A mathematical model for an expanding foam

A theoretical and numerical model is presented for the shape evolution of the thin liquid films separating the gas bubbles in a foam. The motion is due to capillary action, surface tension gradients, and the overall expansion of the foam. The expansion is the result of the increase in gas content with time. Process modeling is accomplished via the solution of three coupled partial differential equations. Two time scales are included in the model: a process time and a drying or curing time. It is demonstrated that the amount of surfactant is the dominant control mechanism for the final film thickness. If sufficient surfactant is present, the films will be shown to dilate uniformly in space. A number of known features of expanding foams are reproduced by the model.

Preclinical efficacy and safety of mepolizumab (SB-240563), a humanized monoclonal antibody to IL-5, in cynomolgus monkeys

BACKGROUND

Allergic respiratory diseases are characterized by large numbers of eosinophils and their reactive products in airways and blood; these are believed to be involved in progressive airway damage and remodeling. IL-5 is the principal cytokine for eosinophil maturation, differentiation, and survival. Mepolizumab (SB-240563), a humanized monoclonal antibody (mAb) specific for human IL-5, is currently in clinical trials for treatment of asthma.

OBJECTIVE

The purpose of this study was to characterize the pharmacologic activity and long-term safety profile of an anti--human IL-5 mAb to support clinical trials in asthmatic patients.

METHODS

Naive and Ascaris suum -sensitive cynomolgus monkeys received various dose levels of mepolizumab and were monitored for acute and chronic pharmacologic and toxic responses.

RESULTS

To support preclinical safety assessment, cynomolgus monkey IL-5 was cloned, expressed, and characterized. Although monkey IL-5 differs from human IL-5 by 2 amino acids (Ala27Gly and Asn40His), mepolizumab has comparable inhibitory activity against both monkey IL-5 and human IL-5. In A suum--sensitive monkeys, single doses of mepolizumab significantly reduced blood eosinophilia, eosinophil migration into lung airways, and levels of RANTES and IL-6 in lungs for 6 weeks. However, mepolizumab did not affect acute bronchoconstrictive responses to inhaled A suum. In an IL-2--induced eosinophilia model (up to 50% blood eosinophilia), 0.5 mg/kg mepolizumab blocked eosinophilia by >80%. Single-dose and chronic (6 monthly doses) intravenous and subcutaneous toxicity studies in naive monkeys found no target organ toxicity or immunotoxicity up to 300 mg/kg. Monkeys did not generate anti-human IgG antibodies. Monthly mepolizumab doses greater than 5 mg/kg caused an 80% to 100% decrease in blood and bronchoalveolar lavage eosinophils lasting 2 months after dosing, and there was no effect on eosinophil precursors in bone marrow after 6 months of treatment. Eosinophil decreases correlated with mepolizumab plasma concentrations (half-life = 13 days).

CONCLUSION

These studies demonstrate that chronic antagonism of IL-5 by mepolizumab in monkeys is safe and has the potential, through long-term reductions in circulating and tissue-resident eosinophils, to be beneficial therapy for chronic inflammatory respiratory diseases.

Evaluation of plasma von Willebrand factor as a biomarker for acute arterial damage in rats

Plasma von Willebrand factor (vWF) was evaluated as a potential biomarker of acute arterial damage in rats after a vasotoxic dose of the dopaminergic vasodilator, fenoldopam (FP). Male Sprague-Dawley rats were given FP or isotonic saline by subcutaneous injection, and plasma vWF was measured at 2, 6, and 24 hours after challenge. Mean plasma vWF values increased in FP-treated rats compared to controls at 2 hours (167 vs 122%; p < 0.05) and 6 hours postdose (172 vs 130%; p < 0.01) but were comparable to control values after 24 hours. Mesenteric arterial lesions were observed microscopically in all FP-treated rats 24 hours postdose but were not present in rats at 1, 2, 4, 6, or 8 hours after FP challenge. Further, plasma vWF concentrations increased in saline-treated rats after only the minimal perturbation of repeated venipuncture. These results indicate an early, minimal, and transient release of vWF that precedes the onset of morphologically evident vascular damage. The minimal increases in plasma vWF concentrations were of limited predictive value, may be more reflective of an acute-phase reactant response, and were not considered a reliable biomarker of acute FP-induced arterial damage in the rat.

Endothelin receptor subtype distribution predisposes coronary arteries to damage

Several vasoactive drugs that lower blood pressure and increase heart rate induce regional cardiotoxicity in the dog, most frequently of right coronary arteries and right atrium. The basis for this selective damage is thought to result from local changes in vascular tone and blood flow. Administration of an endothelin receptor antagonist (ETRA, SB 209670) to dogs induced damage most frequent and severe in the right coronary artery and right atrium. Because site predisposition may correlate with distribution of vasoactive receptors, the objectives of this study were to map endothelin (ET) receptor distribution and density within regions of dog heart using both gene (mRNA) and protein expression endpoints for dog ET(A) and ET(B) receptors, and, additionally, correlate ET receptor subtype density with regional cardiac blood flow. A 10- to 15-mmHg reduction in mean arterial pressure with a concomitant increase in heart rate (10-20%), a six- and twofold increase in regional blood flow to the right and left atrium, respectively, and acute hemorrhage, medial necrosis, and inflammation were observed in the right coronary arteries and arteries of the right atrium after ETRA infusion for 5 days. Radioligand protein binding to quantify both ET receptors in normal dog heart indicated a twofold greater density of ET receptors in atrial regions versus ventricular regions. Importantly, ET receptor density in coronary arteries was markedly (about five- to sixfold) increased above that in atrial or ventricular tissues. ET receptor subtype characterization indicated ET(B) receptors were three times more prevalent in right coronary arteries compared to left coronary arteries and in situ hybridization confirmed localization of ET(B) in vascular smooth muscle. ET(A) receptor density was comparable in right and left coronary arteries. Quantitative real-time polymerase chain reaction for ET(A) and ET(B) receptor mRNA transcripts supported the site prevalence for message distribution. Consequently, the composite of protein and message expression profiles for ET(A) and ET(B) receptors indicated a disproportionate distribution of ET(B) receptors within right coronary artery of dog and this, along with functional measures of blood flow after ETRA infusion indicated a predisposition for exaggerated pharmacological responses and subsequent damage to right coronary arteries by ET and/or ETRAs.

