Occupational exposure to optical radiation and the ocular health status of glassblowers*

The occupational radiation exposure levels and the ocular health status of a sample of glass-blowers in southern Ontario were evaluated. The form of ocular protection was also assessed. Measurements of radiant emissions from different molten glass materials were carried out. A total of six glassblowing installations, 15 glassblowers and 42 non-glassblowers participated in the study. The spectral transmittances of samples of the protective lenses were obtained. Tonometry, biomicroscopy, ophthalmoscopy, pachometry. Schirmer tear test, endothelial photography were completed on all the volunteering subjects. The glassblowers' ocular findings were compared to those of non-glassblowers. No indication of cataract was observed among this group of glassblowers. Although, a preponderance of grade 2 polymegethism among the glass-blowers (47% compared to 11% in non-glassblowers) was found, there was no significant difference in their ocular health. Variation in the corneal irradiance from occupational exposure was obtained, and in addition, the use of protective lenses was found to be inappropriate. In order to prevent against any long-term chronic pathologic effect, the use of appropriate ocular protection is advised.     

Clinicopathologic, ophthalmic, visual profiles and management of mucoceles in blacks

The study aimed at finding out the clinicopathologic, ophthalmic and visual profiles, management and outcome of mucoceles of the paranasal sinuses in Nigerians. The study was a retrospective review of 20 cases of mucoceles who presented to the ENT clinic and referred to the eye clinic of the University College Hospital Ibadan, Nigeria. These included nine males and 11 females with a male:female ratio of approximately 1:1. Mucoceles commonly involved more than one sinus on the same side. The sinuses commonly involved were the frontoethmoidal sinuses, frontal sinus and maxillary sinuses. The preoperative visual acuity in 16 (80%) patients was 6/4-6/9, three (15%) had between 6/9-6/18, and one (5%) patient was CF ("count fingers") in the affected eyes. The majority (90%) of our patients presented with multiple ophthalmic features; however, proptosis was the most popular and ophthalmic presentation and occurred in 15 (75%) patients. Proptosis was nonaxial in all cases with inferior, lateral or inferolateral displacement. Degree of proptosis ranged from 1-20 mm. Other presentations were squint (leading to diplopia) observed in one (5%) patient and epiphora in another [one (5%)] patient. Poor vision appeared to be the main problem in one (5%) patient, while in another [one (5%)] patient, the affected eye was completely immobilized. One (5%) patient presented with orbital cellulitis. Common radiological findings included classical expansive appearance with loss of the normal scalloping appearance with dehiscence of the wall of the affected sinus as was observed in nine (45%) of our patients. All 20 patients had excision of mucoceles (frontoethmoidectomies). At surgery, 11 (55%) patients had a combination of dehiscence of medial and/or posterior walls, and/or floor of the orbit. Materials evacuated were mucopurulent in 15 (75%) cases, moldy in three (15%) and cheesy in two (10%). Nine (45%) patients had intact walls. Three (15%) patients developed orbital cellulitis as postoperative complication. Postoperatively, proptosis regressed spontaneously within one week of surgery in 17 (85%) patients. By six weeks, all the patients had a complete regression of proptosis and visual acuity returned to preoperative visual acuity level except the patient with preoperative visual acuity of CF. This patient later deteriorated and became NPL (no perception of light) in the affected eye. This was a peculiar case in that operative findings in this patient were suggestive of another coexisting pathology, which was later confirmed to be a non-Hodgkin's lymphoma of the orbit. After two months, only three (15%) reported back for follow-up. The study concluded that proptosis is a common feature of mucoceles of the paranasal sinuses and that visual affectation was rather uncommon. Also whilst mucopurulent materials formed the content of most mucoceles, surgical intervention caused proptosis to regress dramatically. However, due to the high default rate in our study, no categorical statement can be made about recurrence rate of these swellings.     

Association between serum CA125 levels in preeclampsia and its severity among women in Lagos,South-West Nigeria

Background: Preeclampsia is a syndrome of unknown etiology characterized by hypertension, proteinuria, and/or organ dysfunction. CA125 is an antigenic determinant recognized by the murine monoclonal antibody OC125 quantified by radioimmunoassay. Its role in obstetrics is yet to be fully understood as most clinical trials advocating its uses are widely experimental in nature and unacknowledged. Aim: This study was done to assess the relationship between serum concentration of CA125 in normal pregnancies and those complicated with preeclampsia. Methods: A case–control study involving 70 women diagnosed with preeclampsia and 70 healthy controls matched for age, parity, and gestational age at enrollment. Venous samples were collected from each participant after informed consent was obtained. The preeclampsia group was further subdivided into mild and severe preeclampsia and all participants were followed up till delivery with records of delivery, maternal, and neonatal outcomes obtained thereafter. Serum CA125 levels were determined by standard enzyme-linked immunosorbent assay (ELISA) method. Hypothesis testing was done using chi-square test for categorical variables, and the independent-samples t-test and ANOVA for numerical variables. All significances were reported at P < 0.05. Results: The mean serum level of CA125 in women with preeclampsia was significantly greater than those with normal pregnancy (54.17 IU/mL vs. 12.49 IU/mL, P < 0.05). CA125 level also correlated positively with systolic blood pressure (r = 0.406, P < 0.05), diastolic blood pressure (r = 0.433, P < 0.05), serum uric acid levels (r = 0.407, P = 0.001), platelet levels (r = 0.341, P = 0.001), and urinary protein levels (r = 0.325, P = 0.002). The CA125 levels between the three categories of participants in the study were: normotensive control (12.49 ± 6.62 mIU/L), mild preeclampsia (29.43 ± 3.7 mIU/L), and severe preeclampsia (64.25 ± 9.21 mIU/L), respectively (P = 0.023). Conclusion: We can infer from this study that increased maternal serum CA 125 levels are associated with the preeclampsia and its severity. However, further validation of these findings with more robust multicenter prospective and longitudinal characterization of maternal serum CA125 profiles in pregnancy should be carried out in subsequent investigations to determine its suitability as a predictive biomarker for preeclampsia in women of African descent.     

