Lauri Merenmies

Exfoliation syndrome in enucleated haemorrhagic and absolute glaucoma.

Abstract. Occurrence of exfoliation syndrome was studied in 172 eyes enucleated for haemorrhagic and absolute glaucoma in 1962–82, using histopathological techniques. Exfoliation was found in 33% of haemorrhagic glaucoma cases and in 22% of absolute glaucoma. In patients over 70, exfoliation was found in 53% of the haemorrhagic cases and in 46% of the absolute glaucoma cases. Capsular glaucoma may provoke haemorrhagic glaucoma and may lead to blindness and enucleation of eye with or without vascular catastrophe.

Untersuchungen ber die tumorauslsende (?tumour promoting?) Wirkung einiger nichtionisierbaren oberflchenaktiven Substanzen bei Maus und Kaninchen

Unsere Forschergruppe hat sich beim Studium einiger mit der Carcinogenese verknfipften Probleme seit 1945 (eine Zusammenfassung der Untersuchungen bis 1954 wurde yon K. SETs 1954 gegeben) gewisser gleichzeitig lipophiler und hydrophiler Substanzen (oberfls aktiver, nichtpo]arer-polarer Substanzen, Emulgatoren, Detergenten) als LSsungsmittel ffir fettlSsliche Carcinogene bedient (vgl. auch K. SETXLX 1948a und b, 1949a, b und c, K. SET;4LX und EKWALL 1950). Hierzu eignen sich diese Stoife die es in fast uniibersehbarer Menge gibt auch datum aul~erordent]ich gut, weft die optimalen yon ihnen in bezug auf gewisse physikochemische Eigenschaften an einige yon den eigenen Biokolloiden des KSrpers erinnern. Bet unseren Untersuchungen hat es sich herausgestellt, d~i3 sich die Wirkung der oberflgohenaktiven Stoife bei der experimentellen chemisehen Carcinogenese keineswegs einzig auf ihr solubi]isierendes VermSgen griinden kann, sondern ein Tell yon ihnen besitzt yon sich selbst aus einen nicht unwesentlichen, die Manifestation des Hautgeschwiilste fSrdernden Effekt. Die diesbeztiglichen orientierenden Befunde sind fr/iher mitgeteilt worden (K. S~XnX nnd Mitarbeiter 1954, 1955a und b, 1956a und b, I-I. S~TXnX 1956). t t ier ist es nun unsere Absicht, die Ergebnisse nnserer Sloateren Untersuchungen mitzuteilen, die sich auf die Phase der TumorauslSsung sowie einige damit verbundene Fragen beziehen, zumal da der Gebrauch der zu diesen Zwecken applizierten chemisch nnd physikochemisch verhaltnismgBig wohluraschriebenen Stoffe wertvolle Aufschlfisse betreffs des Mechanismus der TumorauslSsung geben kann. Well sich die ionisierbaren lipophil-hydrophilen

Ocular pathology in infantile type of neuronal ceroid-lipofuscinosis.

Ocular pathology of the infantile type of ceroid-lipofuscinosis is reported. The material comprised 10 eyes of five autopsies in which the diagnosis had been confirmed by neuropathological autopsy. The condition is clinically characterized by its age of onset from eight to 18 months, rapid psychomotor retardation, ataxia, and muscular hypotony. The patients become blind by the age of two years with optic atrophy and retinal hypopigmentation as the main ophthalmoscopic features. In the retina a complete disappearance of the visual cells, the bipolar cells and the ganglion cells was observed with marked reactive gliosis. Loss of pigment from the retinal pigment epithelium had taken place. The optic nerve showed atrophy and gliosis with complete loss of myelin sheaths. Granular deposits stainable with PAS, and Sudan black B stains were observed in the nonpigmented ciliary epithelium of the pars plana, the pigment epithelium as well as the glial cells of the optic nerve. Granular deposits were also noted in the cytoplasm of large pigmentladen macrophages in the retina. Electronmicroscopy revealed osmiophilic granular deposits in the cytoplasm of many retinal glial cells.

EMBOLISM OF THE CENTRAL RETINAL ARTERY SECONDARY TO METASTATIC CARCINOMA

A 54‐year‐old man experienced sudden loss of vision of one eye and was admitted four hours later for treatment of typical occlusion of the central retinal artery. The patient died three weeks later and the autopsy revealed bronchial carcinoma of the epidermoid type with metastasis in most visceral organs. Microscopic examination of the eye disclosed the central retinal artery to be patent but with atheromatous changes at the level of the lamina cribrosa. The retina showed evidence of acute ischaemic infarction of the inner retinal layers. Tumour emboli were observed in the retinal arterioles. Trypsin‐digest preparations were also employed to demonstrate tumour cells in the retinal arterioles.