A Mathematical Model for Crater Defect Formation in a Drying Paint Layer

Certain deep indentations observed in dry coatings are referred to as "craters". They are believed to arise from gradients in the coating surface tension. A mathematical model of surface-tension-gradient-driven flow, using the lubrication approximation for thin layers, is developed to study the formation of craters. The paint is modeled as consisting of an evaporating "solvent" part and a nonvolatile "resin" part. Surface tension gradients on the coating surface arise due to a nonuniform distribution of surfactant. Axisymmetric numerical simulations using the model are performed to explore two candidate crater production mechanisms: an initial release of concentrated surfactant and a steady surfactant source. The effects of changes in various properties, such as the paint drying rate, the surfactant diffusivity, and the viscosity increase during drying, are examined. The model produces craters with large diameters, pronounced rims, and central peaks, similar to those seen in practice. Drying rate has a large influence on crater diameter and depth, by limiting flow due to surface tension gradients within a given time. Reduction of the paint viscosity increase during drying causes increased flow rates, leading to larger craters. A preexisting layer of surfactant on the paint surface sharply reduces the extent of cratering. Surfactant diffusion also tends to reduce the severity of cratering by alleviating surface tension gradients. In some cases, a simplified form of the drying model may be used to quickly approximate the results of the full model. The model provides useful insights into the craters seen in industrial coating applications. Copyright 2000 Academic Press.

Two-dimensional electrophoresis of liver proteins: characterization of a drug-induced hepatomegaly in rats

Two-dimensional electrophoresis (2-DE) of liver proteins was applied to further characterize an unusual drug-induced increase in hepatocellular rough endoplasmic reticulum (RER) in Sprague-Dawley rats given a substituted pyrimidine derivative. Absolute liver weights of drug-treated rats (9.9 +/- 0.4 g) increased above vehicle-treated controls (7.2 +/- 0.2 g) by 37%. Light microscopy revealed diffuse granular basophilia of the hepatocellular cytoplasm, uncharacteristic of hepatocytes and suggested cells rich in ribosomes, which was confirmed by electron microscopy. Immunostaining for cell proliferation, viz., 5-bromo-2'-deoxyuridine (BrdU) and proliferating cell nuclear antigen (PCNA), indicated marked hepatocellular proliferative activity. 2-DE of solubilized liver using an ISO-DALT gel system indicated significant (p<0.001) quantitative changes in at least 17 liver proteins (12 increased, 5 decreased) compared to controls. The protein with the largest increase was homologous to acute-phase reactant, contrapsin-like protein inhibitor-6. Other markedly upregulated proteins were methionine adenosyltransferase, a catalyst in methionine/ATP metabolism and mitochondrial HMG-CoA synthase, involved in cholesterol synthesis. The complementary strategies of 2-DE coupled either with database spot mapping or protein isolation and amino acid sequencing successfully identified a subset of proteins from xenobiotic-damaged rodent livers, the expression of which differed from controls. However, the current bioinformatics platform for rodent hepatic proteins and limited knowledge of specific protein functionality restricted application of this proteomics profile to further define a mechanistic basis for this unusual hepatotoxicity.

Two-dimensional electrophoresis of liver proteins: characterization of a drug-induced hepatomegaly in rats

Two-dimensional electrophoresis (2-DE) of liver proteins was applied to further characterize an unusual drug-induced increase in hepatocellular rough endoplasmic reticulum (RER) in Sprague-Dawley rats given a substituted pyrimidine derivative. Absolute liver weights of drug-treated rats (9.9 +/- 0.4 g) increased above vehicle-treated controls (7.2 +/- 0.2 g) by 37%. Light microscopy revealed diffuse granular basophilia of the hepatocellular cytoplasm, uncharacteristic of hepatocytes and suggested cells rich in ribosomes, which was confirmed by electron microscopy. Immunostaining for cell proliferation, viz., 5-bromo-2'-deoxyuridine (BrdU) and proliferating cell nuclear antigen (PCNA), indicated marked hepatocellular proliferative activity. 2-DE of solubilized liver using an ISO-DALT gel system indicated significant (p<0.001) quantitative changes in at least 17 liver proteins (12 increased, 5 decreased) compared to controls. The protein with the largest increase was homologous to acute-phase reactant, contrapsin-like protein inhibitor-6. Other markedly upregulated proteins were methionine adenosyltransferase, a catalyst in methionine/ATP metabolism and mitochondrial HMG-CoA synthase, involved in cholesterol synthesis. The complementary strategies of 2-DE coupled either with database spot mapping or protein isolation and amino acid sequencing successfully identified a subset of proteins from xenobiotic-damaged rodent livers, the expression of which differed from controls. However, the current bioinformatics platform for rodent hepatic proteins and limited knowledge of specific protein functionality restricted application of this proteomics profile to further define a mechanistic basis for this unusual hepatotoxicity.

