Biomedical subjects
Publications and source records attributed to J Biswas.
Nonfamilial amyloidosis, a form of primary amyloidosis accompanied by vitreous opacity, is a rare condition. Here, a 50-year-old man developed strand-like opacities in the vitreous of both eyes. Pars plana vitrectomy was performed to improve the patient's vision. The vitreous specimens showed typical light microscopic and ultrastructural features of amyloidosis.
We have previously demonstrated the effects of various inhibitors of arachidonic acid metabolism on experimental lens-induced granulomatous uveitis. In the present study, we investigated the effect of these same inhibitors on the expression of lysosomal enzymes at different stages of choroidal inflammation in experimental lens-induced granulomatous uveitis and compared this to the inflammation observed at each stage examined. Lysosomal enzymes such as acid phosphatase, beta-glucuronidase and succinate dehydrogenase are known to be liberated during the maturation of mononuclear phagocytes to epithelioid cell granulomas. Although animals treated with nordihydroguaiaretic acid showed less severe inflammation than did indomethacin-treated or control animals, none of these agents appeared to affect the expression of acid phosphatase and beta-glucuronidase, as determined histochemically. Succinate dehydrogenase could not be detected in any of the eyes examined, even though sections of liver and kidney from these same animals were positive for this enzyme.
Myxoma of the cornea is extremely rare. To our knowledge, only two cases have been reported in the literature. We report an additional case of a corneal myxomatous lesion that presented as a subepithelial, gelatinous, and whitish mass. Histologic examination revealed a loose mucoid stroma, rich in hyaluronic acid, with a relative paucity of cells.
We studied the clinical and histopathologic features of Pneumocystis carinii choroiditis in three patients with acquired immunodeficiency syndrome. In two cases, a provisional diagnosis of disseminated P. carinii infection was made by ophthalmologic examination. The characteristic fundus changes in this infection consisted of numerous slightly elevated, plaque-like, yellow-white lesions located in the choroid and unassociated with signs of intraocular inflammation. The diagnosis was confirmed by postmortem examination of the eyes and other organs. Histopathologically, the globes showed many choroidal infiltrates that were eosinophilic, acellular, vacuolated, and frothy. Several such infiltrates were noted within the choroidal vessels and choriocapillaries. Gomori's methenamine silver stain demonstrated many cystic and crescentic organisms. Electron microscopy disclosed thick-walled cystic organisms and large numbers of trophozoites.
Erythropoietic responses of fed and starved species of teleosts, viz., Clarias batrachus and Heteropneustes fossilis, to human urinary erythropoietin and thyroxine have been examined. The effects of these hormones on energy reserves have also been evaluated. Twenty-four C. batrachus were divided into two groups: half were fed regularly; the remaining fish were starved 20 days. On the 21st day each group was further divided into three subgroups of four each and received either saline, thyroxine (8 micrograms), or erythropoietin (6 IU) over 4 consecutive days. The experimental protocol was identical for H. fossilis; however, for H. fossilis two identical studies were conducted approximately 1 year apart. A decline in the rate of erythropoiesis and a stimulatory response to human urinary erythropoietin followed starvation in both species of teleosts. In addition, erythropoietin had a pronounced effect on hepatic glycogenesis of fed H. fossilis and stimulated erythropoiesis in the fed teleosts of both species. Prolonged starvation drastically depleted hepatic glycogen in C. batrachus. In contrast, it had no effect on hepatic glycogen in H. fossilis and on muscle glycogen and protein in both species. In general, while both species could respond to erythropoietin and withstand prolonged starvation, H. fossilis alone exhibited remarkable tolerance to fasting.
Entamoeba histolytica was studied in 33 lactating women and their infants in a periurban village in Bangladesh. Infant-mother pairs were followed for a period of 10-15 months: 67% of mothers excreted E. histolytica during the observation period, the majority for 3 months or more. Only one mother was symptomatic, with a mild, non-dysenteric diarrhoea. 58% of mothers were seropositive, several of them continuously and with a high titre, indicating past invasive infection. 67% had detectable antibodies in breast milk and 36% in saliva. Despite the high prevalence of E. histolytica in these mothers, infants were mostly uninfected: E. histolytica cysts in small numbers were found in only 2 of 1200 samples from infants aged 6 and 10 months. Several of the children were infected with Giardia lamblia. Although lower exposure to E. histolytica than to Giardia may account for the difference in infant infection rates with these parasites, defence mechanisms possibly exist which protect against E. histolytica but are ineffective against Giardia.