Vascular alpha-adrenoceptor affinity variation is not due to varying populations of subtypes distinguished by WB 4101 and chlorethylclonidine.

Interaction with chlorethylclonidine has been used to subdivide populations of alpha 1-adrenoceptors in some tissues. WB 4101 can distinguish high and low affinity states of the receptor. The present study was carried out to determine if different populations or affinity states of alpha 1-adrenoceptors distinguished by either of these compounds, could explain the variation in alpha 1-adrenoceptor agonist affinity found amongst rabbit arteries. Five arteries were studied whose affinity for noradrenaline vary between 4.8 and 6.4. These were the thoracic aorta, renal, superior mesenteric, ear and ovarian arteries. WB 4101 was found to be equally effective in antagonizing noradrenaline on all arteries. Chlorethylclonidine caused a 20-fold rightward shift of the noradrenaline dose-contraction curve in the thoracic aorta; but had little or no effect on the other vessels. Thus, the combination of different proportions of subsets of alpha 1-adrenoceptors distinguished by WB 4101 or chlorethylclonidine does not explain the variation in alpha 1-adrenoceptor affinity found in these rabbit arteries.     

Low flow vascular malformations of the head and neck: a study on brightness mode,color coded duplex and spectral Doppler sonography

The clinical presentation of low flow vascular malformations of the head and neck (LFVM) can range from a birthmark to severe disfigurement, functional impairment or relevant hemorrhage. The values of Brightness mode (B-mode) ultrasound and Doppler sonography in the investigation, identifying and differentiating of these lesions has been sparingly documented in the literature. This study evaluates the sonografic features of different morphological subtypes of LFVM. This is a 2-year retrospective study of 51 patients who presented with LFVM based on routine ultrasound exam in the context of their clinical consultation. Diagnosis was based on the clinical and histological findings. B-mode, color coded duplex and spectral Doppler measurements were performed for venous, lymphatic, capillary, and mixed venous-lymphatic lesions of the head and neck. The echogenicity of the majority of venous malformations was heterogenic, of most lymphatic malformations hypoechoic, and of all capillary malformations isoechoic. Blood flow was detected in only 11 cases (36.7%) of venous malformations with a monophasic pattern. There was a statistical significant difference in the mean minimum and maximum Doppler shifts between venous and lymphatic malformation for cases when the blood flow was evident. No statistical significant difference in Doppler parameters existed between capillary and lymphatic, neither between venous and capillary nor mixed malformations. Phleboliths were present in eight cases (26.7%) of venous malformations and were not detectable in any other subtype of LFVM. The detection of flow in ultrasound was only possible in a small portion of LFVM. When considering differentiating among LFVM, features such as the echogenecity, spectral Doppler wave forms, and the evidence of phleboliths contribute to establish the correct diagnosis.     

Heterogeneity of postjunctional alpha 1-adrenoceptors in mammalian aortae: subclassification based on chlorethylclonidine, WB 4101 and nifedipine.

The effects of chlorethylclonidine, WB 4101 and nifedipine on norepinephrine-induced contractions of rat, guinea-pig, rabbit and dog aortae were investigated in order to characterize the alpha 1-adrenoceptor subtype(s) present in the aortae of these different species. The putative alpha 1A-adrenoceptor antagonist, WB 4101, was significantly more potent in the rat aorta compared to the rabbit, guinea-pig and dog aortae which were not significantly different from each other. The calcium channel antagonist, nifedipine (1 microM), had little or no effect on norepinephrine-induced contractions in aortic segments from the rabbit, guinea pig and dog; whereas in the rat aorta, nifedipine significantly inhibited the response to norepinephrine. Based on the studies with WB 4101 and nifedipine, alpha 1-adrenoceptors in rat aorta would be tentatively classified as alpha 1A-adrenoceptors, whereas those in the guinea-pig, rabbit and dog aortae would be of the alpha 1B-adrenoceptor subtype. The putative irreversible alpha 1B-adrenoceptor antagonist, chlorethylclonidine, inhibited the response to norepinephrine in aortae from all species, but to dramatically different degrees. The response to norepinephrine was inhibited by 500-fold and 450-fold by chlorethylclonidine in the rat and dog aortae, respectively, whereas in the guinea-pig and rabbit aortae, the potency of norepinephrine was reduced by only 3- and 20-fold, respectively. Thus, based on studies with chlorethylclonidine, alpha 1-adrenoceptors in the rat and dog aortae would be classified as alpha 1B-adrenoceptors (i.e., chlorethylclonidine-sensitive), whereas alpha 1A-adrenoceptors (chlorethylclonidine-insensitive) would predominate in the guinea-pig aorta, and possibly both alpha 1A- and alpha 1B-adrenoceptors would coexist in the rabbit aorta.(ABSTRACT TRUNCATED AT 250 WORDS)     

Heterotropic pregnancy: a report of two cases

Heterotropic pregnancy is reported infrequently in Nigeria. Two cases were managed within the span of five years with the successful delivery of a live term baby in one of the patients. A high clinical index of suspicion is required because an intra uterine gestation does not rule out a co-existing ectopic gestation especially in this region with high twinning rate and tubal disease