Modeling Draining Flow in Mobile and Immobile Soap Films

A mathematical model is constructed to describe the two-dimensional flow in a vertical soap film that is draining under gravity. An asymptotic analysis is employed that uses the long-wave or "lubrication" approximation. The modeling results in three coupled partial differential equations that include a number of dimensionless input parameters. The equations are solved numerically. The three functions calculated, as they vary in space and time, are the film thickness, the surface concentration of an assumed insoluble surfactant, and the slip or surface velocity. The film is assumed to be supported by "wire frame" elements at both the top and the bottom; thus the liquid area and the total surfactant are conserved in the simulation. A two-term "disjoining" pressure is included in the model that allows the development of thin, stable, i.e., "black," films. While the model uses a simplified picture of the relevant physics, it appears to capture observed soap film shape evolution over a large range of surfactant concentrations. The model predicts that, depending on the amount of surfactant that is present, the film profile will pass through several distinct phases. These are (i) rapid initial draining with surfactant transport, (ii) slower draining with an almost immobile interface due to the surface tension gradient effect, and (iii) eventual formation of black spots at various locations on the film. This work is relevant to basic questions concerning surfactant efficacy, as well as to specific questions concerning film and foam draining due to gravity. Prospects for extension to three-dimensional soap film flows are also considered. Copyright 1999 Academic Press.

Automated double labeling of proliferation and apoptosis in glutathione S-transferase-positive hepatocytes in rats

Immunohistochemical markers for proliferation (bromodeoxyuridine, BrdU) and apoptosis (in situ terminal deoxynucleotide transferase dUTP nick end-labeling, TUNEL) were localized within glutathione S-transferase (GSTP)-positive hepatic foci in rats. Using the TechMate Automated Staining System (BioTek Solutions: Santa Barbara, CA), formalin-fixed, paraffin-embedded sections were run through a double-label avidin-blotin-immunoperoxidase protocol in less than 10 hr. Steam heat-induced epitope retrieval and/or proteolytic digestion preceded each labeling procedure. Color development was achieved using diaminobenzidine (DAB) with nickel enhancement for BrdU and TUNEL and VIP for GSTP. Results illustrate clear staining, brown-black BrdU-positive nuclei or TUNEL-positive apoptotic bodies within purple GSTP-positive hepatocytes. This automated procedure provides a method to easily identify and quantitate proliferating or apoptotic cells within foci of altered hepatocytes in rat liver and may have general applications for studies of cell or tissue kinetics during development, differentiation, and various pathological conditions in animals and humans.

Simulation of Coating Layer Evolution and Drop Formation on Horizontal Cylinders

The lubrication form of the equations governing the flow of a thin liquid film on a horizontal right circular cylinder is derived. The equations are discretized and solved numerically using an alternating-direction implicit algorithm. Simulations demonstrate that the transition from a uniform coating to a final configuration of distinct drops follows a similar evolution for a wide range of cylinder radii. Initially gravity-driven drainage from the top and sides of the cylinder dampens the formation of any axial disturbances; only when this drainage slows do longitudinal waves begin to develop along the bottom of the cylinder. These waves grow rapidly and a series of alternating primary and satellite drops form during the transition from a linear to a nonlinear wave growth regime. This is followed by a slow drainage between adjacent drops as the drop pattern approaches an equilibrium state where surface tension forces exactly balance gravitational forces in each discrete drop. For large cylinder radii, these drops are localized on the bottom of the cylinder, while, for sufficiently small cylinder radii, these drops may wrap around the entire circumference of the cylinder. Integral measures of the evolving coating profile, such as the total energy and viscous dissipation rate, clearly show these growth phases. The equilibrium shape of large-amplitude pendant drops and the maximum sustainable drop volume for various cylinders are also considered.

Efficacy of argon laser trabeculoplasty in aphakic and pseudophakic eyes

BACKGROUND AND OBJECTIVE

This study evaluated the efficacy of argon laser trabeculoplasty (ALT) in patients with aphakia or pseudophakia.

PATIENTS AND METHODS

The authors retrospectively analyzed 63 eyes of 63 patients with aphakia or pseudophakia who had uncontrolled open-angle glaucoma and were treated with 180 degrees or 360 degrees ALT.

RESULTS

The mean intraocular pressure (IOP) before ALT was 25.1 mm Hg (+/- 8.1 mm Hg). Two years after ALT, the mean IOP in the successfully treated group was 15.4 mm Hg. The mean survival time (50% success rate) for all treated eyes was 23 months, and treatment was successful in 34% of eyes at 36 months. Pseudophakic eyes had a better response than aphakic eyes (P = .06), and eyes that had extracapsular surgery did better than eyes with intracapsular surgery (P = .07).

CONCLUSION

ALT in aphakic or pseudophakic eyes with uncontrolled glaucoma is a safe, reasonably effective treatment that can delay the need for trabeculectomy.

Timolol hemihydrate vs timolol maleate to treat ocular hypertension and open-angle glaucoma

PURPOSE

We compared the therapeutic efficacy and safety of timolol hemihydrate to timolol maleate in patients with ocular hypertension and chronic open-angle glaucoma.

METHODS

We conducted this three-month study as a multicentered, masked, parallel group comparison. Both the 0.25% and 0.5% concentrations were evaluated against similar concentrations of timolol maleate. Dosing was twice daily. An open-label, nine-month study followed the masked portion of the protocol, in which all patients received either 0.25% or 0.5% timolol hemihydrate. A total of 371 patients were included in both the 0.25% and 0.5% studies.

RESULTS

We found statistically similar intraocular pressures with both the 0.25% (18.3 and 18.6 mm Hg for the hemihydrate and maleate groups, respectively) and 0.5% (19.9 and 19.5 mm Hg for the hemihydrate and maleate groups, respectively) concentrations of timolol hemihydrate and timolol maleate after three months of masked treatment. Likewise, peak intraocular effect at two hours after taking the medication was statistically similar between medicines at both concentrations. Likewise, both ocular and systemic safety were similar between the maleate and hemihydrate preparations at both concentrations. In the nine-month open-label protocol, therapeutic efficacy (19.9 and 19.1 mm Hg for the 0.25% and 0.5% concentrations, respectively) and safety of timolol hemihydrate were similar to effect and safety of the three-month protocol.

