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PubMedDate not supplied

Pharmacokinetic profile of a 300-mg extended phenytoin sodium capsule (Dilantin) formulation.

The pharmacokinetic profile of a newly developed Dilantin 300-mg Kapseal formulation was compared with that of currently marketed Dilantin 100-mg Kapseals in both a 300-mg single-dose bioequivalence study in nine healthy volunteers and a once-daily 300-mg multiple-dose study in 18 patients with seizures. Results of these studies indicate the rate and extent of absorption of the 300-mg extended phenytoin (PHT) sodium capsule formulation are similar to that of 100-mg extended PHT sodium capsules based on PHT plasma maximum concentrations and time to achieve them (Cmax, tmax), and area under the curve (AUC) values and the urinary excretion of total hydroxy phenylhydantoin (HPPH) in the single-dose study and steady-state PHT plasma Cmax, tmax, minimum plasma concentrations (Cmin), and AUC values and urinary excretion of total HPPH in the multiple-dose study. Control of seizures in patients was equally maintained on a once-daily 300-mg multiple-dosing regimen administered as either one 300-mg extended PHT sodium capsule daily or three 100-mg extended PHT sodium capsules daily. Therefore, 300-mg extended PHT sodium capsules can be safely and effectively interchanged with three 100-mg extended PHT sodium capsules in patients requiring a once-daily 300-mg PHT sodium dosing regimen.

Adult↗
PubMed2006

Safety and tolerability of transoral Bravo capsule placement after transnasal manometry using a validated conversion factor.

OBJECTIVES: To prospectively calculate and validate a conversion factor in healthy volunteers that allows accurate nonsedated, transoral (TO) Bravo capsule placement after transnasal (TN) manometry, and to evaluate the ease and safety of nonendoscopic Bravo placement compared with endoscopic placement. METHODS: Part 1. Twenty-five healthy volunteers underwent sequential TN and TO esophageal manometry to measure the distance to the lower esophageal sphincter (LES). A TN to TO conversion factor was calculated from these measurements. Part 2. Twenty volunteers underwent TN manometry followed by unsedated TO Bravo capsule placement using the conversion factor calculated in part 1. TN endoscopy then measured the location of the Bravo capsule in relationship to the squamocolumnar junction (SCJ). Part 3. During an 18-month period, 370 consecutive patients referred for a Bravo procedure underwent nonendoscopic, unsedated TO placement (308 patients) or standard endoscopically assisted placement (62 patients). RESULTS: Part 1. All 25 volunteers completed TN and TO manometry; a conversion factor of 4 cm was calculated. Part 2. Using the calculated conversion factor of 4 cm, a Bravo capsule was deployed TO 5 cm above the proximal border of the LES. The mean +/- standard deviation (SD) TN endoscopic distance to the capsule was 6.0 cm (+/-0.3 cm) above the SCJ. Part 3. A total of 333 patients completed the entire study (90%). Analysis of 48-h pH measurements did not reveal any significant differences between the two groups. CONCLUSIONS: A reliable and valid conversion factor of 4 cm following TN manometry permits accurate TO placement of the Bravo capsule without endoscopy. TO, unsedated Bravo placement is safe, well tolerated, and may minimize costs and potential risks associated with endoscopy.

Adolescent↗
PubMed1986

A comparison of the soft gelatin capsule and the tablet form of temazepam.

Pharmacokinetics and pharmacodynamics of the soft gelatin capsule and tablet form of temazepam were compared. In a single blind study, six healthy volunteers, in the supine position, took either a tablet of temazepam 20 mg or a soft gelatin capsule of temazepam 20 mg. Sixty gynaecological in-patients received either a tablet or a soft gelatin capsule of temazepam 20 mg the night before surgery as premedication. Subjective parameters were assessed in the morning. The soft gelatin capsule yielded clearly higher serum concentrations during the first hour after administration. In the pharmacodynamic parameters there were slight but insignificant differences in favour of the capsule form. As a premedicant the capsule resulted in a significantly (P less than 0.01) shorter delay in the onset of sedative action and to an almost significant (P less than 0.05) delay in falling asleep; also an almost significantly (P less than 0.05) longer action of sleep in comparison with the tablet.

Adult↗
PubMed1990

The efficacy of a controlled-release albendazole capsule in suppressing nematode burdens in sheep.

