Biomedical subjects
Publications and source records attributed to B H Doft.
An electro-oculogram ratio of less than one was found to be caused by limited ocular excursions under photopic conditions in a patient with a rod-cone dystrophy. Because this inverse electro-oculogram ratio was not caused by a decrease in standing potential under photopic conditions, it should be considered an artefact.
One of two cases of endogenous Aspergillus endophthalmitis in abusers of intravenously administered drugs was treated successfully by subtotal pars plana vitrectomy; amphotericin B administered by intravitreal, periocular, and systemic routes; and flucytosine administered systemically. Aspergillus sp should be considered a possible pathogenic organism in drug abusers with endogenous endophthalmitis. An aggressive diagnostic and therapeutic approach may result in preservation of useful vision.
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Subcutaneous footpad injection of BCG causes a marked augmentation of popliteal lymph node plaque-forming cell (PFC) responses to DNP-derivatized hemocyanin and to sheep red blood cells, both T-dependent antigens, but not to DNP-derivatized Ficoll, a T-independent antigen. This augmentative effect occurs in normal thymus-bearing heterozygous (nu/+) mice, but not in congenitally athymic nude mice (nu/nu). In contrast, intravenous injection of BCG causes a suppressed splenic PFC response to subsequently administered T-dependent or T-independent antigens in both nude and nu/+ mice. BCG's augmenting effect on the lymph node appears to be mediated by a T-helper cell. BCG's suppressive effect in the spleen is not attributable to T cells. The actual mechanism of the BCG-mediated suppressive splenic effect remains incompletely defined at present.
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While thioridazine retinopathy has been well described, the features of nummular thioridazine retinopathy, a unique clinical subset, have been documented in only five previously published cases. This report describes the clinical features in an additional three cases. Nummular areas of retinal pigment epithelial atrophy separated by relatively intact pigment epithelium are found in the midretinal periphery, with sparing of central vision. This entity can occur with doses of thioridazine previously considered safe.
The contribution of diabetes duration, both pre- and postpuberty, to the development of microvascular complications and mortality in diabetic subjects was investigated in three study populations from the Children's Hospital of Pittsburgh Insulin-Dependent Diabetes Mellitus (IDDM) Registry. Life-table analyses by total and postpubertal IDDM duration were used to evaluate differences in the prevalence of microvascular complications and diabetes-related mortality in subjects diagnosed before and during puberty, as defined by an age at IDDM onset marker of 11 yr for girls and 12 yr for boys. The prevalence of retinopathy and overt nephropathy in 552 White adult diabetic subjects (population 1, mean IDDM duration 20.8 yr was significantly greater in subjects diagnosed during puberty compared with those diagnosed before puberty. However, similar analyses by postpubertal duration showed no difference in microvascular complication prevalence between the two groups. These findings did not appear to be due to a confounding effect of age. Additional analyses of 239 adolescent diabetic subjects (population 2, mean duration 8.3 yr) revealed the same trend for the prevalence of retinopathy. Finally, results concerning the risk of diabetes-related mortality in a cohort of 1582 subjects (population 3, mean duration 12.9 yr) indicated that postpubertal duration of IDDM may be a more accurate determinant of the development of microvascular complications and diabetes-related mortality than total duration, and it is suggested that the contribution of the prepubertal years of diabetes to long-term prognosis may be minimal.
The relationship between glycemic control and complications of insulin-dependent diabetes mellitus (IDDM) remains controversial. With the use of glycosylated hemoglobin (HbA1) to assess glycemic control from diagnosis onward, the Pittsburgh Prospective Insulin-Dependent Diabetes Mellitus Cohort Study prospectively evaluated 80 new cases of IDDM diagnosed at Children's Hospital of Pittsburgh. This study presents findings in 62 patients at 5 yr postdiagnosis. Only 7 patients, all girls, had any retinopathy (microaneurysms). These subjects had an elevated 5-yr mean HbA1 compared to those with no retinopathy (13.0 vs. 11.7%; P less than .05). Six female subjects who had an elevated albumin excretion rate (AER; greater than or equal to 20 micrograms/min) had a higher 5-yr mean HbA1 (13.3%) than the 26 subjects with AER less than 20 micrograms/min (11.8%; P less than .05). Current HbA1 was correlated with AER (r = +.36, P less than .05) and systolic blood pressure (r = +.49, P less than .01) in females. However, these associations were not observed in males. Positive correlations were found between HbA1 (5-yr mean and current) and serum triglyceride and cholesterol, but only in females was HbA1 inversely related to high-density lipoprotein cholesterol. However, HbA1 was independent of sex, HLA-DR type, and urine C-peptide status. Age adjustment did not change the above results. These analyses suggest that glycemic control is related to AER, systolic blood pressure, presence of microaneurysms, and serum triglyceride and cholesterol concentrations during the first 5 yr of IDDM. However, these associations appear to be predominant in girls.