The human health effects of ozone depletion and interactions with climate change

Depletion of the stratospheric ozone layer has led to increased solar UV-B radiation (280-315 nm) at the surface of the Earth. This change is likely to have had an impact on human exposure to UV-B radiation with consequential detrimental and beneficial effects on health, although behavioural changes in society over the past 60 years or so with regard to sun exposure are of considerable importance. The present report concentrates on information published since our previous report in 2007. The adverse effects of UV radiation are primarily on the eye and the skin. While solar UV radiation is a recognised risk factor for some types of cataract and for pterygium, the evidence is less strong, although increasing, for ocular melanoma, and is equivocal at present for age-related macular degeneration. For the skin, the most common harmful outcome is skin cancer, including melanoma and the non-melanoma skin cancers, basal cell carcinoma and squamous cell carcinoma. The incidence of all three of these tumours has risen significantly over the past five decades, particularly in people with fair skin, and is projected to continue to increase, thus posing a significant world-wide health burden. Overexposure to the sun is the major identified environmental risk factor in skin cancer, in association with various genetic risk factors and immune effects. Suppression of some aspects of immunity follows exposure to UV radiation and the consequences of this modulation for the immune control of infectious diseases, for vaccination and for tumours, are additional concerns. In a common sun allergy (polymorphic light eruption), there is an imbalance in the immune response to UV radiation, resulting in a sun-evoked rash. The major health benefit of exposure to solar UV-B radiation is the production of vitamin D. Vitamin D plays a crucial role in bone metabolism and is also implicated in protection against a wide range of diseases. Although there is some evidence supporting protective effects for a range of internal cancers, this is not yet conclusive, but strongest for colorectal cancer, at present. A role for vitamin D in protection against several autoimmune diseases has been studied, with the most convincing results to date for multiple sclerosis. Vitamin D is starting to be assessed for its protective properties against several infectious and coronary diseases. Current methods for protecting the eye and the skin from the adverse effects of solar UV radiation are evaluated, including seeking shade, wearing protective clothing and sunglasses, and using sunscreens. Newer possibilities are considered such as creams that repair UV-induced DNA damage, and substances applied topically to the skin or eaten in the diet that protect against some of the detrimental effects of sun exposure. It is difficult to provide easily understandable public health messages regarding "safe" sun exposure, so that the positive effects of vitamin D production are balanced against the negative effects of excessive exposure. The international response to ozone depletion has included the development and deployment of replacement technologies and chemicals. To date, limited evidence suggests that substitutes for the ozone-depleting substances do not have significant effects on human health. In addition to stratospheric ozone depletion, climate change is predicted to affect human health, and potential interactions between these two parameters are considered. These include altering the risk of developing skin tumours, infectious diseases and various skin diseases, in addition to altering the efficiency by which pathogenic microorganisms are inactivated in the environment.

Mouthwash as a low-cost and safe specimen transport medium for human papillomavirus DNA testing of cervicovaginal specimens

The usefulness of mouthwash as a transport medium for cervical specimens for carcinogenic human papillomavirus (HPV) DNA testing has not been evaluated. Two cervical specimens were collected from each of 34 patients, with one placed in mouthwash (Scope, Proctor and Gamble, Inc.) and the other in a liquid cytology medium commonly used for HPV DNA testing in alternating order. Paired specimens were tested by a PCR assay for carcinogenic HPV and a PCR HPV genotyping assay for 37 HPV types at 0, 3, and 6 weeks after collection; the results of the HPV genotyping assay were categorized into HPV risk groups according to cancer risk (HPV-16 > HPV-18 > other carcinogenic HPV types > noncarcinogenic HPV types > negative). After 4 months of storage, specimens were tested using a second, non-PCR test for carcinogenic HPV. We observed a >or=94% total agreement and kappa values of >or=0.88 between media at each time point for PCR-detected carcinogenic HPV. We observed a >or=74% total agreement, >or=0.62 unweighted kappa, and >or=0.75 linearly weighted kappa between media at each time point for PCR-detected HPV cancer risk category. Finally, we observed an 88% total agreement and kappa of 0.77 between media for carcinogenic HPV detection using a second test after 4 months of storage. We suggest that mouthwash might be used as a low-cost, safe, nonflammable storage and transport medium for cervical specimens for HPV DNA testing in cervical cancer screening programs.

The effects on human health from stratospheric ozone depletion and its interactions with climate change

Ozone depletion leads to an increase in the ultraviolet-B (UV-B) component (280-315 nm) of solar ultraviolet radiation (UVR) reaching the surface of the Earth with important consequences for human health. Solar UVR has many harmful and some beneficial effects on individuals and, in this review, information mainly published since the previous report in 2003 (F. R. de Gruijl, J. Longstreth, M. Norval, A. P. Cullen, H. Slaper, M. L. Kripke, Y. Takizawa and J. C. van der Leun, Photochem. Photobiol. Sci., 2003, 2, pp. 16-28) is discussed. The eye is exposed directly to sunlight and this can result in acute or long-term damage. Studying how UV-B interacts with the surface and internal structures of the eye has led to a further understanding of the location and pathogenesis of a number of ocular diseases, including pterygium and cataract. The skin is also exposed directly to solar UVR, and the development of skin cancer is the main adverse health outcome of excessive UVR exposure. Skin cancer is the most common form of malignancy amongst fair-skinned people, and its incidence has increased markedly in recent decades. Projections consistently indicate a further doubling in the next ten years. It is recognised that genetic factors in addition to those controlling pigment variation can modulate the response of an individual to UVR. Several of the genetic factors affecting susceptibility to the development of squamous cell carcinoma, basal cell carcinoma and melanoma have been identified. Exposure to solar UVR down-regulates immune responses, in the skin and systemically, by a combination of mechanisms including the generation of particularly potent subsets of T regulatory cells. Such immunosuppression is known to be a crucial factor in the generation of skin cancers. Apart from a detrimental effect on infections caused by some members of the herpesvirus and papillomavirus families, the impact of UV-induced immunosuppression on other microbial diseases and vaccination efficacy is not clear. One important beneficial effect of solar UV-B is its contribution to the cutaneous synthesis of vitamin D, recognised to be a crucial hormone for bone health and for other aspects of general health. There is accumulating evidence that UVR exposure, either directly or via stimulation of vitamin D production, has protective effects on the development of some autoimmune diseases, including multiple sclerosis and type 1 diabetes. Adequate vitamin D may also be protective for the development of several internal cancers and infections. Difficulties associated with balancing the positive effects of vitamin D with the negative effects of too much exposure to solar UV-B are considered. Various strategies that can be adopted by the individual to protect against excessive exposure of the eye or the skin to sunlight are suggested. Finally, possible interactions between ozone depletion and climate warming are outlined briefly, as well as how these might influence human behaviour with regard to sun exposure.