Acute hemorrhagic conjunctivitis (AHC) has been reported in epidemics. This is a report of 29 sporadic cases of AHC recorded over a period of two years after the 1981 epidemic in and around Chandigarh. A rapid and simple immunofluorescence test was developed and standardized in our Institute for the diagnosis of AHC. It was used for epidemiological monitoring of cases and to establish the diagnosis in suspected cases of AHC reporting after the epidemic. The clinical picture of epidemic and sporadic cases is compared.
Giardia lamblia infection in an endemic area was investigated by following a cohort of 33 lactating mothers and their infants in a semiurban community of Bangladesh for one year. Eighty-two percent of mothers and 42% of infants excreted Giardia at least once during the study period. Infants became infected as early as 3 months of age, and 86% of the infected infants had diarrhea, suggesting that the first exposure to the parasite results in disease. Only one of the infected mothers had diarrhea, indicating that with repeated exposure to Giardia, mothers in an endemic area may develop partial immunity that protects against disease but not infection. An interrelationship between maternal and infant colonization was not found. Local and systemic immune responses to Giardia correlated poorly with infection, but milk antibodies were a better reflection of infection than serum antibodies were. Infection with G. lamblia was significantly lower in infants younger than 6 months (9%), an age when many are totally breast-fed. However, we were unable to establish clear-cut protection related to human milk antibodies, and suggest that the lower infection rate in younger infants results mainly from decreased exposure to Giardia cysts.
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The ocular morbidity pattern in 2010 eyes of 1005 patients with active pulmonary and extrapulmonary tuberculosis was studied prospectively. A complete clinical (ocular and systemic) examination, radiologic evaluation, Mantoux test and sputum analysis for acid-fast bacilli were carried out in all patients. The ocular morbidity in patients in this study with active tuberculosis was 1.39%. The most common ocular finding was bilateral healed focal choroiditis (50%). No case of Eales' disease was found in this series. There was no statistically significant correlation between the ocular lesions and Mantoux positivity.
This report describes a retrospective study of all new patients in our uveitis clinic between January 1992 and December 1994, undertaken to identify the pattern of uveitis in the Indian subcontinent. A standard clinical protocol, and the naming-meshing system with tailored laboratory investigations were used to arrive at a final uveitic diagnosis. Uveitis comprised 1.5% of new cases seen at the centre. Out of 1,273 uveitis cases, anterior uveitis was the most common type (39.28%), followed by posterior uveitis (28.75%), intermediate uveitis (17.44%), and panuveitis (14.53%). The most commonly affected age group were patients in their forties (23.57%). Uveitis was less common in children below 10 years (3.61%) and in adults over 60 years of age (6.44%). Men (62.21%) were more commonly affected than women (37.79%). Aetiology remained undetermined in 59.31% of cases. Anterior uveitis was most commonly idiopathic (58.6%). The most common cause of posterior uveitis was toxoplasmosis (27.87%), and that of panuveitis was the Vogt-Koyanagi-Harada syndrome (21.08%). A higher incidence of microbiologically proven tubercular uveitis (5 cases), and uveitis due to live intraocular nematode (4 cases), and malaria (1 case), were seen, in contrast to other studies. Only 2 cases of AIDS with ocular lesions were seen. This paper reveals the pattern of uveitis seen at a major referral eye institute in India.
