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Postoperative Intraocular Infections
496
SOCIETY PROCEEDINGS
ual haze in the area o f Bowman's mem brane at the site of the dendritic ulcer. Twenty-four of these patients were fol lowed with serial virus cultures. In seven patients, virus was not isolated and these patients showed remarkable improvement on I D U . Virus was initially isolated from 1 7 patients and, in two instances, virus could still be isolated after six days on I D U . The virus-positive patients had a completely typ ical dendritic figure and a more prolonged course than the virus-negative patients. I D U alone was o f little benefit in 1 2 cases o f established stromal disease.
six days induced a delayed aggravation o f weakness in three young myasthenic women. The administration o f desoxycorticosterone acetate in oil intramuscularly in doses rang ing from 5 . 0 to 3 0 mg. per day for three to six days induced a prompt exacerbation o f muscular weakness and ptosis in six patients with myasthenia gravis. The relationship between progesterone and mineralocorticoid hormones is consid ered. T h e effect o f mineralocortlcosteroids upon neuromuscular transmission probably relates to alterations in ionic flux across cel lular membranes.
Preliminary tissue culture data indicate that I D U had no direct effect on the herpes virus in the absence o f cells. In infected parallel culture, I D U inhibited virus and cell multiplication to the same extent. PLASMA-INDUCED
STIMULATION
OF
Miriam D . Eubank, Recording Secretary.
NEW ENGLAND OPHTHALMOLOGICAL SOCIETY
GLUCOSE
UTILIZATION D R . T I B O R G . F A R K A S , University o f Chi cago Hospitals: It has been observed that isolated, intact lenses o f insulin-injected normal rats utilize significantly more glucose than lenses o f untreated animals. Insulin, however, does not affect the glucose utiliza tion o f isolated lenses in vitro. It has been reported that the plasma o f insulin-injected rats contains a substance which is capable o f stimulating glucose utilization o f isolated rat lenses in vitro.
The stimulator substance that is demon strable in blood following insulin injection is probably a protein because it is heat-labile, nondialyzable and can be purified b y stand ard protein purification techniques. Twenty thousand-fold purification of the lens glu cose uptake stimulator factor was achieved b y this combination o f acetic acid, ammo nium sulfate and thanol fractionation. INFLUENCE CYCLE
IN
OF
HORMONES
MYASTHENIA
ON
MENSTRUAL
GRAVIS
DR. MARCEL FRENKEL, University of Chicago Hospitals: Intramuscular injection of 5 0 mg. o f progesterone in oil per day for
February 2 0 , 1 9 6 3 M A H L O N
T.
EASTON,
M.D.,
presiding
RETINOSCHISIS DR.
GARRETT
L.
SULLIVAN:
By
the
use
of routine perimetry, field defects were found in 1 0 individuals, which ultimately led to the diagnosis o f retinoschisis. Thir teen eyes in these 1 0 patients showed ret inoschisis and in none o f the cases was the patient aware o f a field defect prior to the examination. Except in two patients where the defect encroached into the upper part o f the tem poral field, as well as involving a portion o f the nasal field, the defect was confined to the nasal field. T h e borders o f the defect were quite steep and easy to delineate. T h e ages o f the patients when the diag nosis was made varied from 3 7 to 6 1 years o f age. Eight patients were men and two were women. In a follow-up period from one to 1 9 years, there was no change in eight eyes and evidence o f slow progression o f the retinoschisis in five eyes.
497
SOCIETY PROCEEDINGS POSTOPERATIVE DR.
with
INTRAOCULAR
S.
DAVID
Eleven
JOHNSON:
endophthalmitis
following
patients
intraocular
s u r g e r y w e r e treated with a combination systemic mycin,
Chloromycetin, Gantrisin
prednisolone
penicillin,
and
was
administered
in
of
of
strepto
prednisolone.
4 0 m g . daily. T h e diagnosis
i s h i g h l y u n l i k e l y t h a t t h e r e w i l l be a n y r e
INFECTIONS
The
doses
of
endophthal
mitis w a s based primarily on the p r e s e n c e o f h y p o p y o n a s well a s p a i n , i n j e c t i o n a n d Chem osis.