Optical function and mitochondrial metabolic properties in damage and recovery of bovine lens after in vitro carbonyl cyanide m-chlorophenylhydrazone treatment

In order to elucidate the correlation between lens optical function and metabolic function, in vitro bovine lens optical quality and mitochondrial integrity was measured following treatment with carbonyl cyanide m-chlorophenylhydrazone (the mitochondrial depolarizing agent, CCCP). The results indicate that in vitro exposure to CCCP resulted in concentration and time-dependent loss of sharp focus. The concentrations tested included 65.0, 32.5, 16.25 and 8.125 microm CCCP. Lenses treated with two lower concentrations show recovery from damage at the 24-h scan point. In lenses treated with 65 microM CCCP, mitochondria in lens epithelial and superficial cortical fibre cells appeared short and swollen. The results of this study indicate that lens optical function and mitochondrial integrity are closely correlated.

Evaluation of the Hybrid Capture 2 CT/GC DNA tests and the GenProbe PACE 2 tests from the same male urethral swab specimens

BACKGROUND

A previous study demonstrated that Digene's Hybrid Capture 2 (HC2) DNA tests for detection of and (CT/GC) could be performed using cervical swab specimens collected in GenProbe transport media with significantly greater sensitivity for the detection of than with the GenProbe PACE 2 system.

GOAL

The goal was to assess the performance of HC2 tests in comparison with GenProbe PACE 2 tests for the detection of CT/GC in male urethral swab specimens.

STUDY DESIGN

A total of 1,202 male urethral swab specimens were collected in GenProbe PACE transport medium. All specimens were first tested with the PACE 2 system, followed by masked HC2 CT/GC testing. The GenProbe AMPLIFIED CT Assay (AMP CT) and PCR/SHARP Signal System (SHARP) were used for adjudication of discrepant results.

RESULTS

The prevalence rates for this population were 8.4% for and 14.6% for, based on the adjudicated results. The relative sensitivity and specificity for the detection of were 97.0% and 99.8% for HC2 and 69.3% and 98.3% for PACE 2, respectively. The relative sensitivities for the detection of were 98.9% for HC2 and 99.4% for PACE 2, with the same specificity of 99.9% for both tests. Agreement between the two testing methods was 95.4% for and 99.6% for.

CONCLUSION

The HC2 test is compatible with the GenProbe collection medium, with significantly greater sensitivity than the GenProbe PACE 2 test for detecting and similar sensitivities for detecting.

Evaluation of the Digene Hybrid Capture II Assay with the Rapid Capture System for detection of Chlamydia trachomatis and Neisseria gonorrhoeae

Screening for chlamydial and gonococcal infection has been strongly recommended for all sexually active women under the age of 26. Advances in the ability to detect infection by nucleic acid detection techniques have improved access to screening methods in routine clinical practices. To meet the increasing demand for testing, a high-throughput system is desirable. We evaluated the performance of the Hybrid Capture 2 CT/GC (HC2) assay with the Digene Rapid Capture System (HC2-RCS). The results of HC2-RCS for endocervical samples from 330 women were compared to those of culture and the COBAS Amplicor PCR. For detection of chlamydial infection, HC2-RCS had a sensitivity and a specificity similar to those of PCR (P > 0.5) and an improved sensitivity compared to that of culture (P = 0.007). For identification of gonococcal infections, all assays performed similarly (P > 0.5). The performance of HC2-RCS was also compared to that of the manual HC2 format (HC2-M) with these samples and with 911 endocervical samples collected previously. The performance of HC2-RCS was equivalent to that of HC2-M; the overall concordance rates for the detection of chlamydia and gonorrhea were 99.7% (kappa = 0.97) and 99.8% (kappa = 0.97), respectively. When the HC2 assay was performed with a semiautomated system application designed for high throughput, it demonstrated high sensitivity and a high specificity for detection of both Chlamydia trachomatis and Neisseria gonorrhoeae.

Impairment of eye lens cell physiology and optics by broadband ultraviolet A-ultraviolet B radiation

The phototoxicity of ultraviolet A (UVA) alone and UVA plus ultraviolet B (UVB) combined on cultured porcine lenses was investigated by analyzing cellular function as measured with a fluorescence bioassay approach and optical integrity, in terms of sharpness of the lens focus as measured with a scanning laser system. The bioassay consisted of carboxyfluorescein diacetate-acetoxymethyl ester and alamarBlue fluorescent dyes. Aseptically dissected porcine lenses were maintained in modified medium 199 without phenol red supplemented with 1% penicillin-streptomycin and 4% porcine serum. At 1 week of preincubation, baseline measurements were obtained. Then the lenses were treated with single exposures of different UVA and UVB energy levels. The lenses treated with 86 J/cm2 UVA alone showed a significant (P < 0.05) decrease in cellular and optical integrity at 48 h after exposure, whereas those treated with 43 J/cm2 UVA alone did not show significant phototoxic effect. Lenses treated with 15.63 J/cm2 UVA plus 0.019 J/cm2 UVB combined showed significant adverse effects beginning from 48 h after exposure. Also, there was no recovery. These findings show that a high UVA dose alone and relatively low UVA in combination with low UVB radiant exposure can impair lens cellular and optical functions, respectively.

Morphometry of the corneal endothelium in glassblowers compared to non-glassblowers

Acute exposure to high levels of IR radiation (IRR) can damage the endothelial cell layer of the human cornea, but the impact of chronic lower-dose exposure has not been assessed objectively. The corneal endothelium of 10 individuals who had occupational exposure to IRR as glassblowers (average 16 years) was examined by photo-slitlamp biomicroscopy, the endothelial mosaic assessed by morphometry, and compared to 10 non-glassblowers (controls). The analyses reveal the glassblowers to have higher than expected endothelial cell density (ECD, average 3371+/-304 cells/mm(2) compared to a control value of 3072+/-198 cells/mm(2)), a higher variance in cell area, and a lower percentage of the most-prevalent cell type, i.e. the six-sided cells (average 52.0+/-12.2%, compared to controls of 64.1+/-6.6%). Analyses of the sizes of different cell types (four-, five-, six-sided, etc.) indicate that the cells in both groups are proportionately larger as the number of sides increases, but that this area-side relationship is different in the glassblowers, who had both smaller and larger cells compared to controls. Two other cases had even higher cell density values (>5000 cells/mm(2)) and <50% six-sided cells. Occupational exposure to a mixture of IRR, perhaps some UVR as well as thermal convection effects, can apparently result in morphological changes in the human corneal endothelium. These may be the result of IRR-stimulated cell division.

