This study investigated whether patients with ischaemic retinal vasculitis have a worse visual outcome than those with non-ischaemic disease. A retrospective study was made of 53 patients with idiopathic retinal vasculitis (RV), with minimum 5 year follow-up. Patients were categorised into ischaemic and non-ischaemic groups by fluorescein angiography. Visual outcome was determined by visual acuity at their last attendance. Twenty patients (38 eyes) had ischaemic RV; 33 patients (63 eyes) had non-ischaemic RV. At presentation there was no significant difference between the groups in the proportion of eyes with poor vision (6/60 or less). Ischaemic RV patients had a worse visual outcome than those with non-ischaemic RV: 13 of 38 (34%) eyes in the ischaemic group had a final poor vision compared with 4 of 63 (6%) eyes in the non-ischaemic group (Fisher's exact test, p = 0.0005).

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Aims-To determine whether urinary neopterin:creatinine (UNC) ratios relate to disease activity in idiopathic retinal vasculitis (RV). Methods-18 patients with RV were prospectively recruited into a year long longitudinal study. Patients collected first morning urine samples on a weekly basis and on the same day completed a diary which documented their subjective view of RV activity and any concurrent infection. They were examined in clinic on a 6-8 weekly basis and an objective assessment was made of RV disease activity. 14 healthy controls collected urine samples in the same way. Results-UNC ratios were significantly higher in patients than in controls (p=0.004, Mann-Whitney U test). UNC ratios were significantly higher when, according to their diaries, the patients had a subjective flare up of RV (p=0.001, Mann-Whitney U test). Subjective increased RV activity occurred more often when the patients had a concurrent infection (p<0.0001, 2 test). There was no significant diVerence in the UNC ratio between objective clinical relapse and non-relapse of RV. There was moderate agreement between the clinical assessment and patients' subjective impression of RV activity ( =0.48). Conclusions-Higher neopterin levels reflect cell mediated disease that occurs in RV, but UNC ratios are not recommended as a means of monitoring clinical disease activity in RV. (Br J Ophthalmol 2001;85:30-33)

Determination of serum phenytoin has been carried out at the State Hospital for Epileptics in collaboration with the Central Laboratory, Drammen Hospital, since July 1962. METHOD AND MATERIALThe applied technique has been described by Svensmark et al. (8). The main steps are the following:(1) Phenytoin (diphenylhydantoin) and barbiturates are extracted from serum with chloroform.(2) The barbiturates are extracted from the chloroform phase by a borate buffer (PH 9).(3) Phenytoin is subsequently extracted from the chloroform phase by a carbonate (4) Spectrophotometrical reading. During the first year 312 determinations were made in 180 patients, chiefly from the State Hospital for Epileptics and partly from the Diagnostic Station for Epilepsy, Department of Neurology, Rikshospitalet.As the patients at the State Hospital for Epileptics mainly constitute serious cases of the disease, phenytoin only rarely was used alone, but mostly together with a smaller dose of phenobarbital, this group comprising approximately half of the material (Table I).A number of patients treated with other drugs were also investigated in order to obtain a measure of the interference of these preparations upon the determination of serum phenytoin.A smaller group termed "irregular medication" consists of cases revealing exceptional low values of serum phenytoin as compared with the dose, and irregular intake being admitted by the patient upon inquiry. Fig. 1 shows the range of the dosage of phenytoin in mg/kg body weight, with a maximum at 5 mg/kg in the group treated with phenytoin and phenobarbital. buffer (pH 1 I).Epilepsia, 5 (1964) 364-370

The first whole-body analysis of the U.S. Transuranium Registry was initiated in 1979. The donor was a 49-yr-old male Caucasian radiochemist who died of metastatic malignant melanoma. The donor had a recognized, longstanding 241Am internal deposition first identified in a routine urine sample in 1958. A summary of the clinical and postmortem findings is presented with the chronologic sequence of the procedures.

In 85 recurrent stone formers, 2 consecutive 24 h urinary excretions were subjected to chemical examination for calcium, uric acid, magnesium and creatinine. 23 patients had hypercalciuria (greater than 6 mmol/24 h), 22 hyperuricosuria (greater than 3.5 mmol/24 h) and 5 hypomagnesuria (less than 2.4 mmol/24 h). In 1/3 of the cases, the diagnosis would have been missed if based on only one of the two collections, rather than on the mean values from both. Calcium-restricted diet 3 days before and during the sampling is not recommended. Hydrochloric acid appeared to be useful as a preservative and to prevent calcium and magnesium precipitation. No significant seasonal variations were found. Heating of the urine sample before analysis of uric acid did not influence the result.

Increased levels of soluble intercellular adhesion molecule 1 (sICAM-1) in serum have been demonstrated in several human disease conditions. We have previously shown, in a point-prevalence study, a positive correlation between sICAM-1 levels and disease relapse in patients with idiopathic retinal vasculitis. We now report a longitudinal study over 1 year in which sICAM-1 levels were compared with clinical disease status in order to determine this relationship further. Serum samples from 11 patients with idiopathic retinal vasculitis were tested for the presence of sICAM-1 by enzyme linked immunosorbent assay. Eight control subjects were also tested. Five out of 11 patients presented with relapse and had raised sICAM-1 levels compared with quiescent periods of their disease. Five out of 11 patients showed no relapse over 1 year and also no increase in sICAM-1 levels. One patient showed increased levels of sICAM-1, but no clinical signs of relapse. These results indicate that sICAM-1 is associated with disease activity in retinal vasculitis patients and could indicate dysfunction of the blood-retina barrier.

Two common causes of visual loss in idiopathic retinal vasculitis (RV) are retinal ischaemia and cystoid macular oedema. This study investigated whether thrombophilic factors are more prevalent in patients with ischaemic RV than non-ischaemic RV. Twenty patients with RV (10 ischaemic, 10 non-ischaemic) were prospectively recruited before starting systemic immunosuppression. Twenty-one different haemostatic parameters were tested. Seventeen patients had at least one haemostatic abnormality. Three patients had low Protein S, one had low Protein C. Three patients had positive anticardiolipin antibody titres, 1 had poor fibrinolytic activity, 3 had raised fibrinogen levels. Ten patients had raised lipoprotein (a) levels. Fibrinogen levels were higher in the smokers (p = 0.02). Although all von Willebrand's factor levels were within the normal range, they were higher in the ischaemic group (p = 0.008), in which smoking was more prevalent. This study has shown a high prevalence of thrombophilic abnormalities in RV patients, and implicates smoking in the aetiology of ischaemic RV.