Biomedical subjects
D J Addison
Publications and source records attributed to D J Addison.
Pioneers of prevention.
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Fibrous histiocytoma. An uncommon eyelid lesion.
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Scheie's syndrome. An ultrastructural analysis of the cornea.
The histopathology of a corneal graft specimen obtained from a patient with Scheie's syndrome (systemic mucopolysaccharidosis, type IS) is described with particular emphasis on the ultrastructural findings. Numerous vacuoles containing fibrillogranular material were found in the corneal epithelial cells, the keratocytes, and the endothelial cells. The basement membrane of the epithelium contained frequent breaks and peg-like undulations, and Bowman's layer was markedly attenuated. Fibrous long-spacing (FLS) collagen featured prominently in the stroma. Descemet's membrane was normal. The findings of a markedly attenuated Bowman's layer and FLS collagen may be abnormalities specific to Scheie's syndrome resulting from the altered glycosaminoglycan composition of the extracellular matrix.
Canadian National Institute for the Blind: 70 years of caring.
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Adenocarcinoma of the lacrimal gland with metastasis to the preauricular lymph nodes and parotid gland.
We describe a 68-year-old man with adenocarcinoma of the lacrimal gland with metastatic spread to the ipsilateral preauricular lymph nodes and parotid gland. The patient died of metastatic lung involvement. Metastasis to the preauricular nodes and parotid gland by malignant lacrimal gland tumours is rare.
Malakoplakia of the eyelid.
A 35-year-old white man, on immunosuppressive medications for 3 1/2 years following a renal transplant, presented with a whitish-yellow mass at the medial end of the left lower eyelid. An initial incisional biopsy was performed that was misinterpreted as granular cell myoblastoma. The mass was subsequently excised and histopathologic examination revealed malakoplakia. A more extensive recurrent lesion was excised one year later. About two years after the resection of the original lesion the patient died of complications of chronic renal failure. At autopsy there was no evidence of malakoplakia either of the eyelid-or systemically. This is the first case reported of eyelid involvement by malakoplakia, a histiocytic disorder with pathognomonic histopathologic features.
COS manpower study three: projections and recommendations for the supply and demand in Canada for ophthalmologists in the year 2000.
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Glioneuroma of iris and ciliary body.
A 20-year-old woman was noted to have progressive cataractous changes in the left eye for two years. Ophthalmic examination showed a yellow-pink mass in the iris root (between the 8- to 10- o'clock positions, facing the patient). No associated colobomatous defect was present. A sector iridectomy with partial cyclectomy was performed. Histopathologically the mass, which was composed of an admixture of glial cells and neurons, was diagnosed as glioneuroma. It was believed the tumor had been incompletely excised at the posterior margin of surgical resection. No additional therapy was instituted. When the patient was reexamined 6 1/2 years later, the residual mass remained unchanged. Four previously reported cases of glioneuromas of the iris and ciliary body are summarized.
Autoimmunity and the outer retina.
Structurally and therefore antigenically the retina is a complex tissue. Since it develops as an extension from the neural tube it shares with the brain several cell membranes and cytoplasm associated antigens including those present in neurofilaments of the various neurones and the glial filaments of the astrocytes. The advent of monoclonal antibodies has helped to dissect, in detail, the antigenic makeup of the retina. Nervous system antigens (NS-3, 4 and 7) are generously represented in the retina. At least in the chick eye there seems to be a concentration gradient of retinal antigens along a dorsoventral axis which is believed to provide means by which neurones of developing retinal signal and receive the positional information necessary for the formation of specific synapses. It now seems certain that organ-specific antigens are presented not only in the photoreceptors and the retinal pigment epithelium but also in the retinal ganglion cells and the astrocytes. Photoreceptor outer-segment contains soluble antigens which when injected in rats, rabbits, guinea-pigs or monkeys produce varying degrees of intraocular inflammation leading to uveitis, retinal detachment, photoreceptor degeneration and occasionally retinal vasculitis. Both cell-mediated and humoral immunity to photoreceptor antigen has been demonstrated in various types of uveitis (including toxoplasmosis and sarcoidosis), pars planitis, vitriitis, Behçets disease, sympathetic ophthalmitis, Vogt-Koyanagi-Harada syndrome, birdshot retinopathy, retinitis pigmentosa and retinal vasculitis. Retinal autoimmunity is also found in retinal detachment and diabetic retinopathy, particularly after Argon laser photocoagulation. Antibodies to retinal antigens are also found in patients with systemic lupus erythematosus and other systemic immune disorders without ocular involvement. The precise pathogenetic role of retinal autoimmunity in eye disease is therefore uncertain. It may simply represent an epiphenomenon which develops afer retinal damage due to physical, micro-organismal or immunological insult. Alternatively it is possible that although autoimmunity does not initiate ocular inflammation it perpetuates and maintains the inflammatory state and produces further damage to ocular tissues.
Immunoglobulin A (IgA) deficiency and eye disease.
The finding of a deficiency of immunoglobulin A (IgA) in serum is not uncommon. In order to determine whether low serum IgA levels were associated with any particular ocular conditions, the immunological investigations of over 4,000 patients with a variety of ophthalmological disorders, performed at the Department of Pathology of the Institute of Ophthalmology, London, were reviewed and analysed. The study showed an apparent tendency to low levels in patients with conjunctivitis and thyroid disease. These findings are of theoretical interest rather than diagnostic value.
Errors in the diagnosis of choroidal malignant melanoma.
A 10 year review of enucleations at the University of Ottawa affiliated hospitals revealed that of 29 eyes with a visible fundus lesion diagnosed as choroidal malignant melanoma only one was incorrectly diagnosed.
Proliferative retinopathy in anencephalic babies.
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Degeneration of intramural pericytes in diabetic retinopathy.
Retinal pericyte degeneration, a usual finding in diabetic retinopathy, has been shown to be a change probably peculiar to the retina rather than part of a more widespread angiopathy. Thus in a patient with diabetic retinopathy the characteristic eosinophilic degeneration of the pericyte nuclei ceased at the optic disc and could not be found in vessels of the optic nerves and brain.
Is routine ordering of both hemoglobin and hematocrit justifiable?
IN ORDER TO ASSESS THE VALUE OF ROUTINE SIMULTANEOUS HEMOGLOBIN AND HEMATOCRIT DETERMINATIONS, PAIRED DETERMINATIONS IN THE FOLLOWING GROUPS WERE STUDIED: (1) 360 consecutive pairs from the hematology laboratory, (2) 95 pairs on general medical patients, (3) 43 pairs on 10 patients with upper gastrointestinal hemorrhage, and (4) 62 pairs on 10 patients with burns. These values were plotted on scatter diagrams. In the 560 pairs only three disparate determinations were found.It is concluded that, in most clinical situations, determination of the hemoglobin or the hematocrit as a screening procedure provides as much useful information as the simultaneous determination of both.