An experiment was undertaken between July and November 1985 in East Gippsland, Victoria, to determine the efficacy of an intra-ruminal controlled-release albendazole capsule against naturally acquired worm burdens and larval challenge in Merino hoggets. Two groups of 20 sheep, one group untreated, the other dosed with a capsule were grazed together; 5 sheep from each group were slaughtered for total worm counts 30 and 101 d after capsules were administered. Serum anthelmintic concentrations, faecal egg counts and body weights were monitored. Most capsules were exhausted within 91 d of administration. During the estimated 80 d for which they remained active the capsules were highly effective against the benzimidazole-susceptible worm populations. Faecal egg counts were reduced to zero and total worm populations were reduced by over 97% 30 d after administration. By 101 d egg counts were increasing and worm counts indicated that sheep were becoming reinfected. Sheep treated with the capsules grew faster than those not treated.

Albendazole↗
PubMed1993

A survey of the efficacy of sustained-release monensin capsules in the control of bloat in dairy cattle.

Thirty-four farms in the Macalister Irrigation District in Gippsland, Victoria, using sustained-release monensin capsules in 5102 cattle in the 1990 bloat season were surveyed. Questions were asked about the prevention and incidence of bloat in 1989 and 1990. Eight farms not using the capsules were selected to act as controls. Relatively low rates of broken capsules (0.6%), injury to animals at administration (0.06%) and regurgitation (1.02%) were reported. A variety of preventive techniques were used. There was a significant decrease in the use of pasture spraying, drinking water administration and flank spraying of anti-bloat substances on the farms using the capsules in the 1990 season, with no compensatory rise in the use of other techniques. There was no significant change in bloat prevention techniques used on the control farms over the same period. Significantly fewer cattle on the farms using capsules were treated for, and fewer died of clinical bloat in 1990 than in 1989. There was no significant change in the incidence of bloat on the control farms over the same period. It was considered that the anti-bloat capsules were effective in reducing the incidence of clinical bloat in pasture-fed dairy cattle.

Animals↗
PubMed1998

Field trials evaluating ivermectin controlled-release capsules for weaner sheep and for breeding ewes.

OBJECTIVE: To confirm the efficacy of ivermectin released from a controlled-release capsule administered to young sheep and to breeding ewes under field conditions. DESIGN: Randomised field trials. PROCEDURE: In each of ten field trials 25 weaned lambs were treated with ivermectin controlled-release capsules and 25 remained untreated. Eight similar field trials were conducted using adult ewes. Efficacy against infections of gastrointestinal nematodes was assessed by faecal egg counts and faecal larval culture. Body weights were recorded and faecal soiling of the breech wool (dags) was assessed. RESULTS: Nematode faecal egg counts in the two groups were not different (P = 0.13) before treatment in the weaner trials or before treatment in the ewe trials (P = 0.49), but thereafter eggs in the untreated sheep persisted, whereas counts in sheep given capsules were negligible (P < or = 0.01). In the weaner trials, dag scores for the two groups were not different at the start of the trials (P = 0.18) but at the end, untreated sheep had significantly more dags (P = 0.04) than treated sheep. In the ewe trials, dag scores remained low in both groups. Weaners treated with the capsule gained 1.4 kg (95% CL: 0.7, 3.1) more weight over the 16 week trial period compared to untreated weaners (P = 0.01). Both groups of ewes lost weight as a result of parturition but the mean loss by week 16 was greater for untreated (3.7 kg) (95% CL: -5.1, -2.2) than for treated ewes (1.8 kg) (95% CL: -3.3, -0.4). The mean change in ewe body weight for the two groups was however not significant (P = 0.07). Differentiation of nematode larvae recovered from cultures of faeces from untreated animals indicated that the capsules were effective against the common parasites of sheep. CONCLUSION: The capsule was efficacious against gastrointestinal nematodes judging from faecal egg counts. It has the potential to significantly reduce contamination of pasture with nematode eggs. Treated weaners had less dags for 16 weeks and gained more weight than untreated weaners.

Animals↗
PubMed1980

The influence of drug and diluent particle size on the in vitro release of drug from hard gelatin capsules.

