SUMMARY Fifty normal people and 50 diabetic patients were studied by means of an enzymatic method for the glucose content in the blood, tears, and urine before and after the peroral glucose load. In normal subjects the fasting glucose lhvels in the tears averaged 3-6 mg/100 ml (0-2 mmol/l) and in the diabetic patients it averaged .ng/100 ml (0-92 mmol/l). As in blood and urine, tear glucose levels are significantly higher in diabetic patients than normal persons both at fasting and after the peroral glucose load test. The fasting tear glucose level did not appear to be a satisfactory index for classifying a person as a diabetic or normal. It was found that after the peroral glucose load test a tear glucose level at 11 mg/100 ml (0'61 mmol/l) resulted in only 4-6% of the diabetics being missed, while 5 8 % of the normal persons were misclassified as diabetics.It has been the practice to obtain blood or urine samples for glucose analysis to detect hyperglycaemia and diabetes mellitus. Collection of a blood sample is not always convenient and of a urine sample is messy. The difficulties are greater in mass surveys for detecting the prevalence of diabetes in a given population. Attention has therefore been drawn to the study of tear glucose to find out if it can be used as an alternative method for the detection of diabetes and hyperglycaemia, However, the data concerning its level in tears remain confusing and contradictory both as regards its normal level in tears and its relationship with hyperglycaemia.1-4The purpose of this project was to study the relationship between tear glucose and blood glucose in normal people and in diabetic patients before and after the peroral glucose load test. It was also intended to see whether any value of tear glucose could be used to separate diabetics and normal persons. Samples of blood, tears, and urine were collected after overnight fast and without the diabetic patients receiving any antidiabetic drugs. Tear specimens were collected by the method already described.5 All the samples were stored at -20°C and analysed on the same day. An oral load of 100 g of glucose was given to each subject. Further samples of blood, tears, and urine were collected 2 hours after the peroral glucose load test. The samples were analysed by the enzymatic method.6 Patients and methods ResultsThe mean, standard deviation, and coefficient of variation (CV) of the level of glucose in blood, tears, and urine in normal persons and in diabetic patients during fasting and after the glucose load are given, in Table 1. It can be seen that there was considerable variation from one individual to another in fasting glucose level and the level after 693 on 12 May 2018 by guest. Protected by copyright.

S U M M A R YGonococci (strain ss3) passaged three times and harvested directly from plastic chambers implanted subcutaneously in guinea pigs were compared with the parent strain (BS) grown in vitro. The strain grown in vivo produced smaller colonies than that grown in vitro and when examined directly in chamber fluid was sometimes not pilated. It was more resistant to the bactericidal action of human serum and more infective for guinea-pig chambers. In gel diffusion, extracts of the organisms adapted in vivo and cultured once on agar appeared to contain one or two antigens that were different from those in extracts of the in vitvo grown organisms; and on polyacrylamide gels, electrophoresis of similar extracts showed one or more protein components for strain ss3 which were not seen for strain BS. Gonococci grown in guinea-pig subcutaneous chambers appear to be suitable for studies on the determinants of gonococcal pathogenicity.

The classification of human placental villi was reviewed on the basis of material prepared by means of special methods. The material from in situ normal-term placentae was biopsied by aspiration into glutaraldehyde. The classification was made on the basis of light-microscopic observations of semithin sections, reconstructions from serial sections, and scanning-electron micrographs. The peripheral villous tree is roughly divided into stem (ramuli), intermediate and terminal villi. The intermediate villi may be further subdivided as mature and immature types, which are found between the stem and terminal villi. Some of the terminal villi possess a local specialization described as the neck region. The histological characteristics and the branching pattern of each type are described, and the basis of the proposed classification is discussed.

S U M M A R YAttempts to study quantitatively the phagocytosis of gonococci from urethral pus failed because of the small numbers of organisms and technical difficulties. However, gonococci from chambers implanted subcutaneously in guinea pigs, which were similar to gonococci from urethral pus in their resistance to killing by human serum, were obtained in sufficient quantities for comparison in phagocytosis tests with the in vitro grown strain from which they were derived.Microscopic and viable counts of gonococci in phagocytes showed that in vivo grown organisms (strain BSV) were readily phagocytosed by human polymorphonuclear phagocytes. There was little difference between BSV organisms and the in vitro grown organisms (strain BS) in resistance to ingestion. There was, however, a marked difference in the intracellular survival of strains BSV and BS during the first hour of phagocytosis. Whereas BSV organisms survived well, many BS organisms were killed. Subsequently, strain BSV and the survivors of the strain BS inoculum responded similarly to the intracellular bactericidins. These results were supported by electron microscopy of infected phagocytes.Resistance of gonococci in vivo to ingestion and digestion by human phagocytes seem to be important facets of the pathogenesis of gonorrhoea. INTRODUCTIONStrongly staining gonococci are seen both extracellularly and intracellularly in urethral pus from patients with gonorrhoea. The presence of extracellular organisms suggests overloading of phagocytic capacity and indicates that some gonococci in vivo may resist phagocytosis. However, the presence of intracellular organisms shows that phagocytosis occurs and, further, that gonococci may resist the intracellular bactericidins. Thus resistance to ingestion and digestion by polymorphonuclear phagocytes (PMN phagocytes), the predominant cell type in urethral pus, would be important in acute infection; and survival inside the fewer mononuclear phagocytes (MN phagocytes) could be important in chronic infection.Pilated (Dilworth et al., 1975). Thus, resistance to ingestion appears to be correlated with the virulence for man of the Kellogg types, but whether or not pili are responsible for the resistance is still a matter of dispute (Swanson et al., 1974).With regard to resistance to intracellular killing, appreciable numbers of a pilated, small-colony-forming strain of gonococcus (BS) resembling Kellogg type 2 survived and multiplied within human buffy-coat phagocytes (predominantly PMN phagocytes) over I 5 h and also survived for at least 6 h in the few MN phagocytes that could be separated from the buffy coat (Veale et al., I 976). A non-pilated, large-colony-forming strain (AL) resembling Kellogg type 4 survived at a much lower level than the BS strain and was destroyed in 10 to 12 h (Veale et al., 1976). Thus, with strains BS and AL, resistance to digestion could be correlated with infectivity for guinea-pig chambers (Veale et al., 1975) and, by analogy with the Kellogg types, with potential virulence for man. These...

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Villi of placental tissue obtained from normal term placentae at Caesarean section were embedded in Epon. Semithin sections were subjected to morphometry. The villi were first grouped according to the modified classification proposed in the foregoing paper. The parameters examined include villous numbers, size, vascularity, volume of trophoblast and connective tissue. The measured values differ markedly from those obtained from paraffin sections. Statistically significant differences exist between the different types of villi in various parameters, providing further evidence supporting the validity of the structural classification suggested.

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