CONCLUSIONS

This study suggests that timolol hemihydrate had an ocular hypotensive efficacy and safety profile statistically equivalent to that of timolol maleate for up to three months of therapy. Timolol hemihydrate showed efficacy and safety similar to that observed within the first three months, for up to one year of therapy.

Toxicologic Pathology: Modern Challenges and the Need for a New Educational Strategy

STP and ACVP must be guided by the opinions voiced by their memberships, but ultimately both organizations must provide leadership and vision relative to the future of the discipline and the professionals they serve. The process of training and certification of anatomic and clinical pathologists is not broken nor is the product flawed. However, as was recognized earlier with veterinary pathology and more recently with clinical pathology, it is now time to recognize the specialty of toxicologic pathology. This specialty has moved beyond the traditional veterinary pathology training, which focuses on infectious disease, large animal and companion animal pathology, and diagnostics. One cannot expect that the undirected graduate will naturally develop excellence in the principles of toxicology or understand mechanisms of xenobiotic metabolism. There is a need to readdress the educational process and the standards of excellence by which specialists in toxicologic pathology are measured. Our commitment to improving recognized deficiencies and establishment of expectations will move toxicologic pathology forward and create opportunities for those who follow.

The effect of apraclonidine on the intraocular pressure of glaucoma patients following Nd:YAG laser posterior capsulotomy

We retrospectively compared the incidence and level of postoperative intraocular pressure (IOP) spikes in 53 consecutive glaucoma patients undergoing Nd:YAG posterior capsulotomy (YPC) who received apraclonidine immediately postoperatively, with those occurring in 22 consecutive similar patients who did not receive apraclonidine. Postoperative IOP elevations of 5 mm Hg or more occurred in 13% of the apraclonidine recipients and in 59% of the nonrecipients; elevations of 10 mm Hg or more occurred in 4% of the former and in 27% of the latter. Our results suggest that apraclonidine can be a useful adjunct in preventing IOP elevations following YPC in glaucoma patients.

Effect of aminophenols (5-ASA and 4-ASA) on colonic interleukin-1 generation

The effect of 5-ASA and 4-ASA, drugs used for the treatment of inflammatory bowel disease, on modulation of experimental colitis and on colonic generation of interleukin-1 was evaluated. Three weeks of treatment with 5-ASA or 4-ASA (50 micrograms/kg) and one week of treatment with 5-ASA significantly decreased colonic interleukin-1 generation and the extent and severity of inflammation in a rat model of colitis induced by trinitrobenzene sulphonic acid. Colonic biopsies were obtained from patients with active ulcerative colitis and organ cultured 24 hours in the absence or presence of the following drugs: sulphasalazine, sulphapyridine, 5-ASA and 4-ASA (25-100 micrograms/ml). Interleukin-1 content in tissue cultured in the presence of 5-ASA (100 micrograms/ml) was two-thirds of its content in tissue cultured in drug free medium and its release into the medium was decreased by 50%. Sulphasalazine 50 micrograms/ml significantly decreased by 33% the tissue content but did not affect interleukin-1 release and a higher dose was not more effective. Sulphapyridine and 4-ASA in doses up to 100 micrograms/ml did not affect either interleukin-1 colonic content or its release into the culture medium. We conclude that pharmacological suppression of colonic interleukin-1 generation may be one, although not the sole mechanism to explain the therapeutic efficacy of 5-ASA in the treatment of inflammatory bowel disease.

Therapeutic intervention in a rat model of adult respiratory distress syndrome: II. Lipoxygenase pathway inhibition

The present study was designed to investigate the role of 5-lipoxygenase (5LO) metabolites in an endotoxin (LPS)-induced model of the adult respiratory distress syndrome (ARDS) in the rat. The therapeutic value of two 5LO inhibitors and a specific LTB4 and a LTD4 receptor antagonist were examined. Rats were treated 1 hr prior to administration of aerosolized LPS. Rats were either unexposed (n = 11), or pretreated with vehicle sham (n = 63), 50 mg/kg phenidone t.i.d. (n = 7, n = 10 for assessment of mortality), 30 mg/kg SK&F 103842 b.i.d. (n = 6), 50 mg/kg SK&F 106203 t.i.d. (n = 11), or 5 mg/kg SK&F 107324 b.i.d. (n = 6) 1 hr prior to the administration of aerosolized endotoxin (LPS, 7 mg/kg) or phosphate-buffered saline (PBS, n = 22). Twenty-four hours later, blood samples were collected for hematologic evaluation and after wet lung weight was determined, broncho-alveolar lavage (BAL) was performed to measure cells counts and total protein (TP). 5LO inhibition and LTD4 receptor antagonism reduced LPS-induced mortality to zero compared to 35% in rats pretreated with vehicle sham. Pretreatment with the LTD4 receptor antagonist attenuated the LPS-induced increased in wet/dry lung weight (W/D) whereas 5LO inhibition reduced TP increases. Both 5LO inhibition and LTD4 receptor antagonism attenuated the LPS-induced BAL erythrocyte increase. The LPS-induced thrombocytopenia was attenuated by phenidone, the 5LO receptor antagonist. We conclude that the increased microvascular permeability was associated with the formation of 5LO products since 5LO inhibition lessened the severity of the LPS-induced increase in W/D and TP.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapeutic intervention in a rat model of adult respiratory distress syndrome: III. Cyclooxygenase pathway inhibition

