 28. Jenkins, H. P., and Dunham, C. L.: Irritant Properties of Tubing Fluids as a Factor in the Tissue Reactions Observed with Surgical Gut (Catgut) , Ann. Surg. 118:288, 1943.Crossref 29. Bower, J. O.: The Fallacy of Surgical Gut (Catgut) Tubing Fluid as a Tissue Irritant , Surg. Gynec. & Obst. 81:225, 1945. 30. Rost, G. S.: Allergic Reactions to Catgut Preservatives: Phenol Mercuric Acetate Sensitivity: A Case Report , J. Iowa M. Soc. 43:218, 1953.

HUGHES, WENDELL L.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020038005pmid: 14403884

Abstract In recent years, especially since the rise and fall of the use of open-faced integrated implants, there has been a great increase in the popularity of evisceration as compared to enucleation. At a meeting of the Committee on Ocular Prosthetics, held in connection with the American Academy of Ophthalmology, evisceration was voted the procedure which gave the best postoperative results by about nine to one. In 1939, Burch4 reported a type of evisceration in which the cornea was preserved. The contents of the eye were removed through a transverse incision over the ciliary body above and an implant inserted. The sclera and conjunctiva above were then closed. The modification reported here places the scleral incision farther back behind the superior rectus insertion, so that when the muscle is reattached it gives extra support for the closure of the wound instead of pulling on the posterior lip of the wound. References 1. Berens, C.; Carter, G. Z., and Breakey, A. S.: Evisceration, Utilizing a Steel-Meshed Capped Hollow Plastic Intrascleral Implant , Am. J. Ophth. 44:644-649 (Nov., (Pt. 1) ) 1957. 2. Smillie, J. W.: Eye Removal and a Modified Gifford Evisceration , J. Michigan M. Soc. 57:837-841 ( (June) ) 1958. 3. Hughes, W. L.: Report in Proceedings of American Ophthalmological Society, 1956. The plastic tampon speculum is obtainable from Jardon Laboratories, Detroit. 4. Burch, F. E.: Evisceration of the Globe with Scleral Implant and Preservation of the Cornea , Tr. Am. Ophth. Soc. 34:272-282, 1939 5. Am. J. Ophth. 23:47-51 ( (Jan.) ) 1940.

KUHLMAN, ROBERT E.;KAUFMAN, HERBERT E.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020043006pmid: 14412561