The in vitro release of a drug from capsules containing different proportions of controlled particle size fractions of acetylsalicylic acid and lactose, has been assessed in terms of the time for 50% of the drug content of the capsule to be released into solution during a dissolution test (T50), and by a standard disintegration test. In general the two types of test gave closely related responses although some discrepancies existed with certain systems. For capsules containing only the drug, the value of T50 increased as the particle size of the drug decreased. The addition of lactose generally reduced the T50 value, the extent of the reduction showing greater dependence on the proportion of lactose added than its particle size. Capsule formulations containing 80% w/w of lactose had values of T50 which were independent of drug or diluent particle size. Capsule formulations containing lower proportions of lactose usually had an optimum combination of particle size fractions of drug and diluent for maximum drug release. The relationship between drug release and the porosity within the capsule was dependent on the particle size of the drug.

Aspirin↗
PubMed1996

Oral sustained-release cisplatin capsule.

An oral sustained-release cisplatin preparation was prepared by combining microporous water-insoluble pharmaceutical polymer, ethylcellulose, a membrane and a gel-forming polymer, poly(acrylic) acid (Carbopol). As cisplatin is an extremely hydrophilic and small compound, it was difficult to control the release rate solely by the micropores on the ethylcellulose capsule. To retain cisplatin within the capsule, gel-forming polymer was formulated inside the capsule. The release rate of cisplatin was dependent both on the number of micropores of the capsule and the formulated amount of Carbopol. The number of micropores ranged from 20 and 30 to 60, and the formulated amount of Carbopol varied from 15 to 100 mg. In-vitro release experiments suggested that the release rate decreased as the formulated amount of Carbopol increased when the pore number was 60 and 30. However, when pore number was decreased to 20, the effect of the amount of Carbopol was not clearly observed. In the in-vivo study using rabbits, the sustained-release cisplatin capsule was evaluated in comparison with solution after oral administration of 20 mg drug. With the pore number of 60, Cmax was 0.46 +/- 0.02 microgram mL-1 at 4 h and thereafter serum concentrations declined rapidly. When the pore number was 30, serum cisplatin level-time profiles showed long-acting patterns and AUC was reversely correlated with the formulated amount of Carbopol. Cmax and tmax were 0.41 +/- 0.02 microgram mL-1 and 3.33 +/- 0.88 h, respectively and 0.23 +/- 0.01 microgram mL-1 was obtained at 24 h after oral administration of capsule having 30 pores and 15 mg of Carbopol. We conclude that the possibility of developing an oral sustained-release cisplatin preparation is feasible.

Acrylic Resins↗
PubMed1998

Resistance to densification, tensile strength and capsule-filling performance of some pharmaceutical diluents.

The purpose of this study was to compare some indicators of capsule-filling performance, as measured by tapped density under different conditions, and elucidate possible quantitative relationships between variation of capsule fill-weight (%CV) and gravitational and inter-particle forces (attractive or frictional) derived from measurements of particle size, true density, low compression and tensile strength. Five common pharmaceutical diluents (lactose, maize starch, talc, Emcocel and Avicel) were investigated and two capsule-filling methods (pouring powder and dosator nozzle) were employed. It was found that for the pouring-type method the appropriateness of Hausner's ratio (HR), Carr's compressibility index (CC%) and Kawakita's constant (alpha) as indicators of capsule fill-weight variation decreases in the order alpha > CC% > HR; the appropriateness of these indicators also decreases with increasing cylinder size and with impact velocity during tapping. For the dosator-type method the appropriateness of the indicators decreases in the order HR > CC% > alpha, the opposite of that for the pouring-type method; the appropriateness of the indicators increases with decreasing cylinder size and impact velocity. The relationship between %CV and the ratio of inter-particle attractive to gravitational forces calculated from measurements of particle size and true density (Fvdw/Wp) was more significant for the pouring-type capsule-filling method. For the dosator-type method a significant relationship (1% level) was found between %CV and the product of Fvdw/Wp and a function expressing the increase, with packing density (p(f)), in the ratio of frictional to attractive inter-particle forces derived from compression (P) and tensile-strength (T) testing, d(log(P/T))/d(p(f)). The value of tapped density in predictions of capsule-filling performance is affected by the testing conditions in a manner depending on the filling method applied. For the pouring-type method predictions can be based on the ratio of attractive (inter-particle) to gravitational forces, whereas for the dosator-type method the contribution of frictional and attractive forces should, because of packing density change, also be taken into account.

Capsules↗
PubMed2005

Material properties of the human lumbar facet joint capsule.