Current strategies for the treatment of ARDS have been unsuccessful in reducing mortality. In the present study, we have evaluated the role of cyclooxygenase (CO) products in a rat model of ARDS by testing naproxen, indomethacin, ibuprofen, and a thromboxane A2 (TXA2) receptor antagonist (SK&F 96148). Rats were treated 1 hr prior to endotoxin (LPS) exposure and 24 hr later, survival, body weight changes, wet/dry lung weight (W/D), total protein content (TP) of the bronchoalveolar lavage (BAL) fluid, and total erythrocyte and differential leukocyte counts of the BAL fluid were measured. In addition, the following hematologic measurements were taken: hemoglobin (Hb), hematocrit (Hct), circulating erythrocyte, differential leukocyte, and platelet counts. Treatment with the TXA2 receptor antagonist reduced mortality to zero after 24 hr after LPS administration. Other compounds had no significant effect on LPS-induced mortality. Pretreatment with CO inhibitors or the TXA2 receptor antagonist attenuated the LPS-induced increase in TP and W/D. Although all compounds tended to reduce the LPS-induced increase in BAL erythrocytes, only the TXA2 receptor antagonist did so significantly. The LPS-induced increase in BAL neutrophil counts was significantly reduced by 30 mg/kg ibuprofen, but not by the other compounds. In fact, the TXA2 receptor antagonist actually exacerbated BAL neutrophil counts, but diminished the peripheral neutrophilia and lymphopenia induced by LPS. None of the CO inhibitors tested significantly affected LPS-induced hematologic responses. We conclude that by virtue of its protection against LPS-induced mortality, the TXA2 receptor antagonist was the most effective compound in this model. However, it did cause certain negative side effects such as increased pulmonary inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative biochemical and morphometric changes associated with induction of the hepatic mixed function oxidase system in the rat

This study characterized the induction of the rat hepatic cytochrome P-450-dependent mixed function oxidase system by SK&F 86002 [6-(4'-fluorophenyl)-5-(4'-pyridyl)-2,3-dihydroimidazo-(2,1-b)thia zole], an inhibitor of both the cyclooxygenase and 5-lipoxygenase pathways of arachidonic acid metabolism. The induction characteristics of SK&F 86002 were compared to those of the classical inducer, phenobarbital, and morphological features of both SK&F 86002 and phenobarbital induced hepatocellular hypertrophy were quantitated. Rats were administered either SK&F 86002 (6, 18, or 60 mg/kg/day, po) or phenobarbital (8, 24, 80 mg/kg/day, ip) for 3 or 14 consecutive days. Liver to body weight ratio, total hepatic microsomal protein and cytochrome P-450 content, ethoxycoumarin-O-deethylase (ECOD) and leukotriene B4(LTB4) omega- and omega-1 hydroxylase were measured. Ultrastructural morphometry of the liver from control, and high dose SK&F 86002 (60 mg/kg/day) and phenobarbital (80 mg/kg/day) treated rats was completed. On day 3, phenobarbital increased liver to body weight ratio but only at the 80 mg/kg/day dosage; microsomal protein content was unchanged. ECOD activity increased in a dose-dependent fashion. LTB4 omega- and omega-1 hydroxylase activities were unaffected. Administration of SK&F 86002 for 3 days increased the liver to body weight ratio at both the 18 and 60 mg/kg/day dosage; microsomal protein content was unchanged. ECOD activity was significantly increased by the 60 mg/kg/day dosages of SK&F 86002. On day 14, phenobarbital increased the liver to body weight ratio and microsomal protein content but again only at the 80 mg/kg/day dosage. Cytochrome P-450 content was increased by all dosages.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapeutic intervention in a rat model of ARDS: I. Dual inhibition of arachidonic acid metabolism

The protective effects of altered arachidonic acid metabolism, using either methylprednisolone or a dual cyclooxygenase and 5-lipoxygenase inhibitor (SK&F 86002), were compared in a rat model of adult respiratory distress syndrome (ARDS). Rats were either unexposed (n = 9) or pretreated with vehicle (n = 25), 100 mg/kg SK&F 86002 (n = 8) or 30 mg/kg methylprednisolone (MP, n = 7) 1 h prior to the intratracheal administration of 7 mg/kg aerosolized endotoxin (LPS) or phosphate buffered saline (PBS). Twenty-four hours later, blood samples were collected and the rats were anesthetized and exsanguinated. The lungs were surgically removed, weighed and bronchoalveolar lavage (BAL) was performed. LPS caused 30-35% mortality and induced significant differences in body weight, BAL erythrocyte and neutrophil counts, lung wet/dry weight ratio (W/D), total BAL protein (TP), hemoglobin (Hb), hematocrit (HCT), and circulating leukocyte and platelet counts as compared with controls. Pretreatment with MP reduced mortality to zero and also attenuated the LPS-induced alterations in body weight, W/D, TP, BAL erythrocyte count, and circulating platelet count. However, MP exacerbated LPS-induced increases in Hb, HCT and circulating neutrophil counts while enhancing lymphopenia. Pretreatment with SK&F 86002 also reduced mortality to zero and attenuated LPS-induced alterations in W/D, TP, HCT and circulating platelet count. Like MP, SK&F 86002 exacerbated the LPS-induced lymphopenia, and increased circulating neutrophils above baseline values. We conclude that both MP and SK&F 86002 provided protection against LPS-induced responses in this model of ARDS. Mechanistically, this indicates the critical role of eicosanoid mediators in this model. Therapeutically, SK&F 86002, or a similar compound, may be beneficial in preventing the acute phase responses so harmful to ARDS patients.

