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Biomedical subjects

B R Jones

Publications and source records attributed to B R Jones.

At least 235 records · Page 13Linked to original sources

Clinical trials of topical interferon therapy of ulcerative viral keratitis.

An open trial suggested that monkey interferon had a therapeutic effect on ulcerative vaccinial keratitis in humans. A randomized, double-blind, placebo-controlled trial of either monkey interferon or drops of idoxuridine (given hourly by day and at 2-hr intervals by night for three days) suggested a therapeutic effect from idoxuridine but not from monkey interferon. Results of experiments with rabbits suggested that a daily application of human interferon (1.1 X 10(7) international units/ml) would be effective in the prevention of herpetic ulcers but might not affect established lesions. Preliminary results are encouraging in a placebo-controlled, randomized trial of human interferon given once daily for seven days for prevention of recrudescence of epithelial herpetic lesions after minimal wiping debridement with a cotton-tipped swab. The design of the trial is closely analogous to that of the experiments with rabbits and permits ethically acceptable, placebo-controlled trials of antiviral agents.

Administration, Topical↗

Clinical evaluation of adenine arabinoside and trifluorothymidine in the treatment of corneal ulcers caused by herpes simplex virus.

One hundred two unselected patients with ulceration of the cornea due to herpes simples virus were treated with either adenine arabinoside or trifluorothymide; the trial was double-blind, stratified, and radomized. The two drugs were given topically five times per day, and the rate of healing was observed and recorded. The series included 87 patients with dendritic ulcers and 15 with amoeboid ulcers. Dendritic ulcers of the cornea can be accurately measured, and the healing process can be easily followed. In this situation no statistically significant difference between the efficacy of adenine arabinoside and that of trifluorothymidine was demonstrated. Amoeboid ulcers are more difficult to evaluate than dendritic ulcers, and their responses to treatment vary considerably; however, data from this small group of patients suggest that trifluorothymodine may be more effective than adenine arabinoside for the treatment of amoeboid ulcers.

Administration, Topical↗

The need for antiviral therapy and prophylaxis of viral ocular disease.

The cost of development of a compound with clinical potential as an antiviral agent is so great that it cannot be undertaken unless there is likely to be a market that will return the investment. The current practice, assessment of the prospect on the basis of the present market for idoxuridine and calculation of a likely percentage of capture by a potentially superior compound, is basically erroneous and may lead to gross underestimates of the market. In addition to the market for agents effective in treatment of dendritic and amoeboid ulcers, there is a potentially much greater market, first, for somewhat less toxic compounds that may be used more or less continuously over very long periods for prevention of recurrences. Substances with promise of filling each of these requirements are already under investigation. There is also a potential market for therapeutic preparations with activities against a range of agents, particularly herpesviruses, adenoviruses, and chlamydiae, that commonly cause follicular conjunctivitis or keratoconjunctivitis.

Antiviral Agents↗

Neglected lid deformities causing progressive corneal disease. Surgical correction of entropion, trichiasis, marginal keratinization, and functional lid shortening.

The potentially blinding abrasive deformities of the lids--trichiasis, districhiasis, entropion, and marginal keratinization--and the defects in lid closure resulting from functionally shortened upper or lower lids should be corrected surgically before contact lenses are fitted or corneal grafting undertaken. The choice of procedure for surgical correction of various degrees of trichiasis-entropion is indicated by the various associated findings, such as thickness of tarsal plate, presence of functional shortening of the upper lid, and involvement of the lower lid (Table II).

Congenital Abnormalities↗

Immediate hypersensitivity in the guinea pig conjunctiva. II. Effect of treatment with antihistamines, steroids and disodium cromoglycate.

The effects of antihistamines, steroids and disodium cromoglycate on an immediate hypersensitivity reaction in the guinea pig eye are described in terms of clinical observations, histological examinations of sections of eyes and cytological studies of material from the conjunctival surface. The use of brushes to sample the cells on the conjunctival surface is described. The effect of repeated daily challenges on the reaction is also reported.

Animals↗

Proflavine photodynamic viral inactivation in herpes simplex keratitis.