The human facet joint capsule is one of the structures in the lumbar spine that constrains motions of vertebrae during global spine loading (e.g., physiological flexion). Computational models of the spine have not been able to include accurate nonlinear and viscoelastic material properties, as they have not previously been measured. Capsules were tested using a uniaxial ramp-hold protocol or a haversine displacement protocol using a commercially available materials testing device. Plane strain was measured optically. Capsules were tested both parallel and perpendicular to the dominant orientation of the collagen fibers in the capsules. Viscoelastic material properties were determined. Parallel to the dominant orientation of the collagen fibers, the complex modulus of elasticity was E*=1.63MPa, with a storage modulus of E'=1.25MPa and a loss modulus of: E" =0.39MPa. The mean stress relaxation rates for static and dynamic loading were best fit with first-order polynomials: B(epsilon) = 0.1110epsilon-0.0733 and B(epsilon)= -0.1249epsilon + 0.0190, respectively. Perpendicular to the collagen fiber orientation, the viscous and elastic secant moduli were 1.81 and 1.00 MPa, respectively. The mean stress relaxation rate for static loading was best fit with a first-order polynomial: B (epsilon) = -0.04epsilon - 0.06. Capsule strength parallel and perpendicular to collagen fiber orientation was 1.90 and 0.95 MPa, respectively, and extensibility was 0.65 and 0.60, respectively. Poisson's ratio parallel and perpendicular to fiber orientation was 0.299 and 0.488, respectively. The elasticity moduli were nonlinear and anisotropic, and capsule strength was larger aligned parallel to the collagen fibers. The phase lag between stress and strain increased with haversine frequency, but the storage modulus remained large relative to the complex modulus. The stress relaxation rate was strain dependent parallel to the collagen fibers, but was strain independent perpendicularly.

Adult↗
PubMed2007

Regional multiaxial mechanical properties of the porcine anterior lens capsule.

The lens capsule of the eye plays fundamental biomechanical roles in both normal physiological processes and clinical interventions. There has been modest attention given to the mechanical properties of this important membrane, however, and prior studies have focused on 1-D analyses of the data. We present results that suggest that the porcine anterior lens capsule has a complex, regionally dependent, nonlinear, anisotropic behavior. Specifically, using a subdomain inverse finite element method to analyze data collected via a new biplane video-based test system, we found that the lens capsule is nearly isotropic (in-plane) near the pole but progressively stiffer in the circumferential compared to the meridional direction as one approaches the equator. Because the porcine capsule is a good model of the young human capsule, there is strong motivation to determine if similar regional variations exist in the human lens capsule for knowledge of such complexities may allow us to improve the design of surgical procedures and implants.

Animals↗
PubMed1976

Timed-release capsule method for coliform enumeration.

Wax-coated capsules containing selective ingredients (brilliant green and oxgall) were added at the time of inoculation of most-probable-number media (modified lactose broths). The inhibitory ingredients gradually diffused from the capsules into the nonselective media, imparting selectivity to the media. Concentrations of brilliant green did not reach inhibitory levels until 2 or more h had elapsed, which permitted repair of some injured cells. Resuscitation of heat-injured Escherichia coli B cells occurred in the capsule-containing media, but not in conventional brilliant green bile 2% broth or violet red bile agar. No statistically significant differences were noted between coliform counts obtained on two groups of water samples by using the capsule, most-probable-number, membrane filtration, and pour plate methods. The capsule method could be used, however, as a combined presumptive and confirmed test for the examination of water. Improvements are needed to adapt the capsule method to the analysis of some categories of food.

Bacteriological Techniques↗
PubMed1996

The (alpha2-->8)-linked polysialic acid capsule of group B Neisseria meningitidis modifies multiple steps during interaction with human macrophages.