In vitro metabolism of the novel antiinflammatory agent 6-(4'-fluorophenyl)-5-(4'-pyridyl)-2,3-dihydroimidazo-[2,1-b]-thiazole

6-(4'-Fluorophenyl)-5-(4'-pyridyl)-2,3-dihydroimidazo-[2,1-b]-thia zole (SK&F 86002) is a dual inhibitor of arachidonic acid metabolism which has therapeutic potential for the treatment of inflammatory diseases. Previous studies in rats, in vivo, demonstrated that SK&F 86002 metabolism proceeds by sequential steps of sulfur and nitrogen oxidation. Therefore, these studies were designed to 1) identify the enzymes (flavin vs. cytochrome P-450-dependent monooxygenases) which were responsible for SK&F 86002 metabolism in vitro in hepatic microsomal suspensions from Sprague-Dawley rats, 2) characterize sex-dependent differences, and 3) quantitate the effect of pretreatment with SK&F 86002. All three steps in the sequential metabolism of SK&F 86002 to the N-oxide sulfone metabolite were quantitated individually. The three oxidation steps appeared to be catalyzed primarily by cytochrome P-450; heat inactivation (used to destroy flavin monooxygenase) had little effect on the metabolism of each compound. Further,N-octylamine failed to stimulate the metabolism of any compound and the cytochrome P-450 inhibitors (SK&F 525-A, metyrapone, and alpha-naphthoflavone) resulted in a marked inhibition of the metabolism of all three substrates. Maximal velocities for metabolism of all three substrates (SK&F 86002, sulfoxide, and sulfone) in microsomes isolated from male rats, were 3- to 5-fold greater than observed in female rats. Furthermore, pretreatment of male rats with SK&F 86002 (60 mg/kg/day for 3 days) resulted in a change in the in vitro metabolism of all three substrates generally characterized by an increase in Vmax and/or a fall in km.(ABSTRACT TRUNCATED AT 250 WORDS)

Neodymium: YAG laser transscleral cyclophotocoagulation for glaucoma after penetrating keratoplasty

Nd:YAG laser cyclophotocoagulation (CPC) of the ciliary body is a promising cyclodestructive treatment for the management of refractory glaucoma following penetrating keratoplasty. Twenty-eight eyes (27 patients) were treated between August 1985 and September 1987 and followed 6 to 24 months (median, 18 months). The mean intraocular pressure (IOP) was initially 39 mm Hg (range, 30 to 70 mm Hg) on maximally tolerated medications. The Lasag Microrupter 2 was used in the free-running thermal mode with a mean pulse energy of 4.13 J. The laser was retrofocused 3.6 mm from the conjunctival surface and 30 to 50 applications per treatment (mean, 37.5) were given 2 to 3 mm from the limbus for 360 degrees (71%) or 180 degrees (29%). Multiple treatments were necessary in 13 eyes (46%). After CPC, IOP fell to 22 mm Hg or below in 18 eyes (64%) at 3 months, in 20 of 27 eyes (74%) at 6 months, and in 16 to 24 eyes (67%) at 1 year. Inadequate IOP control in four of 28 eyes necessitated cyclocryotherapy in three patients and a Schocket procedure in one other. Of the 14 clear pre-CPC grafts six (43%) became edematous during follow-up. All of the failed grafts had undergone multiple CPCs.

Inflammatory mediators of experimental colitis in rats

Colonic inflammation was induced in rats by intracolonic administration of 0.25 ml of 50% ethanol containing 30 mg of trinitrobenzene sulfonic acid (TNB). Control rats were treated with 0.25 ml of 50% ethanol or with 30 mg of TNB in 0.25 ml of saline. After 24 h, mucosal ulceration and hemorrhage were observed in TNB/ethanol-, 50% ethanol-, and to a lesser extent, in TNB/saline-treated rats. After 1 wk, mucosal damage was completely resolved in the 50% ethanol and TNB/saline-treated rats but the lesions in the TNB/ethanol-treated rats persisted and progressed to a chronic active inflammatory process after 3 wk. Myeloperoxidase activity was significantly elevated in mucosal scrapings from all treatment groups at all time intervals when macroscopic and microscopic mucosal injury was evident. Interleukin-1 was found to be the most sensitive indicator of mucosal inflammation, and its mucosal values correlated with myeloperoxidase activity. Leukotriene B4 was increased in control rats at 1 wk and in TNB/ethanol-treated rats at all time intervals. The maximal increase in leukotriene B4 was observed at 1 wk. Thromboxane B2 generation was reduced while platelet activating factor generation was not increased in TNB/ethanol-treated rats. These results indicate that in this TNB/ethanol model of gut inflammation, myeloperoxidase activity and interleukin-1 are reliable and sensitive indicators of colonic inflammation, and that thromboxane B2 is not involved in the acute lesions, whereas leukotriene B4 appears in the chronic active inflammatory response.

Ovarian effects of SK&F 86002-A2 in the rat: site of action

In a preliminary 30-day study, oral administration of SK&F 86002-A2, an inhibitor of prostaglandin and leukotriene synthesis, blocked ovulation and altered ovarian structure and hormone production in rats. The purpose of the present study was to determine if the locus of action of SK&F 86002-A2 for these effects was the ovary or some other site in the female reproductive system, using a number of experimental approaches. A single sc or intraovarian injection of SK&F 86002-A2 did not block spontaneous or gonadotropin-induced ovulation in proestrous rats, whereas indomethacin, a positive control, acutely disrupted the ovulatory process. Since neither route of administration blocked ovulation, integrated pituitary and ovarian events were not negatively affected by a single injection of SK&F 86002-A2 at doses which caused ovarian dysfunction when administered repeatedly for 30 days. In contrast to a single dose, oral administration of SK&F 86002-A2 to hypophysectomized rats for 2 weeks suppressed follicular growth and estradiol production in response to sc administration of pregnant mare serum gonadotropin. Although ovarian function was suppressed in hypophysectomized rats, LH surges induced by estradiol in ovariectomized rats were not affected by administration of SK&F 86002-A2 for 2 weeks. Thus, hypothalamic/pituitary dysfunction did not contribute to the ovarian effects of SK&F 86002 that occurred after repeated dosing. In conclusion, these results indicate that disruption of ovarian cycles by SK&F 86002-A2 is related to a direct effect on the ovary, and not to altered hypothalamic/pituitary function and LH release. Specifically, SK&F 86002-A2 may suppress the ovarian response to gonadotrophin, retarding follicular growth and estrogen production. The ovarian effects are consistent with a pharmacological expression of the inhibitory action of SK&F 86002-A2 on prostaglandin and leukotriene synthesis.

