Immunohistochemical distribution of delta opioid receptors in the rat central nervous system: evidence for somatodendritic labeling and antigen-specific cellular compartmentalization.

Many studies have reported on the distribution of delta opioid receptors (delta OR) in the mammalian central nervous system (CNS) by using a variety of techniques. However, no general consensus has emerged with regards to the localization of this receptor due to inconsistencies in the immunohistochemical literature. In the present study, we analyzed the cellular and subcellular distribution of immunoreactive delta OR in the rat CNS using two different antibodies (directed against a sequence in the C-terminus or N-terminus of the rat delta OR). By using Western blotting, these two antibodies recognized similar forms of the delta OR in COS-7 cells transfected with this receptor, but distinct forms in membranes from the rat spinal cord. By using light microscopic immunohistochemistry, both antibodies recognized identical populations of nerve cell bodies throughout the CNS; the distribution of these cell bodies conformed to that of delta OR mRNA-expressing cells detected by in situ hybridization. However, whereas the C-terminus-directed antibody recognized predominantly perikarya and proximal dendrites, the N-terminus-directed antibody also labeled extensively dendritic and terminal arbors. Furthermore, by using electron microscopy, the two antibodies were found not only to label differentially somatodendritic versus axonal compartments, but also plasma membrane versus cytoplasmic ones, suggesting that distinct immunological forms of the receptor are being targeted preferentially to different cellular and subcellular domains.

Diagnosis and management of chronic blepharokeratoconjunctivitis in children.

PURPOSE: To describe the history, symptoms, and clinical signs and discuss the treatment of blepharokeratoconjunctivitis. METHODS: Eight children (five girls and three boys), ranging in age from 3.5-13 years, were clinically diagnosed with blepharokeratoconjunctivitis. Microbiology studies were performed in four of the eight children. Treatment consisted of lid hygiene, oral erythromycin suspension, and preservative-free steroids. Duration of therapy was directed by clinical improvement. RESULTS: Average age at onset was 3.2 years (range: 0.5-8 years). Lid disease, conjunctival redness, and inferior superficial corneal vascularization were consistent features (100%). Other signs were punctate corneal epithelial staining, inferior subepithelial vascularization and infiltrate, conjunctival phlyctenules, corneal phlyctenules, and circumferential pannus. Microbiology testing demonstrated coagulase-negative staphylococcus and Propionibacterium acnes. Average follow-up was 8.3 months (range: 2-23 months). All patients had relief of symptoms within 2-3 weeks. Clinical signs took more time to regress but all had progressive improvement of the ocular surface by 2 months. Blepharokeratoconjunctivitis reactivated in all patients during follow-up, and repeat therapy was administered. CONCLUSION: Blepharokeratoconjunctivitis in childhood is a chronic inflammatory process that can have different presentations. It can be successfully treated with oral erythromycin and topical steroids.

Investigation of the role of prolactin in the development and function of the lacrimal and harderian glands using genetically modified mice.

PURPOSE: To determine whether prolactin receptor is essential for normal development and function of the lacrimal gland and whether hyperprolactinemia can alter lacrimal development. METHODS: Lacrimal gland morphology and function were examined in two genetic mouse models of prolactin action: a prolactin receptor knockout model that is devoid of prolactin action and a transgenic model of hyperprolactinemia. RESULTS: Image analysis of lacrimal and Harderian gland sections was used to quantify glandular morphology. In females, lacrimal acinar area decreased by 30% and acinar cell density increased by 25% over control subjects in prolactin transgenic animals, but prolactin receptor knockout mice showed no changes. In males, transgenic animals showed no changes, but prolactin receptor knockout mice showed a 5% reduction in acinar area and an 11% increase in acinar cell density, which was lost after castration. The morphology of the Harderian glands underwent parallel changes but to a lesser degree. A complete loss of porphyrin accretions was seen in the Harderian glands of male and female knockout animals. No differences in tear protein levels were seen in knockout animals by two-dimensional gels. Enzyme-linked immunosorbent assay (ELISA) and Western blot analysis showed that the level of secretory component and IgA in knockout mouse tears remained unchanged. There was no change in the predisposition of the 129 mouse strain to conjunctivitis in the knockout animals. CONCLUSIONS: Prolactin plays a small role in establishing the sexual dimorphism of male lacrimal glands. In females, hyperprolactinemia causes a hyperfemale morphology, suggesting a role in dry eye syndromes. Prolactin is required for porphyrin secretion by the Harderian gland but plays no essential role in the secretory immune function of the lacrimal gland.

The effect of successful contact lens wear on mucosal immunity of the eye.