Cultures
from
the
conjunctiva
were
taken p r i o r to the initiation o f t r e a t m e n t but
t u r n o f v i s i o n n o m a t t e r w h a t is d o n e . 12
saved.
Of
these,
scarring,
two
one later
had
treatment
may
be
of is
value.
extensive
developed
de
tached retinas and the remaining eight
had
a n d , t h o u g h t h e v i s i o n is lost, t h e r e t i n a is n o t i n f a r c t e d . T h e r a p y in t h i s p h a s e is ment
of
with
finger
the
retinal a r t e r y
pressure
dynamometry.
This
serves
as
a guide
r e t i n a l p r e s s u r e is be
exercised
blood
zero, the patient
enough
to
pressure. This
raise
often
his
restores vision.
are given
DR.
percent carbon dioxide
ROBERT
of
W.
The
HOLLENHORST:
occlusive
disease
is
only
loss
of
cent
be
oxygen
to
unsuccessful, a mixture
the of
bed these
patient
5.0- to
10-
with 9 0 - o r 9 5 - p e r
inhale.
This
should
in
few
minutes.
be
initiated.
is o n l y a s y m p t o m a n d it h a s n o t h i n g t o d o
Anticoagulants
with the condition o f the retina o r the p r o g
O t h e r m e a s u r e s which might help a r e o c u l a r
nosis.
m a s s a g e , p a r t i c u l a r l y if a n embolus
of
cases. T h r o m b o s i s
is a l s o a n
important
f a c t o r in o c c l u s i v e d i s e a s e b u t s p a s m
prob
efficacious
of
arterial occlusion
i f s t a r t e d in t h e
paracentesis, and
then
intravenous
M e a s u r e s w h i c h a r e ineffective
is p r e s Diamox.
are retrobul
bar vasodilators, steroids, systemic vasopres
a b l y p l a y s v e r y little r o l e . Treatment
ent,
should
a
bring
v i s i o n . I t is i m p o r t a n t t o r e m e m b e r t h a t t h i s
accounts f o r the m a j o r i t y
improvement
If
about
Embolism
an
results,
be placed back into
should
RETINAL
should systemic
I f this does not p r o d u c e the desired
measures
symptom
for
treatment.
ARTERIOLES
OF T H E
either
pressure o r with the ophthalmo
w i t h h i s h e a d in a l o w e r e d p o s i t i o n . DISEASE
es
s e n t i a l . O f p r i m e i m p o r t a n c e is t h e m e a s u r e
the patient should
visions ranging f r o m 2 0 / 1 0 0 to 2 0 / 1 5 . OCCLUSIVE
In
intermittent
I f t h e e y e is b l i n d w i t h n o c i r c u l a t i o n a n d
O n e eye w e n t on t o phthisis but the r e s t corneal
hours,
m a n y patients, the occlusion
n o g r o w t h w a s r e p o r t e d in m o s t c a s e s .
were
How
e v e r , i f t h e r e is n o h e a v y r e t i n a l e d e m a a f t e r
first
is
few
often
sor drugs and thrombolytic
agents.
B y r o n S.
hours.
Lingeman,
Recorder.
I f v i s i o n h a s b e e n lost 1 2 h o u r s o r m o r e , it
O P H T H A L M I C
MINIATURE
A n e x p e r i m e n t o f another kind gave additional evidence of the change p r o d u c e d in t h e o c u l a r t e n s i o n b y s e c t i o n o f t h e s y m p a t h e t i c . A f t e r t h e n e r v e w a s d i v i d e d o n o n e s i d e in a r a b b i t , a t r a u m a t i c i r i t i s w a s e x c i t e d in b o t h e y e s a t t h e s a m e t i m e b y s i m i l a r i n j u r i e s . I t w a s e v i d e n t t o t h e m o s t u n p r a c t i s e d o b s e r v e r s t h a t t h e eye on t h e side o f t h e section f a r less h a r d t h a n t h e o t h e r , a n d t h e d i f f e r e n c e
was
w a s also shown by the
manometer.
Periscope, Ophth. Hosp. Reports, 5:379, 1866.