Ovarian effects of an anti-inflammatory-immunomodulatory drug in the rat

The purpose of this study was to determine whether a 30-day administration of SK&F 86002-A2, an inhibitor of cyclooxygenase and 5-lipoxygenase pathways of arachidonate metabolism, adversely affected reproductive cycles, ovarian structure, and/or pituitary/ovarian hormone secretion. Cyclooxygenase and 5-lipoxygenase enzymes catalyze the reactions leading to the synthesis of prostaglandins and leukotrienes, respectively, which are physiological regulators of ovarian function. Female rats were dosed once daily by gavage with 0, 1, 5, 10, 30, or 60 mg (base)/kg/day of SK&F 86002-A2 for 30 consecutive doses beginning on the day of vaginal proestrus. Vaginal smears were then examined daily until necropsy, when ovaries and uteri were collected for macroscopic and histological examination. In addition, serum concentrations of estradiol, progesterone, luteinizing hormone, follicle stimulating hormone, and prolactin were estimated by radioimmunoassay. Estrous cycle irregularity, resulting from a dose-related lengthening of the interestrous interval, significantly (p less than 0.05) reduced the number of cycles in rats receiving 60 mg/kg/day of SK&F 86002-A2 compared to controls. Furthermore, the ovaries from this group of rats weighed significantly more (p less than 0.05) than controls, apparently due to an increased occurrence of enlarged, cystic follicles that occasionally contained blood. Luteinized follicles with entrapped ova were also detected during histological examination. Dilatation of the uterine lumen was observed in some rats receiving doses of SK&F 86002-A2 greater than 1 mg/kg/day. Serum progesterone in rats receiving 60 mg/kg/day of SK&F 86002-A2 was significantly (p less than 0.05) lower than controls. In contrast, mean levels of serum estradiol were elevated in rats receiving 30 mg/kg/day of SK&F 86002-A2. Serum concentrations of FSH, LH, and prolactin were not significantly different in any group. The results of this study suggest that SK&F 86002-A2 disrupts cyclic ovarian function by a local, cumulative action that inhibits ovulation and alters steroid secretion.

Neodymium-YAG laser iridectomies in glaucoma associated with closed or occludable angles

A review of our first 200 neodymium-YAG laser iridectomies performed over a two-year period in various forms of glaucoma showed patent iridectomies in 180 of 182 eyes (99% success) at the last examination (one to 26 months postoperatively). Both failures had preexisting chronic uveitis. Eighteen eyes were lost to follow-up. Complications included intraocular pressure increased more than 10 mm Hg in 54 eyes (30%), hemorrhage in 36 eyes (20%), iritis in 21 eyes (11.5%), posterior synechiae in 13 eyes (7%), corneal changes in seven eyes (4%), and pupillary distortion in six eyes (3%). With experience, fewer applications are required to penetrate the iris, and retreatment to obtain patency is less likely to be needed.

Differential effects of methacholine and leukotriene D4 on cyclic nucleotide content and isoproterenol-induced relaxation in the opossum trachea

The effects of leukotriene D4 and methacholine on cyclic nucleotide content and isoproterenol-induced relaxation were examined in the isolated opossum trachea. Although leukotriene D4 (-log EC50 = 6.70) was a more potent contractile agent than methacholine (-log EC50 = 5.78), the maximal response to leukotriene D4 was only 65% of the maximum response to methacholine. Contraction of tracheal strips with leukotriene D4 was accompanied by a 3-fold increase in cyclic GMP accumulation. Methacholine-induced contraction was not associated with an increase in cyclic GMP. Neither agent altered basal cyclic AMP content. Additional experiments were carried out to examine functional inhibitory interactions between bronchoconstricting and bronchodilating pathways. In these studies, cumulative isoproterenol concentration-response curves were constructed in tracheal strips contracted with three different concentrations of methacholine and in tissues contracted with three corresponding equieffective concentrations of leukotriene D4. Although the relaxant response to isoproterenol decreased as tissues were contracted with higher concentrations of either agent, the inhibitory effect of methacholine on isoproterenol-induced relaxation was much greater than the inhibitory effect of leukotriene D4. Previous studies from our laboratory suggested that a potential explanation for the greater inhibitory effect of methacholine on the mechanical response to isoproterenol was that methacholine may inhibit isoproterenol-stimulated cyclic AMP accumulation whereas leukotriene D4 may not. However, neither methacholine nor leukotriene D4 inhibited isoproterenol-stimulated cyclic AMP accumulation in the opossum trachea. The results of this study indicate that the sensitivity of airway smooth muscle to beta adrenoceptor agonists is influenced both by the initial contractile state of the tissue and by the type of agent used to induce tone.

Laser iridectomy. A controlled study comparing argon and neodymium: YAG

Laser peripheral iridectomies were performed on both eyes of 38 patients with acute or chronic primary angle-closure glaucoma or with narrow angles capable of closure. The right eye was treated with the neodymium YAG laser (Nd:YAG) and the left eye with the argon laser. Patients were followed for a minimum of eight months. The mean number of applications to produce iris penetration was six with the Nd:YAG laser and 73 with the argon laser. Visual acuity, postoperative intraocular pressure (IOP), corneal changes, and pigment dispersion were similar in the two groups. Microhyphema was more prevalent in the Nd:YAG iridectomy group. Pupillary distortion, iritis, and late failure of patency were more frequent in the argon laser group. Nd:YAG laser iridectomies require fewer applications and produce less inflammation. This controlled study demonstrates that when properly and carefully performed, the Nd:YAG laser is at least as effective and appears to be as safe as the argon laser for performing peripheral iridectomies.

