The concentration of lactoferrin in tears of normals and of diabetics.

The tear lactoferrin content and the tear secretion rate was determined in 105 normal subjects (age range: 15-93 years) and 21 diabetic patients (age 21-78 years). Tear sampling was performed using glass capillaries and the lactoferrin concentration in tears was tested employing an enzyme-linked immunosorbent assay. Tear secretion rate was measured using standardized Halberg filter paper placed in the inferior fornix for 5 min. The lactoferrin level of normal tears showed a significant inverse correlation with age, the mean value of the 8th decade (0.81 mg/ml) constituting only about half the value of the lactoferrin level found in the 3rd decade (1.48 mg/ml). The tear secretion rate also displayed a significant decrease with age, but no correlation could be demonstrated between the tear secretion rate and lactoferrin concentration. No difference was found in lactoferrin level between men and women. We were not able to demonstrate any correlation between lactoferrin content of tears and the duration of diabetes in the 21 diabetic subjects, and there was no difference between the level of lactoferrin in normal tears compared to the concentration in diabetic tears. No difference was found between the tear secretion rate in normals and in diabetics.

Prostaglandin E2 level in tears during postoperative inflammation of the eye.

The concentration of prostaglandin E2 (PGE2) in tears was measured by a radio immuno assay technique in 25 persons before cataract extraction and during the post-operative period. In addition we studied the clinical signs of inflammation, the tear secretion rate, the content of polymorphonuclear leucocytes (PMNs) in tears, the bacteriology of the conjunctival sac and the central corneal thickness (CCT) during this period. We found pre-operative median level of PGE2 of 82 pg/ml and on the first post-operative day a significant rise in PGE2 concentration despite increased tearing. There was a tendency towards further gradual increase in PGE2 concentration until the 5th day and thereafter a decline to pre-operative level 12 days after surgery. The conjunctiva is proposed as a possible source of the PGE2 in tears. No significant correlation could be demonstrated between PGE2 levels and clinical signs of inflammation, CCT, PMN level, bacteriology or tear secretion rate.

The concentration of lactoferrin in tears during post-operative ocular inflammation.

Tear concentration of lactoferrin (LF) was measured by an ELISA technique and followed in 25 patients undergoing cataract surgery. The pre-operative concentration of LF in tears was 773 +/- 60 micrograms/ml (+/- SE) (range: 407-1514 micrograms/ml). On the first day following surgery, there was a significant decrease in tear LF concentration to 377 +/- 45 micrograms/ml followed by a gradual return to the initial value during a post-operative observation period of twelve days. There was an inverse linear relationship between the LF concentration and the tear secretion rate measured by a modified Schirmer I test (1 min) suggesting a constant LF secretion rate by the tear glands. The contribution of LF from neutrophils to the tear fluid seems to be of minor importance. Since LF has known antibacterial and anti-inflammatory effects, our results may contribute to a further understanding of the microbial vulnerability or resistance of the eye following surgical procedures.

Fibronectin in tears following surgical trauma to the eye.

The concentration of the high molecular glycoprotein fibronectin (FN) was measured by an enzyme-linked immunoadsorbent technique (ELISA) in tears of 25 patients before and after cataract extraction. Both native and degraded FN was measured. The median concentration of FN in tears before surgery was 0.28 mg/l (range: 0.1-3.8 mg/l) and 0.18 mg/l (range: 0.1-1.95 mg/l for degraded and native FN, respectively. The time course of the median values of both types of FN during the post-operative observation period described a biphasic curve with peaks at the second and fifth day following operation. On the twelfth day the concentration of degraded and native FN had almost reached pre-operative levels. The variation in the post-operative FN concentration proved statistically significant. The biological significance of the changes in FN level in the post-operative period is not obvious; the first peak may be explained by a spill-over from plasma, and the second peak may reflect FN production from fibroblasts in the granulation tissue of the corneoscleral cicatrix.

Prostaglandin E2 in tears.

Prostaglandin E2 (PGE2) concentration in tears was measured before and following cataract extraction, during acute anterior uveitis and in patients with chronic conjunctival complaints. Following cataract extraction a significant increased PGE2 level in tears was observed, returning towards normal level within two weeks. In patients with acute anterior uveitis low levels of PGE2 was found in tears. Half of the patients with chronic conjunctival complaints exhibited high levels of PGE2. Conjunctiva is proposed as a likely source of PGE2 in tears.

Bacterial growth in the conjunctival sac and the local defense of the outer eye.