CAUSES OF ENUCLEATION FOLLOWING CATARACT SURGERY

Between the years 1962 and 1976 85 eyes which had undergone cataract surgery were accessioned to the Ophthalmic Pathology Laboratory of the Helsinki University Eye Hospital. The specimens were submitted from the various eye departments of the country. Of these 85 eyes nine had been enucleated within 2 months after surgery while in 64 cases the enucleation had been performed more than 12 months after surgery. 40 eyes had had an attempted operation for senile cataract, 30 eyes for traumatic cataract while the remaining cases were congenital cataract cases or cataracts in pre‐existing glaucomatous or chronic uveitis eyes. Most frequent causes for the loss of the eyes were related to incomplete or abnormal healing of the operative wound such as epithelial down‐growth and closure of the chamber angle with extensive anterior synechiae leading to absolute glaucoma. It is noteworthy that all cases of epithelial downgrowth were derived from the beginning of the observation period. No new cases were obtained after 1969.

Posterior chamber lens implantation. A clinicopathological report of a successful case.

Abstract. This report describes the clinical and histopathological studies of an eye 13 months after successfull extracapsular cataract surgery and J‐loop‐type posterior chamber lens implantation. The lens was of PMMA while the loops were made of polypropylene. The corrected visual acuity of the patient was 1.0 and clinically the eye showed no evidence of anterior uveitis. The lower loop was in the capsular bag while the upper loop was embedded in the ciliary body surrounded by chronic foreign body giant‐cell inflammatory reaction.

Untersuchungen ber das Verhalten einiger nichtionisierbaren oberflchenaktiven Tumorauslsersubstanzen zum Kollagen des Dermas beim Kaninchen

A study was made of the behaviour of certain selected non-ionic surface active agents (sorbitan fatty acid esters, and polyoxyethylene sorbitan fatty acid esters) — both those found to be highly potent tumour promoters, and those which were ineffective — towards skin collagen of the rabbit. Collagen obtained from rat tail tendons served as further comparison. First some motivations are given about the reasons why the present investigation was carried out. The composition of the amino acids of the presipitated collagen was analyzed paperchromatographically. The molecular structure of the collagen was studied with wide-angle X-ray diffraction technique as well as infra-red spectrographically. The appearance of the corresponding cutaneous structures was examined histologically. It was demonstrated that no compounds tested (not even the most potent tumour promoter) produced any detectable alterations in the skin collagen of the rabbit. The results are discussed with special emphasis on the observation that the new type tumour promoters exert the effect by way of their molecular orientation rather than by chemical means.

Suprasellar meningioma 47 years after bilateral retinoblastoma

Abstract. Development of an additional primary tumour, a suprasellar meningioma, is reported 47 years after successful treatment of bilateral retinoblastoma. The left eye of the patient was enucleated at the age of 1.5 years and the left orbit radiated with a total dose of 1200 rads. The right eye was treated by orthovoltage radiation only at the age of 4 years, the total dose being 5100 rads. The right eye became blind and phthisical, and it was enucleated at the age of 42 years. No active retinoblastoma was found. At the age of 48 years a large suprasellar meningioma was diagnosed and partially removed.

Mediastinal Embryonal Carcinoma with Bilateral Choroidal Metastases

28-year-old sportsman developed chest pain, dyspnoea, haemoptysis and swelling of the right leg. 8 weeks later he also complained of blurred vision. Ophthalmoscopy revealed subretinal infiltrates diagnosed as tumour metastases by fluorescein angiography. The patient died 10 weeks after the first symptoms. At autopsy large mediastinal embryonal carcinoma was diagnosed, and both eyes revealed choroidal metastases. This rare tumour usually involves young men and is invariably fatal within a few months. Exceptional bilateral choroidal metastases constituted the presenting sign.

Effect of prednisolone and 6-mercaptopurine on corneal homograft reaction.

The first report of a corneal transplant which had remained transparent was published by Zirm (1905) sixty years ago. A little later there arose the question of the antigenicity of the cornea and the intolerance phenomenon associated with corneal transplants (Magitot, 1911 and Kraupa, 1912). But it is especially in the last decade that the corneal homograft reaction has attracted lively attention. Experimental homograft reaction of the cornea was provoked by Polack (1962) in the rabbit by additional implanting of the skin from the same donor subcutaneously. The initial alterations in the corneal homograft appeared in the periphery and the initial clouding was due to destruction of the endothelial cells by sensitised lymphocytes and plasma cells. Maumenee (1962) demonstrated that the regrafting of the corneal stroma and endothelium of the same donor rabbit caused a homograft reaction when implanted in the abdominal wall of a rabbit, but that an autograft failed to cause a corresponding round cell reaction. Corneal homograft reaction constitutes probably the most important reason for delayed clouding of the graft. The risk is especially great in heavily vascularised corneas. Prevention of homograft reaction can be attempted principally along two different lines: by altering the nature of the donor material, e. g. by freezing, desiccation, radiation, or serum pretreatment; and by damping the response of host tissues with radiation or immunosuppressive medications. The present study deals with the latter field. Corticosteroids have been found to exert a depressive effect on antigen for-