OBJECTIVE: This study aimed to assess the effect of contact lens wear on the mucosal defenses of the outer eye against infection. DESIGN: A case-controlled study of daily contact lens wearers in their initial 6 months of contact lens wear. PARTICIPANTS: Contact lens wearers (mean age, 23.1 years; 47 subjects) were compared with age-matched control subjects (mean age, 24.7 years; 44 subjects). INTERVENTION: Outer eye defenses were studied by assay of tear constituents and quantitative conjunctival microbiology. MAIN OUTCOME MEASURES: Antimicrobial activity of tears was studied by assay of total immunoglobulin A (IgA), IgA isotype-specific antibodies reactive with Escherichia coli, Haemophilus influenzae, Staphylococcus epidermidis, albumin and lysozyme, and the ocular surface microbial load determined using quantitative microbiology of the conjunctival sac. RESULTS: The IgA isotype-specific antibodies reactive with E. coli (P = 0.03) and S. epidermidis (P = 0.068) were lower in contact lens wearers, but antibody:albumin ratios were not significantly different in the two groups. Contact lens wear also had no significant effect on tear IgA, albumin, or lysozyme or its ratios with albumin. Bacterial numbers and colonization rates for coagulase-negative staphylococci were greater in contact lens wearers than in age-matched control subjects. Corynebacterium sp. and non-Enterobacteriaceae (P = 0.007) were isolated more frequently and in greater numbers from contact lens wearers. Colonization rates were increased for Corynebacterium sp., but non-Enterobacteriaceae were transient. In both daily contact lens wearers and age-matched control subjects, most conjunctival flora were transient rather than colonizing, and no subject developed an outer eye infection during the study. CONCLUSION: These results suggest that daily contact lens wear does not significantly alter the mucosal defenses of the outer eye that function to eliminate organisms from the conjunctival sac and prevent outer eye infection.

Mucosal defense of the outer eye.

A combination of mechanical, anatomical, immunological, and microbiological factors prevent infection of the outer eye. Mechanical and anatomical factors include the intact epithelium of the conjunctiva and cornea and the constant blinking action of the eyelids. Tear components that play a role in eye defense include lysozyme, immunoglobulins, lactoferrin, and betalysin. The normal bacterial flora of the conjunctiva may also have an inhibitory effect on the survival of more pathogenic species. The eye is linked to the common mucosal immune system, thus gaining the benefits of a system of microbial defense which is primed in the gastrointestinal tract, where a continuing large antigen load is capable of stimulating ongoing immune protection. The relative roles of the various factors contributing to prevention of eye infection remain to be fully defined.

Nonabsorbable suture material in cataract surgery: a comparison of Novafil and nylon.

We compared the performance of 10-0 Novafil (polybutester, Davis & Geck, American Cyanamid Company, New South Wales, Australia.) with that of 10-0 nylon (Alcon) in 60 patients undergoing extracapsular cataract extraction and implantation of a posterior chamber intraocular lens. A standard technique was used, and the incision was closed with interrupted sutures of either 10-0 Novafil or 10-0 nylon. Length of follow up ranged from 6 to 26 months (average, 15 months). We assessed the intraoperative handling qualities of the suture materials, as well as their effect on wound healing and inflammation. We also compared the surgically-induced astigmatism in the two suture groups over the first 3 postoperative months and then in long-term follow up (average, 15 months). Sutures removed at long-term follow up were examined by scanning electron microscopy (SEM). Both suture materials handled easily at operation and were well tolerated by all patients. There was no significantly different surgically-induced astigmatism in the two suture groups after 12 weeks (P = .962) or during longer follow up (P = .401). SEM confirmed more advanced biodegradation of nylon as compared with Novafil sutures after they had been in place an average of 18 months.

Long-term comparison of Novafil and nylon in corneoscleral sections.

To compare the long-term degradation of Novafil (polybutester, American Cyanamid Company) and nylon suture material, we examined corneoscleral sections of nine rabbits 23 months after the placement of sutures. Only two nylon sutures remained, one in each wound of two rabbits; all the Novafil sutures were still present. However, examination of the Novafil sutures with scanning electron microscopy revealed signs of disintegration.

Vision-threatening thyroid orbital disease--the clinical features.

Thyroid orbital disease may threaten sight when acute proptosis causes corneal exposure or when enlarged extraocular muscles cause compressive optic neuropathy. The early clinical signs of thyroid optic neuropathy include loss of colour perception and visual field defects. The onset of thyroid optic neuropathy is difficult to predict and these clinical tests should be included in the routine examination of patients with thyroid orbital disease.

Transient corneal changes associated with the use of gold foil electrodes.

The corneas of 50 normal subjects were examined before and after electroretinography performed with gold foil electrodes. Examination included slit-lamp biomicroscopy and staining with sodium fluorescein. All corneas were normal on examination prior to electroretinography. Three types of transient corneal changes were observed--punctate epithelial keratitis, corneal erosions, and stromal thinning. Each cornea was assigned a numerical damage score based on a simple scoring system. Thirty one subjects (62%) had some degree of corneal change, and in three cases (6%) follow-up was required. Multiple regression analysis was performed to discover any risk factors. Both age of the subject and the use of local anaesthetic were strongly associated with corneal changes.

Vogt-Koyanagi-Harada syndrome--isolation of cloned T cells with specificity for melanocytes and melanoma cells.