25 patients admitted for cataract surgery were subjected to conjunctival bacterial culturings preoperatively and during the postoperative observation period. Simultaneously lactoferrin (LF), lysozyme (LY) and secretory immunoglobulin A (s-IgA) were measured in tears. The preoperative flora disclosed the growth of Staphylococcus albus (SA) and diphtheroids. Other species were only sporadically present. There was a significant rise in number of patients affected by SA and diphtheroids postoperatively (from 60 to 80%), whereas other bacteria were not present to any significant extent. LF, LY and s-IgA concentration decreased to about 50% of the preoperative level in the early postoperative period gradually returning towards their initial concentration. Correlating an antibacterial score with bacterial score we found a significant inverse relationship between the two (P less than 0.05).

Prevalence of hepatitis B virus infection in out-patient alcoholics.

Sera from 192 out-patient alcoholics attending a clinic for the treatment of alcoholism were tested for hepatitis B surface antigen (HBsAg) and for antibodies to HBsAg and to hepatitis B core antigen (HBcAg). Three sera (1.5%) were positive for HBsAg. Of the remaining 189 alcoholics, 29 (15%) were positive for one or both antibodies. This prevalence is not significantly different from that found in 137 hospitalized HBsAg-negative patients with alcoholic liver disease (35/137 [26%] were positive for one or both antibodies). However, the prevalence of hepatitis B antibodies in out-patient alcoholics is significantly (p less than 0.01) higher when compared with the prevalence in healthy volunteer blood donors (5/114 [4%] were positive for one or both antibodies). A comparison of out-patient alcoholics positive for one or both antibodies (n = 29) with patients negative for both antibodies (n = 160) revealed that the median age in the former group (46 years) was significantly (p less than 0.05) higher than that in the latter group (40 years).

Influence of cataract extraction on cornea and conjunctiva, assessed by vital staining.

A study of the post-operative course in 100 patients subjected to cataract extraction revealed fairly pronounced dehydration of the corneal epithelium and the generally non-exposed segment of the conjunctiva, estimated by Rose Bengal stainability. This dehydration was to become appreciably reduced from the first to the third post-operative day, reaching normal levels of Rose Bengal stainability. The exposed conjunctival segment showed a surprisingly low Rose Bengal stainability on the first post-operative day, in 10% declining until the third day. Disinfection with polyvinylpyrrolidine iodide was found not to alter the stainability of cornea and conjunctiva, compared with the commonly employed method of disinfection with tincture of iodine. In 34% 'bulla'-like formations localized in the superior half of the cornea were noticed on the first post-operative day. These were supposed to represent oedema. The percentage had declined to 20 on the third day.

Local application of indomethacin in healthy eyes and in post-operative cataract patients.

The effects of locally applied Indomethacin were studied. Ten healthy subjects received 1 drop of a 1% watery solution 4 times a day in their left eye during 2 weeks, the right eye serving as control. Neither changes in visual acuity and refraction nor in the appearance and function of the external and anterior segment of the eye were found during this period. Sixty-four patients underwent surgery for simple senile cataract. Half of the patients, by random selection, received Indomethacin solution locally during the first week. The remaining half received routine treatment with a compound preparation of antibiotics and corticosteroid from the third post-operative day. An inflammatory score was calculated and was found to be significantly reduced in the Indomethacin group during the first week.

Demodex folliculorum hominis (Simon): incidence in a normomaterial and in patients under systemic treatment with erythromycin or glucocorticoid.

A study was made of 20 cilia and sebum from 20 nasal follicles from each of 86 persons. In a normomaterial aged 20-30 years. Demodex folliculorum was present in the nasal follicles in 25% and in the cilia in 29% of the subjects. This is consistent with the very high incidence we found 10 years ago. Systemic erythromycin treatment did not erradicate the mite, but the incidence decreased in both regions. Systemic glucocorticoid treatment lowered the incidence in the nasal region, whereas the incidence increased in the ciliary region.

Gamma-glutamyltransferase, aspartate aminotransferase and alkaline phosphatase as markers of alcohol consumption in out-patient alcoholics.

Serum activity of gamma-glutamyltransferase, aspartate aminotransferase and alkaline phosphatase were determined in 316 patients attending an out-patients clinic for treatment of alcoholism. The activity of gamma-glutamyltransferase was raised in 34% and that of aspartate aminotransferase and alkaline phosphatase in 18% and 7%. Neither the activity of gamma-glutamyltransferase, aspartate aminotransferase nor alkaline phosphatase showed any significant (P greater than 0.05) correlation with the history of alcohol consumption. The activities of gamma-glutamyltransferase and aspartate aminotransferase were raised significantly more often in patients with recent alcohol consumption than in patients who had abstained for more than 9 days. The concentration of alkaline phosphatase was not significantly (P greater than 0.05) different in these groups. The predictive value of raised and normal activities of gamma-glutamyltransferase, in deciding whether a patient had had recent alcohol consumption or not, was not superior to the predictive value of raised and normal activities of aspartate aminotransferase.