Abstract The demonstrated importance of enzymes in body fluids suggests that a further knowledge of the enzymatic composition of the aqueous humor may eventually be clinically useful.1 Studies of enzymes have been reported for the retina, lens, cornea, and vitreous, but aside from studies of electrolyte composition, little interest has been devoted to such investigations of the aqueous humor.2 The low protein content of primary aqueous has discouraged previous investigation of its enzyme activity, and only fragmentary reports have been made indicating low or absent activity of cholinesterase, hyaluronidase, and lysozyme.3-6 Conventional methods of investigation are of limited usefulness in the study of aqueous, because more than 0.15 ml. is seldom available for study, and present evidence indicates its enzyme content to be very low. With sensitive microchemical techniques, however, further biochemical studies are possible despite these limitations.7,8 In this study newer techniques of quantitative microchemistry were References 1. "Ophthaine" (proparacaine hydrochloride)—D. R. Squibb & Sons, New York. 2. The following abbreviations are used: DPN+, DPNH, oxidized and reduced diphosphopyridine nucleotide; LDH and MDH, lactic and malic dehydrogenases. 3. Activity is expressed as moles or millimoles of substrate converted or oxidized per kilogram or liter of material per hour and abbreviated M per KH, M per LH, mM. per KH and mM. per LH. When activity is expressed on a per kilogram protein basis, it is abbreviated M per KpH. 4. Wroblewski, F.: Increasing Clinical Significance of Alterations in Enzymes of Body Fluids , Ann. Int. Med. 50:62-93, 1959.Crossref 5. Pirie, A., and van Heyningen, R.: Biochemistry of the Eye , Ed. 1, Springfield, Ill., Charles C Thomas, Publisher, 1956. 6. Dorello, U.: Lysozymic Action in the First and Second Aqueous , Gio. ital. oftal. 2:43-51, 1949. 7. Jaffe, N. S.: Cholinesterase in the Aqueous of the Eye , Arch. Ophth. 40:273-278, 1948.Crossref 8. Barany, E.: Hyaluronic Acid and Hyaluronidase in the Aqueous Humor and the Anterior Chamber Angle , A.M.A. Arch. Ophth. 53:612, 1955.Crossref 9. Toda, S.: Studies on Cholinesterase in the Aqueous Humor , Acta. Soc. ophth. jap. 56:599-604, 1952. 10. Lowry, O. H.; Roberts, N. R., and Lewis, C.: The Quantitative Histochemistry of the Retina , J. Biol. Chem. 220:879-892, 1956. 11. Lowry, O. H.; Roberts, N. R., and Chang, M. W.: The Analysis of Single Cells , J. Biol. Chem. 222:97-107, 1956. 12. Lowry, O. H.; Roberts, N. R.; Leiner, K. Y.; Wu, M., and Farr, A. L.: The Quantitative Histochemistry of Brain. I. Chemical Methods , J. Biol. Chem. 207:1-17, 1954. 13. Kuhlman, R. E.: Species Variation in the Enzyme Content of the Corneal Epithelium, J. Cell & Comp. Physiol., April, 1959, to be published. 14. Lowry, O. H.; Roberts, N. R.; Lewis, C., and Atchison, A.: To be published. 15. Lowry, O. H.; Roberts, N. R., and Kapphahn, J. I.: The Fluorometric Measurement of Pyridine Nucleotides , J. Biol. Chem. 224:1047-1064, 1957. 16. Lowry, O. H.; Rosebrough, N. J.; Farr, A. L., and Randall, R. J.: Protein Measurement with the Folin Phenol Reagent , J. Biol. Chem. 193:265-275, 1951. 17. Kuhlman, R. E. and Lowry, O. H.: Quantitative Histochemical Changes During the Development of the Rat Cerebral Cortex , J. Neurochem. 1:173-180, 1956.Crossref 18. Linderstrøm-Lang, K., and Møgensen, K. R.: Studies on Enzymatic Histochemistry. XXXI. Histological Control of Histochemical Investigations , Compt. rend. d. trav. du lab. Carlsberg, serie Chim. 23:27-35, 1938. 19. Anfinsen, C. B.; Lowry, O. H., and Hastings, A. B.: The Application of the Freezing-Drying Technique to Retinal Histochemistry , J. Cell. Comp. Physiol. 20:231-237, 1942.Crossref 20. Lowry, O. H.: The Quantitative Histochemistry of the Brain; Histological Sampling , J. Histochem. and Cytochem. 1:420-428, 1953.Crossref 21. Kuhlman, R. E., and Resnik, R. A.: Quantitative Histochemical Changes in the Development of the Rat Lens and Cornea , Am. J. Ophth. 46:47-55 ( (Part 2) ), 1958. 22. Lowry, O. H.: A Quartz Fiber Balance , J. Biol. Chem. 140:183-189, 1941. 23. Lowry, O. H.: A Simple Quartz Torsion Balance , J. Biol. Chem. 152:293-294, 1944. 24. Surtshin, A.: The Influence of Age and of Renal Ischemia at Different Age Levels on Renal Alkaline Phosphatase in the Rat , J. Gerontol. 12:161-165, 1957.Crossref 25. Barrows, C. H., Jr.; Shock, N. W., and Chow, B. F.: Age Differences in Cholinesterase Activity of Serum and Liver , J. Gerontol. 13:20-23, 1958.Crossref 26. Barrows, C. H., Jr.; Yiengst, M. J., and Shock, N. W.: Senescence and the Metabolism of Various Tissues of Rats , J. Gerontol. 13:351-355, 1958.Crossref 27. Robins, E.; Roberts, N. R.; Eydt, K. M.; Lowry, O. H., and Smith, D. E.: Microdetermination of α-Keto Acids with Special Reference to Malic, Lactic, and Glutamic Dehydrogenases in Brain , J. Biol. Chem. 218:897-909, 1956. 28. Unpublished observation. 29. Strominger, J. L., and Lowry, O. H.: The Quantitative Histochemistry of Brain. IV. Lactic, Malic, and Glutamic Dehydrogenases , J. Biol. Chem. 213:635-646, 1955.