We used the photodynamic inactivation technique with proflavine as the photoactive dye to treat herpetic epithelial keratitis in a preliminary study of patients who had idoxuridine toxicity or resistance. A comparative study with idoxuridine in treating dendritic ulcerations of the cornea showed a good therapeutic effect. But the investigation was suspended when adverse reactions, consisting of a generalized epithelial keratitis and an anterior uveitis, possibly of phototoxic origin, developed in a few patients receiving treatment. The ulcers treated by photodynamic inactivation apparently healed by a process of "debridement" followed by subsequent re-epithelialization.

Acridines↗

Principles in the management of oculomycosis. XXXI Edward Jackson memorial lecture.

Effective antifungal therapy must be long-term, nondamaging, penetrating to the eye, and highly active against each patient's fungus. Results of antifungal sensitivity testing of 61 collected ocular fungal pathogens and observations in 25 cases treated with one of the nonpolyene antifungal drugs indicated that infection was rapidly controlled and eradicated with restoration of visual acuity, determined by the degree of disorganization present at the time of commencement of rational specific antifungal therapy. Pimaricin has the widest spectrum, a medium level of activity, and rather poor penetration but is recommended as an antifungal prophylactic and as first-line-therapy for ocular fungal disease while awaiting identification and sensitivity testing of the fungus. Flucytosine combined with amphotericin B, or possibly with clotrimazole or miconazole, is recommended for Candida infections. Clotrimazole is the drug of choice for Aspergillus species although miconazole and econazole are more effective with some isolates. Miconazole and econazole are recommended for miscellaneous filamentous fungi although clotrimazole or thiabendazole are superior in some cases. Each of these drugs may be useful in patients infected with Fusarium who do not respond to primaricin. In these cases, drug use should be guided by the results of antifungal sensitivity testing. In addition to medical antifungal therapy some eyes may require excisional keratoplasty with the lens removal and evacuation of the posterior chamber and anterior vitreous cavity.

Adrenal Cortex Hormones↗

Malignant schwannoma of the brachial plexus in a dog.

A 4-year-old Labrador bitch was presented for veterinary examination with a history of lameness and muscle atrophy of the left forelimb. On clinical examination a painful mass was detected medial to the left shoulder joint. Radiographs of the shoulder showed mineralisation of this mass. Exploratory surgery revealed a tumour involving the radial nerve, axillary nerve and the trunk of the median and ulnar nerves. Histopathologic diagnosis was a malignant Schwannoma.

Animals↗

Horner's syndrome in the dog and cat as an aid to diagnosis.

Four cases of Horner's syndrome, two in dogs and two in cats, are described. Miosis, ptosis, and enophthalmos were present in three of the cases and in addition, protrusion of the nictitating membrane was present in the fourth case. In the two cases described in cats, there was also evidence of peripheral vasodilation in the skin of the face on the same side as the Horner's syndrome.

Adenocarcinoma↗

Summary code for ocular herpes simplex.

A code for herpetic eye disease is presented. This simplifies the management of individual patients, and the up-to-date code summary of each case is easily maintained thus facilitating assessment of interrelating factors. It is suggested that the pattern of herpetic eye disease may have prognostic and epidemiological significance. This system has simplified retrieval of such data.

Contact Lenses↗

Lacrimal immunoglobulins and complement quantified by counter-immunoelectrophoresis.

Immunoglobulin and complement concentrations of tears were measured using a sensitive electroimmunodiffusion assay. In the 13 subjects tested, the predominant immunoglobulin was secretory IgA (mean concentration 107 mug/mg protein; standard error of mean 15; n equal 17). The B1C component of complement was measurable in half of the subjects studied. The data illustrate that it is possible to quantify exactly certain humoral indices which may be important in the host defense of the eye.

Complement System Proteins↗

Blinding and non-blinding trachoma: assessment of intensity of upper tarsal inflammatory disease and disabling lesions.

A simplified method of evaluating both the intensity of active inflammatory disease and the visually disabling lesions of trachoma is presented. Evaluation of the active disease is based on the scoring of clinical signs, lymphoid follicles, and papillary hypertrophy. The irreversible lesions of trachoma are classified as conjunctival scarring, trichiasis and/or entropion, and corneal scarring.

Blindness↗