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Digestive manifestations are uncommon in Behçet's disease. The authors reported 3 male patients between 20 and 30 years with Behçet's disease who developed surgical abdomen. Emergency surgical intervention found perfored ileal ulceration. Histological study of resection piece showed mainly intestinal angitis with periphlebitis, venous thrombosis and obliterant endarteritis.
Corticosteroid are the main treatment in both systemic and ocular sarcoidosis. Most cases of ocular sarcoidosis, such as iridocyclitis, retinal periphlebitis, optic disc inflammation, vitritis and snowballs can be managed with topical or subconjunctival injections of corticosteroids. However, only rarely cases are systemic steroids indicated. High doses of systemic steroids are effective in unusual manifestations of retinal vein occlusions, retinal and optic disc neovascularization and vitreous hemorrhage. Systemic corticosteroids starting with moderately high doses (40-60 mg/day) with slow tapering according to the clinical response is necessary. Photocoagulation has not been widely used in the treatment of neovascularization, secondary to sarcoidosis.
Segmental retinal periarteritis is a relatively rare clinical entity with varied etiologies. This report describes a case of acute toxoplasmosis with segmental periarteritis without concomitant periphlebitis. To my knowledge this has never been reported previously. The diagnosis of toxoplasmosis was proven by both clinical findings and serology.
The widespread use of long-term intravenous catheters has produced some concern on the part of the clinician with respect to morbidity and occasional mortality associated with their use. Fourteen polymer surfaces were evaluated in experimental animals in this study. Several of the materials are commercially available; the others are experimental. In all, 160 catheters were placed in the femoral and jugular veins through side branches. The catheters were evaluated in terms of thrombosis, phlebitis, and periphlebitis, using an arbitary grading system. Scanning electron microscopy and light microscopy were employed to document the results. The most successful catheter materials were next evaluated in man, using the same experimental parameters. It is our belief that the observed thrombosis associated with morbidity is largely due to the surface characteristics of the catheter materials. These characteristics are largely surface phenomena related to the interactions between the tissue and catheter material. In this study, we have attempted to determine whether there are any significant differences in thrombogenicity and/or long-term function between the several currently available catheters. Based on this study, ethylene acrylic acid appears to be the most nonthrombogenic surface of the material tested.
A case of a 28-year-old woman with infiltration of sarcoidosis scar tissue after blepharoplasty is reported. Nodules developed two times in her right upper eyelid about 1 and 2 years after blepharoplasty of both eyes and they were resected each time, but eruption recurred. Ophthalmic examination revealed aqueous flare and cells, snowball vitreous opacities, and retinal periphlebitis. A chest X-ray disclosed bilateral hilar lymphadenopathy (BHL). Laboratory studies showed an elevation of the serum angiotensin converting enzyme (ACE). Light microscopy revealed epithelioid granuloma with no caseation necrosis in a biopsy specimen, Viewing through polarized light demonstrated crystalline-like foreign bodies with bi-refringence in the epithelioid granuloma. Electron microscopic X-ray microanalysis confirmed these foreign bodies to be composed of Si, Mg, and O. These findings indicate that this skin lesion was caused by an infiltration of sarcoidosis scar tissue.
A series of 33 patients with histological evidence of sarcoidosis and a retinopathy is reviewed. The fundus can be involved in the absence of anterior uveitis and involvement may be grossly asymmetrical. The most common lesion was a retinal periphlebitis which can progress to occlusion and neovascularization at the same site or at the optic disc. Focal chorio-retinal changes frequently occur, usually without serious visual loss. Central retinal vein or large branch vein occlusions did not occur and the disease appears primarily to affect the smaller retinal veins.
In two generations of a big family two men in each generation were struck with a vitreoretinal disease, which led to vitreous haemorrhage and were first was interpreted as Periphlebitis retinae (Eale's disease). Preretinal, perforated membranes containing vessels and a severe macular degeneration pointed to a vitreoretinal dystrophy. The uniform alteration of the ERG with reduction of the b-waves were striking in all four patients. Judging from the X-chromosomal pattern of transmission, from the juvenile vitreous haemorrhages and from the macular dysplasia with radial plication we seem to be dealing with a sexlinked juvenile retinoschisis, although at first microscopic examination the vitreous veils did not make us think of a retinoschisis.
Tbc has not yet been eradicated in Western Europe. Among 311 human/bovin-tuberculin tested cases out of 500 patients with uveitis (1971-1974), 37-50% (average age 40-45 years) reacted highly positive. Chorioretinitis disseminata and periphlebitis retinae (Eales' disease): 90% positive. The criteria for a long term tuberculostatic treatment are exposed. 20% of all cases of uveitis and 90% of Jensen Retinochorioditis have been interpreted as caused by toxoplasmosis. 75% are relapses. The gigantic toxoplasmotic lesions of the eyeground is stressed. As a rule low Sabin Feldmann titers are found. Quantitative serology is valuable. In the closing discussion the immunologically well known adjuvans-effect of Koch's bacillus-extract is supposed to be of importance in highly tuberculin positive uveitis.
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