ROSENBLUTH, JOSEPH;LAVAL, JOSEPH;WEIL, J. VICTOR

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020049007pmid: 14438981

Abstract Adenoma of the bronchus is usually included among the benign tumors. Although bronchial adenoma is infrequently encountered, it is not rare. It comprises about 5% of all bronchial neoplasms detected by bronchoscopy. For many years bronchial adenomata were not considered to have malignant potential, and as recently as 1941, Foster-Carter, in a review of bronchial adenomata stated that these tumors were entirely benign. Since that time, there have been reports of bronchial adenomata metastasizing to regional lymph nodes, bone marrow, and other organs. Nevertheless, the occurrence of distant metastasis from a bronchial adenoma remains an infrequent finding. Adenoma of the bronchus is as common in females as in males. Seventy per cent give rise to symptoms in the third or fourth decade of life. The etiology of bronchial adenoma is not known with certainty, but the most prevalent hypothesis is that the tumor arises from the bronchial glands. A cardinal References 1. Stout, A. P.: Cellular Origin of Bronchial Adenoma , Arch. Path. 35:803, 1943. 2. Jackson, C. L., and Konzelman, F. W.: Bronchoscopic Aspects of Bronchial Tumors , J. Thoracic Surg. 6:312, 1937. 3. Warner, R. P., and Southern, A. L.: Carcinoid Syndrome Produced by Metastasizing Bronchial Adenoma , Am. J. Med. 24:903, 1958.Crossref 4. Goldman, A.: The Malignant Nature of Bronchial Adenoma , J. Thoracic Surg. 18:137, 1949. 5. Adams, W. E.; Steiner, P. E., and Block, R. G.: Malignant Adenoma of the Lung , Surgery 11:503, 1942. 6. Anderson, W. M., and Neubuerger, K. I.: Bronchial Adenoma with Metastases to the Liver , Arch. Otolaryng. 40:487, 1944.Crossref 7. Van Hazel, W.; Holinger, P. H., and Jensik, R. S.: Adenoma and Cylindroma of Bronchus , Dis. Chest 16:146, 1949.Crossref 8. Holley, S. W.: Bronchial Adenomas , Mil. Surgeon 99:528, 1946. 9. Rabin, C. B.: Personal communication to the author. 10. Foster-Carter, A. F.: Bronchial Adenoma , Quart. J. Med. 10:139, 1941. 11. Womack, N. A., and Graham, E. A.: Mixed Tumors of the Lung , Arch. Path. 26:165, 1938. 12. Duke-Elder, W. S.: Text Book of Ophthalmology , Vol. 3, St. Louis, C. V. Mosby Company, 1942, p. 2522.

COGAN, DAVID G.;KUWABARA, TOICHIRO

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020053008pmid: 13810884

Abstract The clinical manifestations of cystinosis in the eye have been repetitively documented. Tinsel-like opacities are regularly seen in the cornea with this disease and their slitlamp appearance is pathognomonic of the condition. Biopsies of the conjunctiva in something less than a dozen cases have uniformly shown the presence of cystine crystals similar to those found elsewhere in the body. Yet to our knowledge, histologic examination of the whole eye, permitting microscopic study of the cornea, has been reported only twice.* The first case, reported by Bürki,1 is said to have shown crystals in the cornea similar to those in conjunctiva but "not present in all the sections." The second case, reported by Garron,2 revealed no microscopic evidence of crystals in the cornea. This was surprising (and disappointing) to the author since the crystals had been abundantly present prior to fixation and the alcoholic fixative could not have dissolved References 1. Weyers ( Acta Paediatrica 41:334-354, 1952Crossref 2. The chromatography was kindly done for us by Lorenzo Merola. 3. The tyrosinase was obtained from the Worthington Biochemical Corporation, Freehold, New Jersey. 4. Bürki, E.: Ueber die Cystinkrankheit in Kleinkindersalter unter besonderer Berucksichtigung des Augenbefundes , Ophthalmologica 101:257-331, 1941.Crossref 5. Garron, L. K.: Cystinosis , Tr. Am. Acad. Ophth. 63:99, 1958. 6. Cogan, D. G.; Kuwabara, T.; Kinoshita, J.; Sudarsky, D., and Ring, H.: Ocular Manifestations of Systemic Cystinosis , A.M.A. Arch. Ophth. 55:36-41, 1956.Crossref 7. Freudenberg, E.: Weitere Beobachtungen zur Frage der "Cystinosis," Ann. paediat. 182:85, 1954. 8. Weyers, H.: Neue Befunde z. Diagnose und Klinik der chronischen Aninoacidurie mit Cystinspeicherung , Acta paediat. 41:334-354, 1952.Crossref 9. Ullerich, K.: Ueber Augenveränderungen bei der Cystinkrankheit , Ber. deutsch. Ophth. Gessellsch. 57:306-309, 1951. 10. Parker, W. S.; Prader, A., and Fanconi, G.: Further Observations on Cystine Storage Disease , Pediatrics 16:228-238, 1955. 11. Bickel, H.: Die Entwicklung der biochemischen Läsion bei der Lignac-Fanconi Krankheit , Helvet. pædiat. acta 10:259-268, 1955.

HARDING, C. V.;HUGHES, W. L.;BOND, V. P.;SCHORK, P.