SOCIETY PROCEEDINGS
ual haze in the area o f Bowman's mem brane at the site of the dendritic ulcer. Twenty-four of these patients were fol lowed with serial virus cultures. In seven patients, virus was not isolated and these patients showed remarkable improvement on I D U . Virus was initially isolated from 1 7 patients and, in two instances, virus could still be isolated after six days on I D U . The virus-positive patients had a completely typ ical dendritic figure and a more prolonged course than the virus-negative patients. I D U alone was o f little benefit in 1 2 cases o f established stromal disease.
six days induced a delayed aggravation o f weakness in three young myasthenic women. The administration o f desoxycorticosterone acetate in oil intramuscularly in doses rang ing from 5 . 0 to 3 0 mg. per day for three to six days induced a prompt exacerbation o f muscular weakness and ptosis in six patients with myasthenia gravis. The relationship between progesterone and mineralocorticoid hormones is consid ered. T h e effect o f mineralocortlcosteroids upon neuromuscular transmission probably relates to alterations in ionic flux across cel lular membranes.
Preliminary tissue culture data indicate that I D U had no direct effect on the herpes virus in the absence o f cells. In infected parallel culture, I D U inhibited virus and cell multiplication to the same extent. PLASMA-INDUCED
STIMULATION
OF
Miriam D . Eubank, Recording Secretary.
NEW ENGLAND OPHTHALMOLOGICAL SOCIETY
GLUCOSE
UTILIZATION D R . T I B O R G . F A R K A S , University o f Chi cago Hospitals: It has been observed that isolated, intact lenses o f insulin-injected normal rats utilize significantly more glucose than lenses o f untreated animals. Insulin, however, does not affect the glucose utiliza tion o f isolated lenses in vitro. It has been reported that the plasma o f insulin-injected rats contains a substance which is capable o f stimulating glucose utilization o f isolated rat lenses in vitro.
The stimulator substance that is demon strable in blood following insulin injection is probably a protein because it is heat-labile, nondialyzable and can be purified b y stand ard protein purification techniques. Twenty thousand-fold purification of the lens glu cose uptake stimulator factor was achieved b y this combination o f acetic acid, ammo nium sulfate and thanol fractionation. INFLUENCE CYCLE
IN
OF
HORMONES
MYASTHENIA
ON
MENSTRUAL
GRAVIS
DR. MARCEL FRENKEL, University of Chicago Hospitals: Intramuscular injection of 5 0 mg. o f progesterone in oil per day for
February 2 0 , 1 9 6 3 M A H L O N
T.
EASTON,
M.D.,
presiding
RETINOSCHISIS DR.
GARRETT
L.
SULLIVAN:
By
the
use
of routine perimetry, field defects were found in 1 0 individuals, which ultimately led to the diagnosis o f retinoschisis. Thir teen eyes in these 1 0 patients showed ret inoschisis and in none o f the cases was the patient aware o f a field defect prior to the examination. Except in two patients where the defect encroached into the upper part o f the tem poral field, as well as involving a portion o f the nasal field, the defect was confined to the nasal field. T h e borders o f the defect were quite steep and easy to delineate. T h e ages o f the patients when the diag nosis was made varied from 3 7 to 6 1 years o f age. Eight patients were men and two were women. In a follow-up period from one to 1 9 years, there was no change in eight eyes and evidence o f slow progression o f the retinoschisis in five eyes.
497
SOCIETY PROCEEDINGS POSTOPERATIVE DR.
with
INTRAOCULAR
S.
DAVID
Eleven
JOHNSON:
endophthalmitis
following
patients
intraocular
s u r g e r y w e r e treated with a combination systemic mycin,
Chloromycetin, Gantrisin
prednisolone
penicillin,
and
was
administered
in
of
of
strepto
prednisolone.
4 0 m g . daily. T h e diagnosis
i s h i g h l y u n l i k e l y t h a t t h e r e w i l l be a n y r e
INFECTIONS
The
doses
of
endophthal
mitis w a s based primarily on the p r e s e n c e o f h y p o p y o n a s well a s p a i n , i n j e c t i o n a n d Chem osis.