The pathogenesis of Vogt-Koyanagi-Harada syndrome is poorly understood. A unifying mechanism for its diverse clinical manifestations affecting central nervous system, eye, integument and auditory system has not been found, although many authors have suggested that the features of the disease are the result of autoimmune responses. We performed immunological studies on two patients with Vogt-Koyanagi-Harada syndrome. In one case antibodies to melanoma cells in cytotoxic assay were detected, which it was thought may indicate the presence of antibodies to melanocytes. In the second patient three clones of interleukin-2-dependent T cells were isolated which appeared to have specificity in both cytotoxic and proliferative assays to cultured normal melanocytes and to three allogeneic melanoma cells. These findings further support a role for autoimmunity to pigmented cells in the pathogenesis of Vogt-Koyanagi-Harada syndrome. However, the precise role of autoimmunity in this disease is yet to be established.

Microbial investigations in keratitis at the Sydney Eye Hospital.

We investigated 107 cases of presumed microbial keratitis amongst patients presenting to the Sydney Eye Hospital between October 1986 and August 1988 to determine the frequency of infection, the common causative organisms and those factors that predispose to corneal infection. We found that 95% of culture-proven cases were caused by bacteria and that Staphylococcus epidermidis and Corynebacterium sp. accounted for 42.5% of these cases. All bacteria (except Staphylococcus epidermidis and Mycobacterium chelonae) were sensitive to gentamicin. In 62.6% of cases, cultures for bacteria and fungi were negative. Retrospective review of the clinical records of these patients showed that herpes simplex virus, contact lens wear, staphylococcal marginal keratitis and recurrent erosion were important causes of keratitis in this group.

Late development of localized band keratopathy in relation to a Molteno tube.

We report a case in which, 6.5 years postoperatively, localized band keratopathy developed in relation to a Molteno tube. At no stage had direct contact been noted between the tip of the tube and the corneal endothelium. The mechanisms of development of corneal opacities in relation to anterior chamber drainage tubes are discussed and the implications for the placement of such tubes are examined.

Nonabsorbable suture material in corneoscleral sections--a comparison of novafil and nylon.

We compared a newly available nonabsorbable monofilament ophthalmic suture, 9/0 Novafil (Davis & Geck), with 10/0 nylon (Alcon), currently the most popular suture for closure of corneoscleral sections. Surgery was performed on nine rats and ten rabbits. In each case a 120 degrees corneoscleral section was made in each eye and closed with interrupted sutures of 9/0 Novafil in one eye and 10/0 nylon in the other. We compared their handling qualities during surgery, as well as their effect on postoperative wound inflammation. In addition we examined the suture material from each eye of the rats by scanning electron microscopy (SEM) after 3 months, and we compared the surgically induced astigmatism in the rabbits in the two suture groups. Both suture materials were easy to handle and well tolerated. Nylon sutures from six of the eight rat eyes studied showed SEM evidence of surface disintegration after 3 months, whereas all the Novafil sutures remained intact.

Traumatic hyphaema. Outcome and management.

The files of 206 patients who had sustained a hyphaema as a result of a contusion injury and had been admitted to Sydney Eye Hospital between January 1979 and December 1981 were reviewed. Most hyphaemas were small (189 or 91.7 per cent), occupying less than one-third of the volume of the anterior chamber. Fifteen patients had a secondary haemorrhage while in hospital and nine of these had a small hyphaema.

Thermal and water source effects upon the stability of enteroviruses in surface freshwaters.

The long-term survival of three human enterovirus serotypes, Coxsackievirus B3, echovirus 7, and poliovirus 1 was examined in samples of surface freshwater collected from five sites of physically different character. These were an artificial lake created by damming a creek, a small groundwater outlet pond, both a large- and a medium-sized river, and a small suburban creek. Survival was studied at temperatures of -20, 1, and 22 degrees C. The average amount of viral inactivation was 6.5-7.0 log10 units over 8 weeks at 22 degrees C, 4-5 log10 units over 12 weeks at 1 degree C, and 0.4-0.8 log10 units over 12 weeks at -20 degrees C. The effect of incubation temperature upon viral inactivation rate was statistically significant (p less than 0.00001). As determined by pairing tests, survival was also significantly related to both viral serotype and water source at each of the three incubation temperatures (p less than or equal to 0.05). Efforts were made to determine whether the rate of viral inactivation observed at the different incubation temperatures was related to characteristics inherent to the water that was collected from the different locations. The characteristics examined included physical and chemical parameters, indigenous bacterial counts, and the amount of bacterial growth that the waters would support (measured as the maximum number of generations which seeded bacteria could undergo after being placed into either pasteurized or sterile-filtered water samples). Analysis of viral inactivation rate versus these characteristics revealed three apparent effectors of viral persistence.(ABSTRACT TRUNCATED AT 250 WORDS)

Atypical mycobacterial keratitis.

A case of marginal corneal abscess and hypopyon due to Mycobacterium chelonae is presented. Its therapy is described, followed by a brief discussion of atypical mycobacterial keratitis.