PURPOSE: Vogt-Koyanagi-Harada (VKH) disease is known to have varied manifestations in different ethnic groups. In order to analyze the clinical profile of VKH cases in the Indian population, we studied 87 consecutive cases of VKH disease treated in an uveitis clinic in South India between 1985 and 1996. METHODS: Retrospective analysis and review of charts of consecutive new VKH cases diagnosed in a referral clinic. RESULTS: VKH disease comprised 2.2% of all uveitis referrals. Extraocular symptoms or signs were seen in 64% of cases at the time of presentation. Most common was meningism (95.9%). However, subsequently all patients developed extraocular manifestations. Panuveitis (92%) was the commonest presentation. Systemic corticosteroid was the usual form of therapy (50.3%) followed by immunosuppressive therapy (39%); surgical treatment was needed in 8% of the cases. Complicated cataract (33%) and glaucoma (24%) were major complications. Final vision was between 6/60 and 6/18 in 88% of the cases and 6/18 and better in 15.4%; there was no improvement in 11% of the cases. CONCLUSIONS: VKH disease occurs less frequently in India than in Japan and about as commonly as in the United States. Extraocular signs are far less common than in the Japanese population. Visual prognosis is good in patients presenting within 1 month of onset of symptoms. Immunosuppressive agents and vitreoretinal surgery are needed in advanced cases and in cases reported later. Jpn J Ophthalmol 2000;44:296-301
Melanocytoma of the ciliary body is quite rare. Although the tumor is benign, it can spread to the surrounding structures, causing glaucoma and giving an erroneous impression of melanoma. We report a case of melanocytoma of the ciliary body in a 19-year-old woman who presented with diffuse melanocytic proliferation of the iris with uncontrolled secondary glaucoma and a subconjunctival pigmented mass. Fine-needle aspiration of the iris lesion and a histopathologic study of the subconjunctival mass could not rule out melanoma. Enucleation of the painful glaucomatous eye showed evidence of ciliary body melanocytoma with extension into the angle structures as well as the subconjunctival tissue.
Leiomyoma of the ciliary body is a rare tumor that often causes a diagnostic dilemma. Sclerouvectomy has been found to be beneficial in the management of iris and ciliary body leiomyoma. We treated a case of leiomyoma of the ciliary body presenting as a fleshy mass in the anterior chamber, removed by partial lamellar sclerouvectomy. Ultrasound biomicroscopic and histopathologic features, including light microscopic, immunohistochemistry, and transmission electron microscopic features, were studied and the literature was reviewed.
Retinoblastoma usually presents in children younger than 5 years. To our knowledge, 20 cases of retinoblastoma in adults (older than 20 years) have been reported in the literature. Of 173 patients with histopathologically proven retinoblastoma seen in our institute, three were adults. All the patients had endophytic tumors with vitreous seeds. Ultrasonography did not reveal calcification in two cases. Immunohistochemistry with neuron-specific enolase was used to confirm the diagnosis in two cases. All three patients ultimately required enucleation. None of the patients had been referred with a diagnosis of retinoblastoma. The diagnosis of retinoblastoma should be considered in cases of whitish mass lesion in the fundus of an adult.
Eales' disease is a primary retinal perivasculitis of an undetermined etiology seen predominantly in the Indian subcontinent and rarely in the West. Strong HLA association has been proven in retinal vasculitis of Behcet's disease. HLA association of Eales' disease is unknown and therefore the present study was undertaken to determine the same. The frequency of 30 HLA antigens (9 HLA-A antigens, 10 HLA-B antigens, 3 HLA-C antigens, 7 HLA-DR antigens and 1 HLA-DQ antigen) was studied by standard micro-lymphocytotoxicity test in 57 patients with Eales' disease and 50 age and sex-matched normal persons as controls. Both the patients and controls underwent complete ocular and clinical examinations and laboratory investigations. Inflammatory diseases similar to Eales' disease were ruled out in the patients before they were enrolled. Statistically significant higher phenotype frequencies of HLA B5 (B51), DR1 and DR4 were observed among patients with Eales' disease as compared to controls. The gene frequency of HLA B5 (B51) in our group of patients and controls was comparable with other earlier studies in the Indian population. The finding of significant association of Eales' patients with positive disequilibrium ( ) haplotypes A3-B44 and A11-B12 may be related to the development of this disease. The presence of the above HLA antigens may be indicative of predisposition to Eales' disease.