Comparison of Digene hybrid capture 2 and conventional culture for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in cervical specimens

Digene's Hybrid Capture 2 (HC2) CT/GC, CT-ID, and GC-ID DNA tests were evaluated by comparison to traditional culture methods for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections in 669 cervical specimens from high-risk female populations attending two sexually transmitted disease clinics. For detection of either or both infections, the HC2 CT/GC test algorithm had 93.8% sensitivity and 95.9% specificity compared to those of culture. After resolution of discrepant results by direct fluorescent-antibody (DFA) staining or PCR assay, the relative sensitivity and specificity of the HC2 CT/GC test algorithm increased to 94.8 and 99.8%, while the values for culture were 83.6% (McNemar's P value, 0.0062) and 100%, respectively. For detection of the individual pathogens, the relative sensitivities for the HC2 CT-ID and GC-ID tests were 97.2 and 92.2% and the specificities were greater than 99% compared to culture adjucated by DFA staining and PCR. Test performance varied at the two clinics: the HC2 CT/GC algorithm, CT-ID, and GC-ID tests had significantly higher sensitivities (McNemar's P value, <0.05) than that of culture for the population at one clinic as well as for the combined populations. At the other clinic, the HC2 tests performed as well as culture.

Action spectrum and recovery for in vitro UV-induced cataract using whole lenses

PURPOSE

To establish the in vitro action spectrum for acute UV cataractogenesis using whole cultured lenses. The recovery pattern of the induced cataract was also investigated.

METHODS

Aseptically dissected porcine lenses were cultured in glass chambers. At 1 week, lenses were exposed to a predetermined UV energy (J/cm(2)) at specific wavebands ranging from 270 to 370 nm at 5- and 10-nm intervals. The UV energy was generated by a PRA integrated arc lamp system using a water-cooled 1000 W, high-pressure xenon lamp. The lamp output was limited using a deionized water filter, a monochromator, and secondary optics. An electronic shutter was used to control the exposure time. The median effective dose, ED(50) (i.e., UV energy threshold) for each waveband was statistically determined using probit analysis. Irradiated spots (3.06 mm(2)) on the lenses were monitored every 6 to 12 hours up to 48 hours postirradiation for any UV-induced opacity with a dissecting microscope and photomicrography. The ED(50)s were plotted against wavelengths to obtain the action spectrum.

RESULTS

The threshold values for 270, 300, and 365 nm were 0.057, 0.069, and 137.19 J/cm(2), respectively. Permanent UV-induced cataract was obtained at twice the threshold values for UVB and UVA.

CONCLUSIONS

An action spectrum for in vitro UV-induced cataract using whole cultured lens is established. These data are comparable to published in vitro (with isolated lens epithelial cells) and in vivo action spectra. The recovery pattern appears to be similar to the in vivo situation.

Eye exposure to optical radiation in the glassblowing industry: an investigation in southern Ontario

OBJECTIVE

To investigate if the levels of optical radiation hazards in glassblowing are well classified according to the hazard types defined in the Canadian Standards Association (CSA) standard for industrial eye protectors.

METHODS

We carried out radiometric measurements, and questionnaire survey in 4 university glassblowing laboratories, and 3 private studios.

RESULTS

There is exposure to low levels of UV and IR radiation in all glassblowing operations. A supra-threshold IR radiation level exists in the craft glassblowing. The use of eye protectors is based on past experience regardless of the level of ocular exposure.

CONCLUSIONS

Optical radiation hazards exist in both craft and scientific glassblowing. There seems to be an inadequate understanding about radiation types encountered by glassblowers.

Light-dependent and -independent behavioral effects of extremely low frequency magnetic fields in a land snail are consistent with a parametric resonance mechanism

Exposure to extremely low frequency (ELF) magnetic fields has been shown to attenuate endogenous opioid peptide mediated antinociception or "analgaesia" in the terrestrial pulmonate snail, Cepaea nemoralis. Here we examine the roles of light in determining this effect and address the mechanisms associated with mediating the effects of the ELF magnetic fields in both the presence and absence of light. Specifically, we consider whether the magnetic field effects involve an indirect induced electric current mechanism or a direct effect such as a parametric resonance mechanism (PRM). We exposed snails in both the presence and absence of light at three different frequencies (30, 60, and 120 Hz) with static field values (BDC) and ELF magnetic field amplitude (peak) and direction (BAC) set according to the predictions of the PRM for Ca2+. Analgaesia was induced in snails by injecting them with an enkephalinase inhibitor, which augments endogenous opioid (enkephalin) activity. We found that the magnetic field exposure reduced this opioid-induced analgaesia significantly more if the exposure occurred in the presence rather than the absence of light. However, the percentage reduction in analgaesia in both the presence and absence of light was not dependent on the ELF frequency. This finding suggests that in both the presence and the absence of light the effect of the ELF magnetic field was mediated by a direct magnetic field detection mechanism such as the PRM rather than an induced current mechanism.

The cornea swells in the posterior direction under hydrogel contact lenses

Two mathematical models were developed to describe the topographical corneal swelling response to hydrogel contact lenses and the effect of these changes on refractive error. In one, corneal thickness changes resulted in deformation of the anterior corneal surface. In the other, the posterior surface only was deformed. Refractive error, corneal thickness and corneal shape were monitored in a sample of adapted contact lens wearers with one eye patched for 4 h while wearing a soft contact lens. The experimental data were most consistent with the model in which the posterior surface only was deformed.

Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in swab specimens by the Hybrid Capture II and PACE 2 nucleic acid probe tests

BACKGROUND AND OBJECTIVES

The Digene Hybrid Capture II (HC II) CT/GC Test (Digene Corp., Beltsville, MD) is a new nucleic acid signal amplification-based test for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in specimens from the genital tract. For optimal results, the HC II CT/GC Test employs a special conical shaped brush for cervical specimen collection from nonpregnant women and swabs from pregnant women.

GOALS

To validate a protocol for HC II C. trachomatis and N. gonorrhoeae testing of specimens collected for the GenProbe PACE 2 System.

