Persistent pupillary membrane in the Basenji

One hundred and five Basenjis of varying ages were examined for the presence of persistent pupillary membrane. Lesions were detected in 75 individuals and were judged to be of minor significance in 26 cases, and of major significance in 49 cases. A system of scoring individuals for breeding merit was devised. The condition would appear to be a major problem in the breed in Victoria and some control measures are warranted.     

A clinical analysis of pupillary membrane formation after intraocular lens implantation

In 540 cases having undertaken extracapsular cataract extraction and intraocular lens implantation, a pupillary membrane developed in 76 cases, the rate of occurrence being 14%. Generally, the membrane appears on the fifth post-operative day and corticosteroids are effective in its treatment. After treatment no significant sequela is left and the corrected postoperative visual acuity is not affected. The pathogenesis, treatment and prognosis of the pupillary membrane are briefly discussed in the report.     

Hyperplastic parathyroiditis--a new autoimmune disease?

A case of parathyroiditis with epithelial hyperplasia is reported in which the histological features suggest an autoimmune process analogous to Hashimoto's disease.     

Lateral asymmetries of pupillary responses

Migration of mature B lymphocytes within secondary lymphoid organs and recirculation between these sites are thought to allow B cells to obtain T cell help, to undergo somatic hypermutation, to differentiate into effector cells, and to home to sites of antibody production. The mechanisms that direct migration of B lymphocytes are unknown, but there is evidence that G protein-coupled receptors, and possibly chemokine receptors, may be involved. Stromal cell- derived factor (SDF)-1alpha is a CXC chemokine previously characterized as an efficacious chemoattractant for T lymphocytes and monocytes in peripheral blood. Here we show with purified tonsillar B cells that SDF-1alpha also attracts naive and memory, but not germinal center (GC) B lymphocytes. Furthermore, GC B cells could be converted to respond to SDF-1alpha by in vitro differentiation into memory B lymphocytes. Conversely, the migratory response in naive and memory B cells was significantly reduced after B cell receptor engagement and CD40 signaling. The receptor for SDF-1, CXC chemokine receptor 4 (CXCR4), was found to be expressed on responsive as well as unresponsive B cell subsets, but was more rapidly downregulated on responsive cells by ligand. Finally, messenger RNA for SDF-1 was detected by in situ hybridization in a layer of cells surrounding the GC. These findings show that responsiveness to the chemoattractant SDF-1alpha is regulated during B lymphocyte activation, and correlates with positioning of B lymphocytes within a secondary lymphoid organ.     

Sato needling for pupillary membranes

Dense pupillary membranes are resistant to needle-knife incision. Trauma to attached intraocular structures may be produced during discission techniques that stretch the membrane. The Sato discission technique produces membrane stabilization on a fixation needle. This allows controlled incision of the pupillary membrane at a right angle to the direction of the fibers without tension on surrounding structures. The Sato technique is not difficult, and surgical complications are minimal. Using this technique, adequate pupillary openings were produced in 62 of 65 eyes, with an average follow-up of 50 months. Postoperative visual acuity was 6/24 or better in 43 (74%) eyes. No long-term surgical complications were encountered.     

Sympathetic pupillary tone in old age

In an attempt to determine whether autonomic neural factors might be involved in senile miosis, we tested pupillary responses to agents acting on the ocular sympathetic system in old subjects and compared them to responses in young adults. Our results suggest that sympathetic tone is decreased in the elderly. The dilator pupillae muscle does not lose its sensitivity to norepinephrine with age.     

Psychological significance of pupillary movements.

Pupillary dilation, the light reflex, and spontaneous fluctuations in pupil size have been used as dependent variables in psychological investigations. A review of these studies provides evidence for the effectiveness of the pupil as an index of autonomic activity in psychophysiological research. Methodological problems in the pupillary literature are discussed, and directions for further research are suggested. (105 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hyperplastic gastric polyp causing progressive gastric outlet obstruction

Hyperplastic polyps represent 75 to 90% of gastric polypoid lesions. The manifestations of these unique gastric neoplasms vary, including abdominal pain, nausea, and vomiting or gastrointestinal bleeding. The vast majority of these lesions are small, asymptomatic, and found incidentally on radiologic evaluation or endoscopic examination of the upper gastrointestinal tract. Herein we describe a large, benign, pedunculated hyperplastic polyp that led to progressive gastric outlet obstruction. In addition, we provide an overview of gastric polyps and a review of the literature. Excision of gastric polyps by endoscopic or surgical means is recommended as prudent treatment to eliminate occurrence of malignant foci.     

A chromatic-cancellation property of human pupillary responses

The pupil exhibits a response property somewhat analogous to perceptual red-green cancellation. Across a limited range of flash intensities near threshold, pupillary constrictions evoked by red flashes can be reduced, if not nulled, by the simultaneous addition of a green flash. The percentage of trials on which a stimulus-evoked response can be correctly discriminated from noise also falls to chance level as a green flash is added to the red flash. In terms of the quanta absorbed by L and M cones, the cancellation can be modelled as a function of magnitude of 0.65*L-M.     

