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Biomedical subjects

S M Whitcup

Publications and source records attributed to S M Whitcup.

117 records · Page 7Linked to original sources

Immunohistochemistry of Terrien's and Mooren's corneal degeneration.

Lamellar keratoplasty specimens from a patient with Terrien's marginal degeneration and a patient with Mooren's ulcer were compared using routine histopathologic and immunohistochemical staining with an avidin-biotin-peroxidase complex. Less than 25% of the resident cells in the Terrien's marginal degeneration specimen expressed major histocompatibility class II antigens compared with 75% to 100% of the resident cells in the Mooren's ulcer specimen. The ratio of CD4 cells (T-helper/inducer) to CD8 cells (T-suppressor/cytotoxic cells) in the Terrien's marginal degeneration specimen was almost 1:1 compared with 24:1 in the Mooren's ulcer specimen. In addition, less than 5% of the infiltrating cells from the Terrien's marginal degeneration specimen stained positive for CD22 (B cells), compared with 25% to 50% from the Mooren's ulcer specimen. These data may help explain why Terrien's marginal degeneration runs a more benign course than does Mooren's ulcer and provides a rationale for the use of immunosuppressive drugs to treat Mooren's ulcer.

Adult↗

Ocular complications of Stevens-Johnson syndrome and toxic epidermal necrolysis in patients with AIDS.

Recent reports suggest that acquired immunodeficiency syndrome (AIDS) patients are at higher risk of developing mucocutaneous reactions such as toxic epidermal necrolysis and Stevens-Johnson syndrome (SJS). Resultant dry eye may be further exacerbated by human immunodeficiency virus (HIV) related lacrimal gland dysfunction and lead to a chronic keratoconjunctivitis. We report one patient with AIDS and toxic epidermal necrolysis and two patients with AIDS and SJS who developed severe dry eye misdiagnosed as infectious keratoconjunctivitis. Cicatrizing mucocutaneous reactions should be suspected in AIDS patients and the dry eye treated to control symptoms and prevent complications.

Acquired Immunodeficiency Syndrome↗

Saccadic eye movements in myasthenia gravis.

The peak velocities of horizontal saccades were measured in patients with myasthenia gravis (MG) to determine whether they can differentiate MG from other causes of ophthalmoplegia. Eye movements were recorded with electrooculography (EOG) or infrared scleral reflection (IR) in 42 patients with MG, 26 patients with sixth cranial nerve palsy (CNP), 19 patients with chronic progressive external ophthalmoplegia (PEO) and 28 normal subjects. Despite limitation of ductions in MG, the group means of velocities of 10 deg saccades recorded with IR were similar in MG and normal subjects. With EOG, small but statistically significant decreases in mean velocities of 10, 20 and 30 deg saccades were found in MG, compared to those in normal subjects. Twenty-one to 28% of MG patients had velocities outside of the normal range (outliers). In contrast, the group means in CNP and PEO were markedly lower than those in MG and normal subjects. The frequencies of outliers were 89 to 100% in CNP and 88 to 100% in PEO. Measurement of saccadic velocities can be helpful in differentiating MG from other causes of ophthalmoplegia.

Adolescent↗

Unrecognized drug dependence in psychiatrically hospitalized elderly patients.

The psychiatric in-patient records of 90 patients greater than or equal to 65 years of age were reviewed retrospectively to determine the prevalence of chemical dependence and if lack of recognition and treatment of chemical dependence resulted in serious complications. Nineteen of the 90 patients were characterized as drug dependent and ten of these patients were neither recognized nor detoxified. Seven of the ten nondetoxified patients, but only one of the nine detoxified patients, experienced serious medical complications typically requiring transfer to a medical floor or medical intensive care unit. Unrecognized chemically-dependent patients were significantly more likely to be female benzodiazepine abusers, while recognized chemically dependent patients were significantly more likely to be male alcohol abusers.

Aged↗

Lithium-neuroleptic neurotoxicity in the elderly bipolar patient.

The frequency and clinical characteristics of lithium- and neuroleptic-mediated neurotoxicity were determined in 10 elderly bipolar patients. When lithium was used alone and therapeutic serum lithium levels were achieved, neurotoxicity did not develop. However, when a neuroleptic was added, neurotoxicity developed in 60% (three of five) of patients and was characterized by delirium, extrapyramidal signs, and cerebellar dysfunction. Neurotoxicity occurred despite the use of neuroleptic dosages that are considered safe and useful when administered in the absence of other psychoactive drugs.

Aged↗

Iris involvement in primary intraocular lymphoma: report of two cases and review of the literature.

Non-Hodgkin's lymphoma involves ocular tissues either as a primary tumor or as secondary metastasis from systemic disease. Diagnosis is based on the identification of malignant cells in the eye by biopsy. Although primary intraocular lymphoma cells have been identified in the optic nerve, ciliary body, and iris of a small number of patients by histopathology, these sites of infiltration have rarely been observed on clinical examination. We studied clinical and histopathological findings of two patients with iris infiltration by primary intraocular lymphoma and reviewed the findings of 163 cases reported in the literature.

Biopsy↗

Node way out.

A 47-year-old woman without a history of melanoma experienced visual hallucinations, abnormal visual field, and an ERG suggestive of melanoma-associated retinopathy (MAR). A lymph node biopsy showed malignant melanoma. Appropriate evaluation, management, and treatment of MAR is discussed.

Antibodies, Neoplasm↗

Ocular immunopathology of Behçet's disease.

A patient developed progressive, severe, recurrent bilateral iridocyclitis, retinal vasculitis, and hemorrhagic infarction of the retina that led to blindness despite immunosuppressive therapy. Histopathology of an enucleated blind and painful eye revealed marked nongranulomatous uveitis with a predominantly CD4+ T-lymphocytic infiltration, as well as B-cell and plasma cell aggregation. Extensive expression of adhesion molecules on vascular endothelial cells were found. This finding suggests that adhesion molecules play an important role in the vasculitic process, the trademark of Behçet's disease. The ocular pathology and the therapeutic approach to Behçet's disease are briefly reviewed.

Adult↗