STUDY DESIGN

Specimens were collected from 1,746 patients with a swab and placed in GenProbe transport media according to the manufacturer's recommended procedure. The specimens were first tested at two clinical laboratories by the PACE 2 system, and then blindly tested by HC II CT/GC using an adjusted cutoff value. Discrepant specimens were adjudicated by polymerase chain reaction (PCR), and the result common to two of the three testing methods (HC II, PACE 2, and PCR) was defined as the consensus result.

RESULTS

Combining the data from both sites, the relative sensitivity of the HC II Test compared with the consensus result for the detection of 1,761 specimens for C. trachomatis and 1,750 specimens for N. gonorrhoeae was 100% for both organisms. The relative specificities for C. trachomatis and N. gonorrhoeae detection were 99.8% and 99.7%, respectively. The relative sensitivities of the PACE 2 CT and GC Systems were 86.5% and 87.1%, respectively, with relative specificities of 99.9% and 100%. The difference in sensitivity between HC II and PACE 2 for C. trachomatis detection was significant (P < 0.016).

CONCLUSION

The HC II CT/GC Test can be performed using specimens collected in GenProbe transport media and has a significantly greater sensitivity for C. trachomatis detection than the PACE 2 System.

Evaluation of the digene hybrid capture II CT-ID test for detection of Chlamydia trachomatis in endocervical specimens

The performance characteristics of the new signal amplification-based Hybrid Capture (HC) II CT-ID test system (Digene, Silver Spring, Md.) with endocervical specimens were compared to those of tissue culture and PCR (AMPLICOR CT PCR; Roche Molecular Systems, Branchburg, N.J.) for detection of Chlamydia trachomatis in 587 women. HC II CT-ID identified 62 of 65 confirmed C. trachomatis-positive patients (sensitivity of 95.4%) and was negative for 517 of 522 patients who were negative by culture and PCR (specificity of 99.0%). Twelve of the 65 confirmed positive patients were negative by culture but were identified by both HC II CT-ID and PCR (sensitivity of culture was 81.5% [P < 0.01]). In comparison, PCR detected 59 of 65 positive specimens (sensitivity of 90.8%) and had a specificity of 99.6% (520 of 522). These results demonstrate that the Digene HC II CT-ID test is a highly sensitive and specific assay for the detection of C. trachomatis infection in endocervical specimens.

Endothelial cell density and contact lens-induced corneal swelling

PURPOSE

To determine the relationships among endothelial morphometric variables and contact lens-induced corneal swelling in a homogeneous sample of adapted contact-lens wearers.

METHODS

Fifteen male subjects ranging in age from 20 to 40 years, all adapted to daily wear of hydrogel lenses, wore uniform-thickness lenses (Dk/L = 5.78) under unilaterally patched eyes for 4 h. Unpatched fellow eyes served as controls. Central corneal thickness was measured with an optical pachometer. Central endothelial images were obtained with a Topcon SP-1000 Specular Microscope and analyzed by the Topcon IMAGEnet processing system. Thickness and morphometric data were collected on test and control eyes before and after the patching sessions.

RESULTS

A strong correlation (r = -0.795; p < 0.001) was found between central corneal swelling and endothelial-cell density. Correlations between swelling and the coefficient of variation in cell area (r = 0.502; p < 0.06) and between swelling and the percentage of six-sided cells (r = -0.200; p < 0.48) were not significant. Correlations among the morphometric variables were not significant. Differences in the morphometric variables between test and control eyes were not significant before or immediately after the patching sessions.

CONCLUSION

Endothelial-cell density is useful in explaining differences in corneal-swelling responses to closed-eye contact-lens wear among adapted wearers, whereas morphometric variables based on cell-size variability and shape are not.

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 glassblowers 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 glassblowers (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.

Rapid detection and typing of herpes simplex virus DNA in clinical specimens by the hybrid capture II signal amplification probe test

A second-generation signal amplification, nucleic acid-based test for the rapid detection and typing of herpes simplex virus (HSV) DNA was developed and evaluated with artificial and clinical specimens. The analytical sensitivity of the Hybrid Capture II (HC II) HSV DNA assay was determined by testing either cloned HSV DNA or total genomic HSV DNA titrations and resulted in detection thresholds of between 5 x 10(3) and 1 x 10(4) copies per assay. Specificity was assessed by testing a panel of bacteria and viruses commonly found in the female genital tract. Sensitivity was assessed by testing 112 ulcerative genital lesions by the HC II assay and comparing the results to those obtained by routine cell culture. Discrepant results were resolved by PCR testing. After resolution of the discrepant results, the sensitivity of the HC II assay compared to the consensus result (the results of two of three tests, the HC II assay, culture, and PCR, were in agreement) was 93.2% (41 of 44 specimens), and the specificity was 100% (60 of 60 specimens). Culture gave a sensitivity of 84.1% (37 of 44 specimens) and a specificity of 100% (60 of 60 specimens) compared to the consensus result. The results of HSV typing by the HC II assay and culture agreed in all cases. The HC II assay is a rapid and accurate assay for detecting and typing HSV types 1 and 2, with a sensitivity comparable to that of culture and greater ease of use than culture.

Glassblowers' ocular health and safety: optical radiation hazards and eye protection assessment

The aims of this study were to investigate the levels of optical radiation exposure in glassblowing and to determine type(s) of protective eyewear commonly used. Radiometric measurements of radiant emissions from different molten glass materials and heating systems were carried out in six installations. Spectral transmittance curves of available protective lenses used at the locations were obtained. Significant variation (P = 0.0001) in ocular irradiation was obtained. All operations produced irradiances higher than the threshold limit values (TLVs) for the visible spectrum (400 to 700 nm). In craft glassblowing which employs furnace systems, irradiance levels exceeding the TLVs for near infrared (760 1o 1100 nm) were obtained. Molten soda-lime and quartz glasses emitted substantial subthreshold near UV radiation. This study shows that variation exists in glassblowing ocular radiation exposure due to different glass materials and heating systems, therefore selection of appropriate eye protector should be on an individual basis.

Ocular hazards of industrial spot welding

Any welding process is perceived to be a radiation hazard to the eye. Site visits were made to an automotive assembly plant to assess the levels of optical radiation and other hazards on the production line. Measurements were taken with a scanning spectro-radiometer and optical power and energy meters at operating working distances at spot welding stations where nonrobotic procedures were performed. Ultraviolet (UV) irradiance levels produced while spot welding with electrodes operating at 10 to 15 kA and 10 to 20 V were several orders of magnitude below recommended safety limits for industrial exposure. Flashes were rich in visible light and infrared (IR) radiation, but not at hazardous levels. The principal hazards in manual spot welding with high-current electrodes are high-speed droplets of molten metal produced by the process. These are easily defended against by wraparound polycarbonate eye shields.