Group B Neisseria meningitidis causes systemic disease, including meningitis, after initial colonization and subsequent penetration of nasopharyngeal mucosa, a tissue which is richly populated by macrophages. In an initial effort to characterize the interaction of N. meningitidis and mature human macrophages, the influence of the alpha2-->8) -linked polysialic acid capsule on the interaction of N. meningitidis with human monocyte-derived macrophages was investigated with a capsulate case isolate and an isogenic Tn916-derived noncapsulate transformant. The capsulate strain was fourfold less adherent to the macrophage surface after cold incubation, although adherence of both strains was significantly increased after opsonization with nonimmune C5-depleted serum. When opsonized inocula were adjusted so that they adhered to macrophages in equal numbers, the two strains were internalized at equivalent rates and both entered membrane-bound compartments (phagosomes). Colocalization of bacteria with the late endosomal and lysosomal marker lysosome-associated membrane protein revealed that fusion of lysosomes with phagosomes containing the capsulate organism was significantly reduced 10 and 30 min after entry, but by 1 h, no difference between the strains was observed. Once internalized, meningococci were effectively killed, although more rapid killing of the capsulate strain was observed over the first 3 h. These results indicate that the (alpha2-->8)-linked polysialic acid capsule modifies the interaction of meningococci with human macrophages at multiple steps, including adherence to the macrophage surface and phagosome-lysosome fusion. Moreover, the discordance between the kinetics of phagosome- lysosome fusion and bacterial killing suggests that a nonlysosomal mechanism may be responsible for a significant fraction of macrophage killing of N. meningitidis.

Antigens, CD↗
PubMed1998

An epimerase gene essential for capsule synthesis in Vibrio vulnificus.

The extracellular capsule polysaccharide (CPS) of Vibrio vulnificus is a primary virulence factor which allows survival of the bacteria in the human host. To study the genes involved in expression of the capsule, we generated mutants that lost the ability to produce CPS following the insertion of a minitransposon into the genome of an encapsulated, clinical strain of V. vulnificus. A genomic region, from one nonencapsulated mutant, containing the transposon and flanking V. vulnificus DNA was cloned, and a probe complementary to the chromosomal DNA immediately adjacent to the transposon was used to locate this fragment in the genome of the encapsulated parent strain. The fragment, which contained a putative capsule gene, was cloned and, when supplied in trans, complemented the mutation in the nonencapsulated mutant to restore capsule production. In addition, virulence studies, using the 50% lethal dose assay, showed that the restoration of capsule production also restored the virulence of the organism. Sequence analysis of the gene disrupted by the transposon revealed that it matched a nucleotide-sugar epimerase of Vibrio cholerae O139, with 75 and 85% identities at the nucleotide and amino acid levels, respectively. In addition, computer analysis recognized epimerases of various organisms as highly similar to the putative epimerase of V. vulnificus. Finally, a combination of PCR amplification and Southern blotting showed that this epimerase is common to at least 10 strains of V. vulnificus that each express a serologically distinct CPS. Our results indicate that the epimerase gene is essential for capsule expression in V. vulnificus.

Amino Acid Sequence↗
PubMed2001

Transcriptional regulation of divergent capsule biosynthesis and transport operon promoters in serogroup B Neisseria meningitidis.

The clinically important serogroups B, C, Y, and W-135 of Neisseria meningitidis produce sialic acid capsules that are critical in pathogenesis. In each of these serogroups, the capsule transport (ctrABCD) and capsule biosynthesis (synABCD) operons are divergently transcribed from putative promoters located in a 134-bp intergenic region (J. S. Swartley, J. H. Ahn, L. J. Liu, C. M. Kahler, and D. S. Stephens, J. Bacteriol. 178:4052-4059, 1996). In this study we further assessed the role of the intergenic sequence in the transcriptional regulation of the sialic acid capsules of N. meningitidis. Insertional mutagenesis or deletions of the 134-bp sequence in the serogroup B meningococcal strain NMB resulted in a marked reduction or elimination of ctrABCD and synABCD transcription, with a concomitant loss of encapsulation. Chromosomal transcriptional lacZ-ermC reporter fusions of syn and ctr promoters were constructed through allelic exchange. Using these constructs, both operons were found to be constitutively transcribed in meningococci, the biosynthesis operon about fourfold higher than the transport operon. Both promoters showed increased activity during stationary-phase growth. In addition to the promoters, a 70-bp 5' untranslated region (UTR) upstream of synA was found to have a direct repeat and an inverted repeat that overlapped three putative integration host factor binding sites. Mutation of this 70-bp UTR and of the direct repeat upregulated both syn and ctr transcription. Regulation through the synA UTR was absent in a K1 Escherichia coli strain that produces identical capsular polysaccharide, implicating species-specific regulation. Meningococcal sialic acid capsule expression is initiated by divergent promoters in a 134-bp intergenic region, is repressed at the transcriptional level by the 5' UTR of synA, is increased during stationary-phase growth, and shows species-specific regulation. Transcriptional regulation is another important control point for sialic capsule expression in N. meningitidis.