Absence of relative afferent pupillary defect and pupillary hemiakinesia in a child with homonymous hemianopia due to ((retro-)geniculate) porencephaly

We report a 29-year-old pregnant woman who developed toxic epidermal necrolysis at 29 weeks of gestation after administration of ritodrine, indomethacin and betamethasone. Toxic epidermal necrolysis is an unreported side effect of this widely used combination of medications. Since toxic epidermal necrolysis is a potentially fatal disease, awareness of a possible association is warranted.     

Consistency of pupillary abnormality in children and adolescents with diabetes

Repeat measurements on pupillary adaptation to darkness were performed in a cohort of 66 children and adolescents with insulin-dependent diabetes mellitus (IDDM) (initial age 6.9-17.0 years) after a mean interval of 3.5 years, using a portable pupillometer. While there was a close correlation between the results of the two studies (r = 0.94, p < 0.001), the pupillary dilatation, the ratio of the pupil diameter to the iris diameter % (PD%), had decreased significantly (61.5% vs 62.9%, p < 0.001) over these 3.5 years in children with diabetes. The same measurements were performed on 89 healthy control children in the first study and 66 in the reassessment period and PD% was not significantly different in the two control groups. Five children with diabetes identified as having abnormal pupillary dilatation in the first study were outside the normal range 3.5 years later. In addition 4 children in whom initial testing had been normal, showed abnormality at the time of the second study. None of these children had symptoms of autonomic neuropathy. These findings suggest that abnormality in pupillary adaptation in diabetic children is consistent and increases with time and may serve as an early marker of tissue damage associated with diabetes.     

Pupillary block after pupillary capture of an AcrySof intraocular lens

A 54-year-old man developed pupillary block resulting from pupillary capture 2 months after uneventful phacomulsification and AcrySof intraocular lens (IOL) implantation. The IOL was placed in the bag through a 6.0 mm continuous curvilinear capsulorhexis. The glaucoma was treated with intravenous drip infusion of a hyperosmotic diuretic, followed by peripheral iridectomy, iridocapsular synechiolysis, and IOL repositioning. The IOL loops were located completely in the bag. However, pupillary capture recurred 3 weeks after the surgery, at which time intraocular pressure was normal. The flexibility of the IOL optic and its large overall length and rigid, low-angulated loops were the probable causes for the recurrence of the pupillary capture. The IOL was exchanged for a sulcus-fixated, single-piece poly(methylmethacrylate) lens with 10 degree angulated loops. Pupillary capture did not recur during the follow-up.     

Abnormal pupillary responses in myasthenia gravis. A pupillographic study

Using an open-loop stimulus (Maxwellian view), the direct pupillary response to light and its derivative curves (velocity and accleration of pupillary reactions) were recorded by infrared video pupillography in seven patients with myasthenia gravis and in three normal subjects. Responses before and after intravenous injection of 5 mg edrophonium hydrochloride were determined. Five of the patients had never taken anticholinesterase drugs except for diagnostic injections of edrophonium while the other two patients had been treated with oral preparations of corticosteroids. Analyses of the pupillary responses showed reduced amplitude, amximal velocity, and maximal acceleration of pupillary constriction in the myasthenic patients. On the other hand, changes in parameters of pupillary dilatation were minimal. Abnormal values returned towards normal within five minutes after edrophonium injection in all patients except in one individual who was being treated with corticosteroids at the time of examination. These results suggest that involvement of the iris sphincter may be common in patients with myasthenia gravis and this can be demonstrated by analysing the pupillary reaction and its derivative curves in response to an open-loop stimulus.     

Effects of retention interval on pupillary responses during a simple discrimination

Responses from 6 subjects show that pupillary changes observed during short-term information processing with retention intervals of 0, 5, and 10 sec. delay occur during recognition memory for tones as well as recall of 7-digit numbers.     

Mathematical procedures in data recording and processing of pupillary fatigue waves

Spontaneous pupillary behaviour in darkness provides information about a subject's level of vigilance. To establish infrared video pupillography (IVP) as a reliable and objective test in the detection and quantification of daytime sleepiness, the definition of numerical parameters is an important precondition characterising spontaneous pupil behaviour adequately for further statistical procedures. The correct measurement of the pupil size, even if the lid or eyelashes are occluding the pupil, is of particular concern when testing vigilance. In this case many edge points of the pupil are detected and a fitting procedure is described that fits these edge points to a circle and excludes outliers. The first step of data preparation consists of a mathematical artefact management consisting of blink detection and elimination, followed by interpolation. Second, a fast Fourier transformation is carried out for frequencies from 0.0 to 0.8 Hz for each time segment of 82 s. Results are given in absolute and relative power of each frequency band per time segment and mean values over the entire record of 11 min. Third, the changes of the mean pupillary diameter per data window against time are shown graphically. An additional parameter referring to the pupil's tendency to instability, the pupillary unrest index (PUI), is defined by cumulative changes in pupil size based on mean values of consecutive data sequences. These mathematical procedures provide a high level of quality in both data collection and evaluation of IVP as an objective test of vigilance. In a pilot study, the pupillary behaviour of two groups were measured. One group rated themselves as alert (ten men), the other group as sleepy (12 men). The power and PUI were compared using the Mann-Whitney U-test. Both parameters show significant differences between the two groups.