Corneal swelling and recovery following wear of thick hydrogel contact lenses in insulin-dependent diabetics

Thick, 0.34 mm, 38% water hydrogel lenses were fitted, under a pressure patch, to one eye of 18 type I diabetic patients (aged 18-40 years) to assess the acute response to hypoxia and hypercapnia; the response was compared with that in 18 healthy, aged-matched non-diabetic subjects; the closed-eye lens wear was started mid-morning. Pre-lens wear assessments were made of acuity, intraocular pressure (IOP), central corneal thickness (CCT) and corneal appearance by biomicroscopy. The mean duration of the diabetes was 13 +/- 7 years and the average fasting blood glucose was 8.7 +/- 3.3 mMl-1. Baseline CCT values were marginally greater in diabetic patients (600 +/- 33 microns) compared with a group of non-diabetic control subjects (584 +/- 26 microns; P > 0.5). A 7.7 +/- 2.1% increase in CCT was measured after 3 h lens wear in the diabetic patients while an average 10.6 +/- 2.4% increase in CCT was measured in the control subjects (P < 0.05). The recovery of corneal thickness to baseline values in diabetic patients was slower (at 44.8 +/- 2.0% per hour) than the control subjects (53.9 +/- 2.1 per hour; P < 0.05) although recovery of corneal thickness occurred in both groups within 2.5-3h. IOP values (non-contact tonometry) were higher in the diabetic patients than in the controls (14.5 +/- 2.9 vs 12.4 +/- 1.7 mmHg; P < 0.01). Overall, those corneas with greater baseline CCT values tended to swell less than those with lower baseline CCT values (r = 0.582). Positive correlations were also found between corneal thickness and IOP and blood glucose. The diabetic patients thus tended to have slightly thicker corneas (but this could be related to blood glucose or IOP rather than true corneal disease) and also had corneas that tended to swell less with a contact lens stress test (but this could be constitutively due to the slight oedema already present). The different corneal response in diabetic patients may thus be the result of physical determinants such as initial oedema and IOP and not the result of a disease of the cornea itself.

Lenticular changes in rainbow trout following chronic exposure to UV radiation

Rainbow trout (Onchorynchus mykiss) were exposed to broad band ultraviolet irradiation for a period of 205 days with a 12h/12h on/off cycle. Total radiant exposure was 8.279 x 10(3) J cm-2 of UVA and 1.050 x 10(2) J cm-2 of UVB. Control fish were maintained under UVB-free and blue-free conditions. Quantitative and qualitative evaluation of the teleost crystalline lenses involved photo slitlamp biomicroscopy, dark-field stereomicroscopy and automated scanning laser monitoring. More cataractous changes including discrete anterior subcapsular and 'doughnut' opacities, and peri-nuclear haze were recorded in the lenses of the fish that received chronic UV exposure. However, no significant differences were found in focal lengths and scatter within the sensitivity of the instrumentation. These results support the hypothesis that chronic exposure to ambient levels of ultraviolet radiation is cataractogenic.

Optical effects of UV-A and UV-B radiation on the cultured bovine lens

The effects of repeated exposures to UV-A (335 nm) and UV-B (305 nm) radiation on the crystalline lens were studied by treating cultured bovine lenses daily or weekly. The effects of irradiation on lens optical quality were monitored using an automated scanning laser system that records both relative transmittance and focal length across the lens. Relatively low radiant exposures of UV-B were used (0.06, 0.03, 0.01 J/cm2) compared to UV-A (1.44 J/cm2). In total, 38 treated lenses and 32 controls were cultured for times ranging from 400-1000 hours. Results indicate that this range of UV-B exposure may represent the threshold for in vitro UV-B induced opacification. Lenses treated weekly with 0.06 J/cm2 UV-B showed a significant decrease in transmittance compared to controls 69 hours after the first treatment and an increase in focal length variability. The ability of the lens to repair itself, as found in a previous single dose study, was absent after repeated doses. Lenses exposed daily to 0.03 and 0.01 J/cm2 UV-B showed no significant change in transmittance or focal length variability compared to controls. Daily exposure to 1.44 J/cm2 UV-A resulted in no significant change in transmittance or focal length variability compared to controls.

Ultraviolet-induced lenticular fluorescence: intraocular straylight affecting visual function

Ultraviolet radiation (UVR) excitation of fluorophores within the crystalline lens results in intraocular straylight. These fluorescent emissions are known to increase with age. The visual effect of this increase in fluorescent straylight has not previously been published. In this study, the visual deficit associated with UV-induced lenticular fluorescence was measured for 61 normal subjects between the ages of 21 and 80 yr of age using the Regan visual acuity charts at varying levels of contrast. UVR was shown to decrease low contrast acuity and this loss increased linearly with age.

Role of lasers in eye care

This review discusses the role of lasers in eye care under five headings: Absorption of laser radiation by ocular tissues. Types of lasers include: ruby, argon, gas, organic dye, krypton, Nd:YAG, excimer, and infrared. Applications of lasers for examining the eye include: laser refraction, determining visual acuity by laser fringes, measuring retinal blood flow, scanning laser ophthalmoscopy and tomography, measuring aqueous flare, ocular holography, measuring retinal absorption, measuring visually evoked potentials, and measuring corneal sensitivity. Applications of laser radiation for ocular surgery include: photocoagulation, destruction of tumors, reattaching the retina, treating glaucoma by producing an iridotomy or by trabeculoplasty or by cyclodestruction. Lasers can be used to remove surface irregularities or superficial opacities from the cornea or eyelids. Other uses are for producing a capsulotomy and for altering corneal curvature as a means of correcting ametropia. Potential adverse effects of laser radiation on the eye are summarized.

Damage to the rainbow trout (Oncorhyncus mykiss) lens following an acute dose of UVB

Rainbow trout (Oncorhynchus mykiss) were used to model the solar radiation-induced cataract that occurs in hatchery-reared lake trout (Salvelinus namaycush). Rainbow trout eyes were exposed to wideband predominantly UVB radiant energy from a filtered 1000W xenon source. Lenticular damage was assessed and classified and comeal damage noted. Lenticular threshold radiant exposure was 0.48 J.cm-2 which is in the same range as the mammalian lens. Permanent lenticular damage occurred at radiant exposure levels approximately twice the threshold for lenticular radiant exposure (also similar to the mammalian response). Slit-lamp and scanning electron microscopical results support the theory of post-exposure anterior subcapsular epithelial cell damage, lens fibre swelling, and eventual rupture, leading to areas of lower refractive index in the anterior subcapsular region of the lens.