5' Untranslated Regions↗
PubMed2005

Capsule and fimbria interaction in Klebsiella pneumoniae.

The capsular polysaccharide and type 1 fimbriae are two of the major surface-located virulence properties associated with the pathogenesis of Klebsiella pneumoniae. The capsule is an elaborate polysaccharide matrix that encases the entire cell surface and provides resistance against many host defense mechanisms. In contrast, type 1 fimbriae are thin adhesive thread-like surface organelles that can extend beyond the capsular matrix and mediate d-mannose-sensitive adhesion to host epithelial cells. These fimbriae are archetypical and consist of a major building block protein (FimA) that comprises the bulk of the organelle and a tip-located adhesin (FimH). It is assumed that the extended major-subunit protein structure permits the FimH adhesin to function independently of the presence of a capsule. In this study, we have employed a defined set of K. pneumoniae capsulated and noncapsulated strains to show that the function of type 1 fimbriae is actually impeded by the concomitant expression of a polysaccharide capsule. Capsule expression had significant effects on two parameters commonly used to define FimH function, namely, yeast cell agglutination and biofilm formation. Our data suggest that this effect is not due to transcriptional/translational changes in fimbrial gene/protein expression but rather the result of direct physical interference. This was further demonstrated by the fact that we could restore fimbrial function by inhibiting capsule synthesis. It remains to be determined whether the expression of these very different surface components occurs simply via random events of phase variation or in a coordinated manner in response to specific environmental cues.

Bacterial Capsules↗
PubMed2000

Capsule biosynthesis and basic metabolism in Streptococcus pneumoniae are linked through the cellular phosphoglucomutase.

Synthesis of the type 3 capsular polysaccharide of Streptococcus pneumoniae requires UDP-glucose (UDP-Glc) and UDP-glucuronic acid (UDP-GlcUA) for production of the [3)-beta-D-GlcUA-(1-->4)-beta-D-Glc-(1-->](n) polymer. The generation of UDP-Glc proceeds by conversion of Glc-6-P to Glc-1-P to UDP-Glc and is mediated by a phosphoglucomutase (PGM) and a Glc-1-P uridylyltransferase, respectively. Genes encoding both a Glc-1-P uridylyltransferase (cps3U) and a PGM homologue (cps3M) are present in the type 3 capsule locus, but these genes are not essential for capsule production. In this study, we characterized a mutant that produces fourfold less capsule than the type 3 parent. The spontaneous mutation resulting in this phenotype was not contained in the type 3 capsule locus but was instead located in a distant gene (pgm) encoding a second PGM homologue. The function of this gene product as a PGM was demonstrated through enzymatic and complementation studies. Insertional inactivation of pgm reduced capsule production to less than 10% of the parental level. The loss of PGM activity in the insertion mutants also caused growth defects and a strong selection for isolates containing second-site suppressor mutations. These results demonstrate that most of the PGM activity required for type 3 capsule biosynthesis is derived from the cellular PGM.

Amino Acid Sequence↗
PubMed1984

Ultrastructural observations on (pseudo-) exfoliation of the lens capsule: a re-examination of the involvement of the lens epithelium.

One lens each from 2 separate patients suffering from pseudoexfoliation and one lens from a normal eye were examined ultrastructurally. The normal lens capsule was internally lamellar in places and externally of a somewhat reduced electron density but otherwise of a homogeneous appearance and free of inclusions. Observations on the abnormal lenses revealed an electron dense and mainly granular but sometimes fibrillar material along the surface of the peripheral one-third of the capsule. Material of similar ultrastructural appearance was also found deeper in the capsule and in the immediately underlying epithelium. Since the capsule close to the pole of the lens was completely free of these abnormal inclusions and the underlying epithelium also lacked this material, it is concluded that the lens epithelium is a source of the surface debris in pseudoexfoliation. These findings therefore support previous authors who proposed a lenticular involvement in this disease. The present study does, however, not rule out the possibility of a uveal contribution of abnormal material but disputes its exclusive involvement in this disease, as has previously been postulated. Build-up of exfoliated material close to the capsular surface caused an apparent peeling of the lens capsule. It is therefore concluded that the anomalous lenses suffered from a true exfoliative process that may be more correctly termed 'exfoliation of the lens capsule.'

Epithelium↗