Cultures
from
the
conjunctiva
were
taken p r i o r to the initiation o f t r e a t m e n t but
t u r n o f v i s i o n n o m a t t e r w h a t is d o n e . 12
saved.
Of
these,
scarring,
two
one later
had
treatment
may
be
of is
value.
extensive
developed
de
tached retinas and the remaining eight
had
a n d , t h o u g h t h e v i s i o n is lost, t h e r e t i n a is n o t i n f a r c t e d . T h e r a p y in t h i s p h a s e is ment
of
with
finger
the
retinal a r t e r y
pressure
dynamometry.
This
serves
as
a guide
r e t i n a l p r e s s u r e is be
exercised
blood
zero, the patient
enough
to
pressure. This
raise
often
his
restores vision.
are given
DR.
percent carbon dioxide
ROBERT
of
W.
The
HOLLENHORST:
occlusive
disease
is
only
loss
of
cent
be
oxygen
to
unsuccessful, a mixture
the of
bed these
patient
5.0- to
10-
with 9 0 - o r 9 5 - p e r
inhale.
This
should
in
few
minutes.
be
initiated.
is o n l y a s y m p t o m a n d it h a s n o t h i n g t o d o
Anticoagulants
with the condition o f the retina o r the p r o g
O t h e r m e a s u r e s which might help a r e o c u l a r
nosis.
m a s s a g e , p a r t i c u l a r l y if a n embolus
of
cases. T h r o m b o s i s
is a l s o a n
important
f a c t o r in o c c l u s i v e d i s e a s e b u t s p a s m
prob
efficacious
of
arterial occlusion
i f s t a r t e d in t h e
paracentesis, and
then
intravenous
M e a s u r e s w h i c h a r e ineffective
is p r e s Diamox.
are retrobul
bar vasodilators, steroids, systemic vasopres
a b l y p l a y s v e r y little r o l e . Treatment
ent,
should
a
bring
v i s i o n . I t is i m p o r t a n t t o r e m e m b e r t h a t t h i s
accounts f o r the m a j o r i t y
improvement
If
about
Embolism
an
results,
be placed back into
should
RETINAL
should systemic
I f this does not p r o d u c e the desired
measures
symptom
for
treatment.
ARTERIOLES
OF T H E
either
pressure o r with the ophthalmo
w i t h h i s h e a d in a l o w e r e d p o s i t i o n . DISEASE
es
s e n t i a l . O f p r i m e i m p o r t a n c e is t h e m e a s u r e
the patient should
visions ranging f r o m 2 0 / 1 0 0 to 2 0 / 1 5 . OCCLUSIVE
In
intermittent
I f t h e e y e is b l i n d w i t h n o c i r c u l a t i o n a n d
O n e eye w e n t on t o phthisis but the r e s t corneal
hours,
m a n y patients, the occlusion
n o g r o w t h w a s r e p o r t e d in m o s t c a s e s .
were
How
e v e r , i f t h e r e is n o h e a v y r e t i n a l e d e m a a f t e r
first
is
few
often
sor drugs and thrombolytic
agents.
B y r o n S.
hours.
Lingeman,
Recorder.
I f v i s i o n h a s b e e n lost 1 2 h o u r s o r m o r e , it
O P H T H A L M I C
MINIATURE
A n e x p e r i m e n t o f another kind gave additional evidence of the change p r o d u c e d in t h e o c u l a r t e n s i o n b y s e c t i o n o f t h e s y m p a t h e t i c . A f t e r t h e n e r v e w a s d i v i d e d o n o n e s i d e in a r a b b i t , a t r a u m a t i c i r i t i s w a s e x c i t e d in b o t h e y e s a t t h e s a m e t i m e b y s i m i l a r i n j u r i e s . I t w a s e v i d e n t t o t h e m o s t u n p r a c t i s e d o b s e r v e r s t h a t t h e eye on t h e side o f t h e section f a r less h a r d t h a n t h e o t h e r , a n d t h e d i f f e r e n c e
was
w a s also shown by the
manometer.
Periscope, Ophth. Hosp. Reports, 5:379, 1866.