Prevalence and cytologic manifestations of human papilloma virus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 among 500 consecutive women

The prevalence and associated cytologic manifestations of cervical infection with human papillomavirus (HPV) types 6, 11, 16, 18, 31, 33, 35, 42, 43, 44, 45, 51, 52, and 56 were studied among 500 consecutive women attending the Harborview Medical Center Sexually Transmitted Diseases (STD) Clinic in Seattle, WA. Using radiolabeled-probes without prior amplification of DNA, HPV DNA was detected in cervical specimens from 120 (24%) of the women and was found to be more prevalent than Chlamydia trachomatis (13%), Neisseria gonorrhoeae (12%), or mucopurulent cervicitis (20%). High-risk HPV types 16 or 18 were present alone in 5% of the women; intermediate-risk types 31, 33, 35, 45, 51, 52, or 56 in 3%; and low-risk types 6, 11, 42, 43, and 44 in 5%. In an additional 8% HPV DNA was detected but could be characterized only as being type 6, 11, 16, 18, 31, 33, or 35. Each grouping of HPV types was equally associated with squamous intraepithelial lesions (SILs) of the cervix. In the absence of SIL and koilocytosis, the cytologic changes associated with HPV infection included frequent binucleation and variation in nuclear size and chromatin distribution. Parakeratosis and hyperkeratosis without nuclear atypia were not associated with HPV DNA. The natural history and clinical significance of these HPV-associated lesions remain to be defined.

Protection from acute exposure to ultraviolet radiation by ultraviolet-absorbing RGP contact lenses

One eye in each of 12 female pigmented rabbits was irradiated with UVB while wearing an EqualensR I rigid gas-permeable contact lens. The other eye served as a control. The irradiance level was 625 microW cm-2 (285-315 nm total bandpass) with exposure times up to 2364 s. Eyes were evaluated 24 h and 48 h after exposure by biomicroscopy and pachometry, and later by scanning electron microscopy (SEM). The contact lens was found to protect the central cornea from radiant exposures up to 60 times threshold. The exposed areas of cornea showed characteristic ultraviolet damage with an arc of demarcation indicating the position of the lens. With time the area formed a ridge of damaged cells (confirmed by SEM). At radiant exposure over 0.75 J cm-2 some oedema was seen in the 'protected' region, apparently by extension rather than as a direct effect. These findings suggest that in the human being exposed to ultraviolet radiation this ultraviolet-absorbing RGP lens would permit nasal and temporal photoketatitis with sparing of the central cornea and provide some protection of more posterior ocular structures.

Analysis of the physical state of different human papillomavirus DNAs in intraepithelial and invasive cervical neoplasm

The integration of human papillomavirus (HPV) DNA into the human genome has been generally accepted as a characteristic of malignant lesions. To gain a better understanding of this phenomenon, genomic DNA from 181 cervical biopsy specimens was isolated and analyzed for HPV type and physical state of the HPV genome. These specimens represented the full spectrum of cervical disease, from condyloma to invasive carcinoma. Discrimination between integrated and episomal HPV DNA was accomplished by the detection of HPV-human DNA junction fragments on Southern blots. In most cases in which ambiguous Southern blot results were obtained, the specimens were reanalyzed by two-dimensional gel electrophoresis. Of the 100 biopsy specimens of cervical intraepithelial neoplasia analyzed, only 3 showed integrated HPV DNA, in contrast to 56 (81%) of 69 cervical carcinomas (P less than 0.001) showing integrated HPV DNA. Of the 40 carcinomas containing HPV 16 DNA, 29 (72%) had integrated HPV DNA, of which 8 (20%) also had episomal HPV DNA. In 11 (27%) cancers, only episomal HPV 16 DNA was detected. All 23 HPV 18-containing carcinomas had integrated HPV DNA, and 1 also had episomal HPV 18 DNA. The difference between HPV types 16 and 18 with respect to frequency of integration was statistically significant (P less than 0.01). The results of this study indicate that detectable integration of HPV DNA, regardless of type, occurs infrequently in cervical intraepithelial neoplasia. The absence of HPV 16 DNA integration in some carcinomas implies that integration is not always required for malignant progression. In contrast, the consistent integration of HPV 18 DNA in all cervical cancers examined may be related to its greater transforming efficiency in vitro and its reported clinical association with more aggressive cervical cancers.

UV-B radiation and the optical properties of cultured bovine lenses

The effect of UV-B radiation on the crystalline lens was examined by subjecting bovine lenses in culture to varying low exposures at 300 nm. Lens optical quality was monitored on a long-term basis (to 1000 hrs.) with an automated scanning laser system that recorded both change in relative scatter and focal length across each lens. Data were collected for 20 lens positions at each scan. Radiant exposure levels consisted of 0.5, 0.25, 0.125, 0.06 and 0.03 Jcm-2. Twenty irradiated lenses were compared to twelve untreated controls. All of the irradiated lenses showed changes in scatter and focal length relative to the controls. Most (about 75%) of the treated lenses showed significant increases in scatter (200-400%) and focal length (10-20%) at 40 to 60 hours after exposure. A similar time frame for lens damage was noted by visual inspection. Exposure to UV-B at the above doses did not affect culture longevity.

Acute effects of ultraviolet-B irradiation on the corneal surface of the pigmented rabbit studied by quantitative scanning electron microscopy

The eyes of female pigmented rabbits were exposed to a single dose of UV-B (300 +/- 9 nm, 0.05 J/cm2 total dose) between 13.30 and 15.00 h. The average irradiance was 225 +/- 36 microW/cm2 delivered over 191 to 264 s. At various time periods thereafter (24, 48, 72 and 96 h post-irradiation), the animals were euthanized by pentobarbital overdose and the eyes fixed with 2% glutaraldehyde in 80 mM cacodylate buffer (pH 7.4, total osmolarity of 330-340 mOsm/L). Corneal quadrants were examined by high resolution scanning electron microscopy at 100 X and 500 X at-stage magnification at central, mid-peripheral and peripheral sites. The micrographs from the central cornea were subjected to a quantitative analysis using a computer based digitization system. A peak effect was observed at 48 h at which cellular exfoliation was noted at the corneal apex. In the region immediately adjacent to the exfoliating cells, the number of light and dark electron reflex cells decreased to 48 h while the numbers of medium-reflex cells decreased after 48 h. The relative surface area of all cells was also decreased at 48 h compared to unirradiated controls. Significant recovery was observed by 96 h. Mid-peripheral and peripheral sites were largely unaffected by this just supra-threshold irradiation.