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020060009pmid: 14399723

Abstract A single layer of epithelial cells exists on the anterior surface of the lens just below the lens capsule. Techniques have been described for making whole-mount preparations of this entire layer of epithelium.1,2 The advantage of a whole-mount preparation over sections is that one can view and compare regions of the entire epithelium all in one preparation. This procedure has been used to follow the cytological changes after irradiation.2 Also, the mitotic index, which can be determined from these preparations, has proven to be a sensitive criterion of the "normalcy" of the lens maintained in tissue culture.3,4 Tritiated thymidine has been used very effectively in studies of cellular proliferation in various tissues.5 Thymidine, which is a precursor to DNA synthesis, has been shown to be incorporated into cell nuclei. It is assumed that cells which incorporate thymidine are undergoing a synthesis of DNA in preparation for References 1. Eagle, H.: Science 122:501, 1955.Crossref 2. Howard, A.: Whole Mounts of Rabbit Lens Epithelium for Cytological Study , Stain Technol. 27:313, 1952. 3. von Sallmann, L.: Experimental Studies on Early Lens Changes After Roentgen Irradiation. III. Effect of X-Radiation on Mitotic Activity and Nuclear Fragmentation of Lens Epithelium in Normal and Cysteine-Treated Rabbits , A.M.A. Arch. Ophth. 47:305, 1952.Crossref 4. Kinsey, V. E.; Wachtl, C.; Constant, M. A., and Camacho, E.: Studies on the Crystalline Lens. VI. Mitotic Activity in the Epithelia of Lenses Cultured in Various Media , Am. J. Ophth. 40:216 (Nov., (Pt. 2) ) 1955. 5. Wachtl, C., and Kinsey, V. E.: Studies on the Crystalline Lens. VIII. A Synthetic Medium for Lens Culture and the Effects of Various Constituents on Cell Division in the Epithelium , Am. J. Ophth. 46:280 (Nov., (Pt. 2) ) 1958. 6. Hughes, W. L.; Bond, V. P.; Brecher, G.; Cronkite, E. P.; Painter, R. B.; Quastler, H., and Sherman, F. G.: Cellular Proliferation in the Mouse as Revealed by Autoradiography with Tritiated Thymidine , Proc. Nat. Acad. Sc. 44:476, 1958.Crossref 7. Cronkite, E. P.; Bond, V. P.; Fliedner, T. M., and Rubini, J. R.: The Use of Tritiated Thymidine in the Study of DNA Synthesis and Cell Turnover in Hemopoietic Tissues , Lab. Invest. 8:263, 1959. 8. Pelc, S. R.: Autoradiograph Technique , Nature, London 160:749, 1947.Crossref 9. Leblond, C. P.; Messier, B., and Kopriwa, B.: Thymidine-H3 as a Tool for the Investigation of the Renewal of Cell Populations , Lab. Invest. 8:269, 1959. 10. Painter, R. B.; Drew, R. M., and Hughes, W. L.: Inhibition of He La Growth by Intranuclear Tritium , Science 127:1244, 1958.Crossref 11. Hughes, W. L.: Chromosomal Replication and the Dynamics of Cellular Proliferation—Some Autoradiographic Observations with Tritiated Thymidine , in McElroy, W. C., and Glass, B.: A Symposium on the Chemical Basis of Development , Baltimore, The Johns Hopkins Press, 1958, p. 136.

AMDUR, JOSEPH

1960 A.M.A. Archives of Ophthalmology

doi: 10.1001/archopht.1960.00950020068010pmid: 13793141

Abstract Since Goldmann first described his version of the applanation tonometer in 1955,1 it has rapidly gained popularity. Mounted on the Haag-Streit slit lamp, the applanation tonometer is appearing in many United States clinics. However, although the actual measurement of the intraocular pressure with this instrument requires a certain technique, few articles of instruction in procedure have appeared in the English literature. In 1958, Moses2 presented a practical guide to the use of this instrument, and it is the purpose of this paper to add further practical points in its usage. Scleral Rigidity Criticism of indentation tonometry has focused on the role of scleral rigidity in measurements of intraocular pressure. The indenting plunger displaces a significant volume of fluid from the anterior chamber, causing distention of the ocular coats. The resistance to distention of the ocular coat, or the "scleral rigidity", requires a counterpressure to be exerted by the References 1. Goldmann, H.: Un nouveau tonometre à aplanation , Bull. Soc. opht. France 67:474, 1955. 2. Moses, R. A.: The Goldmann Applanation Tonometer , Am. J. Ophth. 46:865, 1958. 3. The Goldmann Slit Lamp Applanation Tonometer , Hagg-Streit Manufacture's Bulletin, No. 248, Geneva, Switzerland, 1958. 4. Friedenwald, J. S.: Contribution to the Theory and Practice of Tonometry , Am. J. Ophth. 20:985, 1937. 5. Moses, R. A.: Am. J. Ophth. 20:866, 1958. 6. Moses, R. A.: Am. J. Ophth. 20:867, 1958. 7. Hagg-Streit Manufacture's Bulletin. No. 274. 8. Weekers, R., and Lavergne, G.: Changes in Ocular Rigidity in Endocrine Exophthalmos , Brit. J. Ophth. 42:680, 1958.Crossref 9. Friedenwald, J. S.: Brit. J. Ophth. 42:993, 1937. 10. Gay, A. J., and Becker, B.: Applanation Tonometry in the Diagnosis and Treatment of Glaucoma, read before the 108 Meeting A.M.A., June 11, 1959, to be published.