al Antitrypsin is an a1 globulin protease inhibitor (Pi) produced by the liver, which controls the proteolytic action of several enzymes including elastase, collagenase, and trypsin.
Two hundred and twenty-one patients in slow-stream geriatric wards in the Portsmouth district were questioned about their vision; 159 of these were examined. It was possible to give help with vision to 21 per cent of patients and to give a further 6 percent help with other eye problems. Eighteen months later, when half the patients examined had died, 14 per cent of those still alive were continuing to enjoy their improved vision, and 6 per cent were benefitting from the help they had received with other eye problems. As a result, we recommend that all admissions should be assessed with regard to their visual ability and that all those with adequate mental faculties should be examined by an ophthalmologist or an optician on admission and when necessary therafter.
THE Goldmann applanation tonometer (1954), as modified by Goldmann and Schmidt (1957), is becoming the standard instrument for measuring the intra-ocular pressure. The accepted method of preparing the eye for a pressure reading is to anaesthetize the cornea and then to stain the pre-corneal film with fluorescein (DukeElder, 1962). The disadvantage of this method is that it requires two manceuvres which are frequently carried out in the dark-room under inadequate illumination. This paper introduces a method of anaesthetizing the cornea and staining the precorneal film with fluorescein using one drop combining the two agents (Fenton, 1964).The problem was twofold. First, to find an anaesthetic which would mix with a fluorescein solution. Secondly, to ensure that the final concentration of the two constituents was adequate for their respective functions. One part of this solution was then mixed in a neutral glass bottlet with three parts of a solution containing an anaesthetic agent. Table I shows the anaesthetic solutions used and their final strengths when mixed with the fluorescein solution. All hydrochlorides were made up with 0-1 per cent. methylhydroxybenzoate for bacteriostasis; the butacaine sulphate was made up with 0 004 per cent. phenylmercuric nitrate.The mixtures were observed. A precipitate formed in almost every case. Table II shows the degree of precipitation after one hour at 250C. The mixtures which precipitated to a degree indicated by one or more + were not used in further experiments.The mixtures which had minimal precipitate were divided into three parts, each part being kept for 24 hours at 4°C., 25°C., and 37°C. Table III shows the precipitation in each case.The character of the precipitate varied. After a week of shelf life at 25°C., all the mixtures were re-examined.
Protein S is an antithrombotic plasma protein that serves as a cofactor for another plasma protein, activated protein C. Patients who express a deficiency of protein S have an increased propensity to experience thromboembolic events. These events are often precipitated by factors that may cause thrombosis in nondeficient individuals, particularly in cases of trauma, pregnancy, or surgery. Anticoagulation therapy was instituted in a 45-year-old woman with known protein S deficiency and bilateral total hip arthroplasties.
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