Cycloscopy of angle-closure glaucoma

Summary Cycloscopy was performed in eyes with primary angle-closure glaucoma and non-glaucomatous wide-angle. In all eyes of primary angle-closure glaucoma, the ciliary processes were accessible through the small pupil by Cycloscopy with minimal or no indentation. In fellow eyes of the previously acute-attack eyes, the ciliary processes were visualized through the small pupil without indentation. On the contrary, in primary angle-closure glaucoma eyes the significant shallow chamber depth was seen in 66%, and the positive prone-position test in 41%.The results obtained seem to suggest that morphological changes of the ciliary processes might be causally related to the manifestation of primary angle-closure glaucoma, and that cycloscopy is a reliable diagnostic method.This study was supported by research grant 148277 from the Ministry of Education     

Spontaneous rupture of the esophagus. Report of two cases successfully treated by intravenous high caloric nutrition and review of 59 cases collected from Japanese literature.

For the period from 1951 through 1975, 4 cases of spontaneous rupture of the esophagus have been successfully treated at the IInd Department of Surgery, Tohoku University Hospital, Sendai, Japan. Two cases of them conservatively treated with intravenous high caloric nutrition were reported. Fifty-nine Japanese cases of spontaneous rupture of the esophagus were reviewed. Symptoms, diagnosis, treatment and prognosis of the disease were discussed.     

Serum neuron-specific enolase as a marker of lung cancers

Neuron-specific enolase (NSE) in sera of lung cancer patients was studied in order to evaluate its clinical significance as a tumor marker. The subjects included 15 normal volunteers, 13 cases without malignant neoplasms or neuronal diseases and 42 lung cancer cases. NSE was quantified by a double antibody radioimmunoassay. As one of the sera from normal volunteers and control patients showed an NSE content 10 ng/ml or more, values of 10 ng/ml or over were considered to be positive. Seventeen of 42 sera from lung cancer patients showed positive NSE levels. Histological evaluation revealed that the degrees of NSE positiveness for small cell carcinoma, large cell carcinoma, squamous cell carcinoma and adenocarcinoma were 73%, 50%, 33%, and 21%, respectively, and that all the positive cases except for one were confined to disease stages III or IV. The level of NSE in patients with 10 ng/ml or more before surgery decreased to within normal limits 1-2 weeks after surgery Localization of NSE could be confirmed immunohistologically in small cell carcinoma cells. In conclusion, NSE was considered to be very useful as a tumor marker of the lung, especially in small cell carcinoma for diagnosis and determination of disease extent and response to therapy, and also in non-small cell carcinoma for the evaluation of treatment effectiveness.     

Angiotensin-converting enzyme in sarcoid uveitis.

The diagnosis of ocular sarcoid is presumptive in the absence of systemic disease. The association of elevated serum angiotensin-converting enzyme (ACE) levels with active systemic sarcoid has been well described. With a sensitive fluorimetric assay for ACE, we found that five of ten chronic granulomatous uveitis patients without systemic sarcoid had elevated serum ACE levels. None of ten patients with uveitis of known etiology had elevated serum ACE levels. We believe that the association of an elevated serum ACE level with chronic granulomatous uveitis suggests the diagnosis of ocular sarcoid.     

A diagnostic approach to inflammatory disease of the pancreas by means of endoscopic retrograde cholangio-pancreatography

Role of ERCP in the diagnosis of inflammatory lesions of the pancreas was evaluated and following conclusions were obtained. 1) Following criteria were considered to be practical for clinical diagnosis of chronic pancreatitis by ERCP; a) More than moderate irregularity or rigidity of margin, dilatation, or irregularity in caliber of PDS, whether extensive or localized, or b) Cyst formation or c) Obstruction of PDS. These criteria permit to diagnose 100% of pancreatolithiasis, 82% of chronic pancreatitis without pancreatolithiasis and 64% of histologically diagnosed chronic pancreatitis but about 13% of "false positive results" must be taken into consideration. 2) ERCP plays an important role in detecting and locating localized or scattered lesions without noticable abnormalities in P-S test. It is also useful in deciding an indication for surgical intervention. However, it has limitations in detecting minimal to moderate pancreatitis. Some of these cases are often picked up by P-S test. 3) Combined approach with ERCP and P-S test is required for diagnosis of inflammatory lesions of the pancreas and either one is incomplete by itself.