Long-term effects of a single dose of ultraviolet-B on albino rabbit cornea--II. Deturgescence and fluid pump assessed in vitro

Both eyes of female albino rabbits (1.9 kg: 9-10 wk old) were exposed to a single dose of UV-B (300 +/- 9 nm; 0.125 J/cm2 total dose) between 13.30 and 15.00 h. At various time periods thereafter (every 12 h for 3 days, 6, 7, 14, 28, 42, 56, 112, 224 and 336 days post-irradiation), animals were sacrificed, samples of aqueous humor taken for analysis and stroma-endothelium preparations obtained from the corneas. Following such threshold irradiation, small increases in aqueous humor tonicity and protein levels were observed. The preparations were mounted in a specular microscope assembly (for measuring the rate and magnitude of corneal deturgescence) or between two half chambers (for measuring fluid pump) and equilibrated for 2 h with a CO2-equilibrated glucose-adenosine-glutathione-supplemented Ringer solution at 37 degrees C and a hydrostatic pressure of 20 cm H2O. After equilibration the stromal thickness showed large variation with large reductions in both the rate and amplitude of deturgescence function observed by 36 h. Large reductions in fluid pump activity were also observed by 36 h. The magnitude of the effects on fluid pump were somewhat greater than the effects on deturgescence. Both functions recovered to pre-irradiation levels by 112 days post-irradiation.

Physical characteristics and perceptual effects of "blue-blocking" lenses

The transmission-optical properties of a "blue-blocking" lens and its influence on several aspects of human visual performance were assessed. Results showed that the lens was effective in absorbing ultraviolet and blue wavelengths and that its effects on contrast sensitivity and visual evoked potentials (VEP's) were similar to those produced by an equivalent neutral density (ND) filter. Although the lens did not alter stereopsis, it did produce severe color discrimination losses for normal and dichromatic subjects.

Contact lenses and acute exposure to ultraviolet radiation

The eyes of twenty-three pigmented rabbits (weight approximately 2kg) were irradiated with a single dose of UVB (285 to 315 nm total bandpass at approximately 450 muW.cm-2 irradiance) for exposure times of 22s to 1680s. One group wore UV-transmitting soft contact lenses during exposure of one eye with the fellow eye serving as a control while another group wore a UV-absorbing lens on each eye with only one eye irradiated. UV-transmitting contact lenses did not affect the clinical response to UV exposure whereas the UV-absorbing contact lenses protected the corneas as could have been predicted by consideration of the absorption characteristics of the lenses at the experimental waveband. In no case was there any evidence of adhesion between the contact lens and the corneal epithelium.

Long-term effects of a single dose of ultraviolet-B on albino rabbit cornea--I. in vivo analyses

Both eyes of female albino rabbits (1.9 kg) were exposed to a single dose of UV-B (300 +/- 9 nm; 0.125 J/cm2 total dose) between 13.30 and 15.00 h. The average irradiance was 209 +/- 4 microW/cm2 delivered over 612 +/- 13 s. At various time periods thereafter (every 12 h for 3 days, 6, 7, 14, 28, 42, 56, 112, 224 and 336 days post-irradiation), the animals were subjected to a full slit lamp examination to evaluate the status of the cornea and the anterior segment along with optical or ultrasonic pachometry of central corneal thickness. The results were compared with studies on age-matched rabbits over the same time period. In response to the UV-B irradiation, the corneas showed a modest edema (20% increase in central corneal thickness) that peaked at 48 h. Nearly normal central corneal thickness returned in 6 days and followed by a secondary very slight swelling (less than 5%) that resolved by 14 days. The edema was accompanied by keratitis over the same period. Thereafter, both control and UV-B irradiated corneas progressively increased in thickness with age. Biomicroscopy also revealed the appearance of granular opacities in the corneal epithelium that peaked at 72-96 h and resolved over 28 days. In addition, very small microdot opacities of the corneal epithelium were present in the UV-B irradiated corneas that reached maximum at 72 h but persisted to some degree throughout the evaluation period. Biomicroscopy also revealed a progressive disruption of the homogeneous nature of the corneal stroma by the appearance of large 'bread crumb'-like opacities that started at 72 h and was still present at the end of the evaluation period. These results suggest that long-term evaluation of the cornea is important after acute UV-B exposure and indicate that acute exposure to UV-R can produce corneal changes resembling those reported following chronic exposure to UV-R-rich environments.

The influence of contact lens wear on the corneal response to ultraviolet radiation

One eye of each of 15 male pigmented rabbits was fitted with a gas-permeable rigid contact lens. Lenses were worn on a daily basis for an initial period of 7 days with the other eye serving as a control. After this initial period the lenses were removed and both eyes were irradiated with UV-B (305 nm +/- 9 full width half maximum) using either 0.03 J cm-2 or 0.12 J cm-2 which were approximately the epithelial and endothelial damage thresholds for this waveband respectively. The responses of the cornea were followed by microscopy and pachometry. Biomicroscopically there was a dramatic difference in response between contact lens wearing and non-wearing eyes for the higher radiant exposure, whereas little difference was observed at the lower level. For both levels of radiant exposure there was a significantly less corneal thickness increase in contact lens wearing eyes after UV-B irradiation. Recovery patterns were similar.

Optical management of posterior chamber lens tilt

A pseudophakic patient reported blurred vision and diplopia one year after the surgery. We suspected that the origin of both these problems was subluxation of the intraocular lens. His blurred vision was eliminated by a cylindrical spectacle lens at an oblique axis. Monocular diplopia could only be eliminated occasionally. The displacement of the IOL is shown photographically in this report.

Keratopathy with low dose chloroquine therapy

Antimalarial drugs (4-aminoguinolines) are often used as non-steroidal anti-inflammatories and remission inducers in the treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). In this paper we report on ocular signs of aminoquinolinic toxicity among 39 patients, 31 with RA and 8 with SLE. These patients received either chloroquine 250 mg q.h.s. or hydroxychloroquine 200 mg b.i.d. No maculopathy was detected, however 75% of the patients showed various degrees of keratopathy ranging from epithelial haze to dense "whorl" deposits. No correlation was found between severity of the keratopathy and the estimated total amount of aminoquinoline administered.

Ultraviolet-B damages corneal endothelium

Direct in vivo observation of acute ultraviolet (UV)-induced corneal endothelial damage is not possible due to the more severe damage produced in the epithelium. In order to quantify damage and evaluate endothelial recovery an indirect method was used. Eyes of pigmented rabbits were irradiated with UV-B (290 to 320 nm) isolated from the output of a high-pressure 1000 W reflectorized Xenon arc lamp by a grating monochromator and appropriate filters. The peak wavelength of the radiation used was 305 nm, with a 18 nm bandwidth at half-maximum. Corneal thickness variations measured with a modified Zeiss (Oberkochen) pachometer were used to follow alterations in epithelial and endothelial function. Epithelial damage alone resulted in a maximum thickness increase of 13.5% within 24 hr with recovery within a further 24 hr. Greater increases in corneal thickness, in the absence of anterior uveal involvement, were taken to indicate endothelial damage, and reached maximum at 2 days, with recovery occurring in 7 days. The threshold for endothelial damage sufficient to disturb corneal deturgescence was 0.12 J X cm-2.

Determination of infrared radiation levels for acute ocular cataractogenesis

One hundred pigmented rabbit eyes and ten primate eyes were exposed to infrared (IR) radiation in the 715 to 1,400 nm wavelength range and to the full spectrum output from a 5,000 W Xenon high-pressure source. The ocular exposures were evaluated independently with a slitlamp by two researchers and classified for ocular damage. The primary ocular lesions resulting from exposure to IR radiation were corneal, iritic, and lenticular. Corneal damage varied from epithelial haze to epithelial erosion but no endothelial damage was found. The iris showed stromal haze and swelling. Lenticular changes showed small white dots that, occur at the level of the anterior cortex. All lens damage depended on iris involvement. Ocular damage was related to the rate of delivery of the IR radiation since the data show that as the irradiance level increases, the radiant exposure threshold decreases. Exposures for the full spectrum were found to be additive for irradiance levels at 4 W.cm-2 and above. The threshold radiant exposures for the full spectrum of 750 J.cm-2 for the cornea, 1,000 J.cm-2 for the iris, and 2,000 J.cm-2 for the lens were essentially identical to the IR exposure thresholds for the same irradiance levels. The primate threshold radiant exposure was a factor of six above the respective rabbit thresholds.

The ratio of the size of the optic cup (as determined by the place where the vessels deviate) to size of the disc

The vessel deviation to disc ratio (VDR) of the optic nerve head can be defined for a given meridian as the ratio of the size of the cup as indicated by small blood vessel deviation in that meridian to the size of the disc. Thus, VDR is a relative measure similar to cup/disc ratio. The difference between VDR and other methods of measuring cup/disc ratio is that the former identifies the rim of the cup with the deviation or bending of the small blood vessels as they fan out over the disc, whereas the latter determine the location by the other criteria which vary from examiner to examiner. The purpose of this study is to quantify the variation in VDR and its relation to age, refractive error, and sex.

Additive effects of ultraviolet radiation

A 5000 W xenon-mercury high pressure lamp and a double monochromator were used to produce a 3.3-nm half-bandpass ultraviolet (UV) radiation at 295 nm. Pigmented rabbit eyes were irradiated with radiant exposures given in joules per cm2 and ranging from 0.014 to 1.0 J.cm-2 and evaluated by slitlamp biomicroscopy. Corneal threshold (Hc) was 0.05 J.cm-2 and lens threshold (hL) was 0.75 J.cm-2. Other eyes were irradiated with 2 Hc and evaluated from 4 to 24 hr at 4-hr intervals. After a latent period of 4 hr, the corneal response was observed to increase to a maximum by 12 hr. Addition eyes were subjected to repeated Hc and 0.5 Hc followed by Hc exposures with varying intervals between exposures. Corneal damage was only greater than that expected from a single Hc exposure if the separation between the two Hc exposures did not exceed 8 hr. The subthreshold exposures did not sensitize the cornea to later Hc irradiations. The most repeatable and reliable corneal response to these levels of UV was the development of corneal epithelial granules.

Ultraviolet induced lysosome activity in corneal epithelium

A 5,000 W Xe-Hg high pressure lamp and a double monochromator were used to produce a 3.3 nm half-bandpass ultraviolet radiation at 295 nm. Pigmented rabbit eyes were irradiated with radiant exposures from 140 Jm-2 to 10,000 Jm-2 and evaluated by slit-lamp biomicroscopy, light and electron microscopy. Corneal threshold (Hc) was 200 Jm-2 and lens threshold (HL) was 7,500 Jm-2. The most repeatable and reliable corneal response to these levels of UV was the development of corneal epithelial granules. Histological changes included a loss of superficial epithelial cells and selective UV induced autolysis of the wing cells. It is suggested that the biomicroscopically observed granules are the clinical manifestation of the secondary lysosomes revealed by light and electron microscopy. It is proposed that UV breaks down the primary lysosome membranes to release hydrolytic enzymes which in turn form the secondary lysosomes during autolysis. Extreme levels of radiant exposure at 295 nm result in indiscriminate destruction of all layers of the corneal epithelium, but the posterior cornea was spared.

Experimental acute pancreatitis: action of atropine and beta-haloethylamine furoate on muscarine-induced exocrine pancreatic secretion

Intraarterially administered muscarine induced predictable and reproducible experimental acute pancreatitis with a simultaneous increase in amylase levels in blood. Muscarine also caused a transient rise followed by a lowering of blood glucose levels. The stimulated amylase secretion was dose-response related. The guinea pigs survived 2--2 1/2 h after muscarine administration. Atropine (3 and 5 mg/kg), an antimuscarinic agent, injected intraperitoneally 2 h prior to muscarine administration, (a) inhibited muscarine-induced amylase secretion, and (b) marginally increased the survival time of guinea pigs, but could not sustain the animals for further experimentation. The high death rate of experimental animals prevented the use of this method as a model for investigation of experimental acute pancreatitis.

The regression of hypertensive retinopathy

The detection of severe hypertensive retinopathy in a relatively symptomless 30-year-old white female contact lens patient is reported. The regression is documented during subsequent antihypertensive therapy. The retinopathy resolved uneventfully despite fluctuating blood pressure.