Variation of techniques on the results of argon laser trabeculoplasty

Patients with uncontrolled open-angle glaucoma were treated with argon laser to the trabecular meshwork. These patients were divided into six groups. Each group of eyes had a slightly different technique of argon laser therapy. Except for one group, there was an adequate pressure lowering effect at the longest follow-up (-18 to -28%). Since the worst complication of argon laser trabeculoplasty is the immediate elevation in intraocular pressure with subsequent worsening of the field and/or disc, the immediate rise in intraocular pressure was measured and compared for each of the various techniques. In addition comparison was made when treating 180 degrees in one eye and 360 degrees in the other eye of 30 individuals having similar glaucomatous disease bilaterally. Little difference was noted between the two eyes.

Bovine peripheral blood polymorphonuclear neutrophil chemotactic response to Pasteurella haemolytica or zymosan-activated serum

The chemotactic influence of Pasteurella haemolytica and of products of its growth was evaluated in vitro, using bovine peripheral blood polymorphonuclear neutrophils (PMN) in an underagarose migration assay system. Pasteurella haemolytica was cultured, quantitated, killed, and lysed by freeze-thawing. The PMN directional migration toward P haemolytica lysate was not significantly (P less than 0.9) different from spontaneous random PMN migration. Also, there was no chemotactic effect of viable 6-hour cultures of P haemolytica when tested in the in vitro underagarose system. Directional migration (1.70 +/- 0.53 mm) of PMN to zymosan-activated pooled bovine serum was observed and determined to be significantly (P less than 0.001) greater than was spontaneous random PMN migration (0.84 +/- 0.21 mm).

The effect of alpha-difluoromethylornithine on the development of bleomycin-induced pulmonary fibrosis in hamsters

The development of bleomycin-induced lung fibrosis was studied in hamsters drinking tap water or 2% alpha-difluoromethylornithine (DFMO) dissolved in tap water for 14 days. The fibrotic lesions in the lung were evaluated by biochemical measurements of total neutral salt soluble (NSS) and insoluble (NSI) collagens and by morphometric histopathologic techniques. Daily ingestion of DFMO failed to offer any protection against bleomycin-induced lung fibrosis; instead, it increased the deposition of total lung NSI collagen to 396% of control, as compared with 145% of control caused by bleomycin treatment alone. Daily intake of DFMO by itself increased the accumulation of total lung NSI collagen to 250% of control, as opposed to a 145% increase caused by bleomycin treatment alone. Histopathologically, the lung lesions in hamsters treated with bleomycin and DFMO were qualitatively similar to those of hamsters treated with bleomycin alone. However, morphometric estimates revealed that of lung lesions were more diffuse and severe in the former than in the latter group.

Chronic bronchiolitis in nonhuman primates after prolonged ozone exposure

Bonnet monkeys (Macaca radiata) were exposed to 0.0, 0.5, or 0.8 ppm ozone for 7, 28, or 90 consecutive days, 8 hours per day. The pulmonary response was evaluated by means of pulmonary function testing, light microscopy, scanning electron microscopy, transmission microscopy, autoradiography, and morphometry. Pulmonary function values obtained before exposure did not statistically differ from values obtained after exposure. A general trend of increased quasistatic compliance of the lung was observed in both groups of exposed monkeys. Morphologic changes were principally characterized as low-grade chronic respiratory bronchiolitis. Major features were intraluminal accumulations of macrophages and hypertrophy and hyperplasia of cuboidal bronchiolar epithelial cells. The intensity of this inflammatory response was determined by counting the number of intraluminal inflammatory cells per millimeter of respiratory bronchiolar surface. The magnitude of inflammation was greatest at the 0.8 ppm ozone concentration at each exposure period; however, the number of inflammatory cells present at 90 days was less than one half that observed at 7 days, in spite of persistent ozone insult. Tritiated thymidine labeling and counts of respiratory bronchiolar epithelium demonstrated up to a 37-fold increase in labeling index at 7 days but only a sevenfold increase at 90 days. Differential cell counts demonstrated an increase in the proportion of cuboidal bronchiolar cells constituting the respiratory bronchiolar epithelium. In control monkeys, 60% of the epithelial cells were cuboidal bronchiolar cells. At 90 days of exposure, more than 90% of the respiratory bronchiolar cells were cuboidal in appearance. The cuboidal bronchiolar cell in control monkeys does not appear secretory, but membrane-bound electron-dense secretory granules are present in this cell type from exposed monkeys. Epithelial hyperplasia (increased number of cells per millimeter of airway length) persisted through 90 days of exposure at a level slightly above that present at 7 days.

Information control for a general ophthalmic practice

An integrated ophthalmic office computer system is now functional at five sites. The system automates clerical functions such as appointment scheduling, billing, and preparation of doctors' schedules and insurance forms. It eliminates the need for filing and storage of records. The medical system records the history and physical examination of the eye, offers a broad differential diagnosis, writes prescriptions for glasses and drugs, types referral letters, orders contact lenses from specifications, and catalogues photographic and other patient data vital to the medical record. The accounting system prepares complex accounting records and general ledgers for the combined practice and the individual physician.

Pulmonary effects of prolonged ozone insult in rats. Morphometric evaluation of the central acinus

Groups of Sprague-Dawley rats were exposed to 0.2, 0.5, or 0.8 p.p.m. of ozone 8 hours a day for 20, 50, or 90 consecutive days to evaluate the prolonged effect of oxidant exposure on the centriacinar area of the lung. Morphologic evaluation revealed that epithelial changes and accumulations of macrophages in centriacinar regions at 90 days were similar to but less severe than lesions seen at 7 days. Quantification of inflammatory cells in centriacinar regions using scanning electron microscopy revealed a 5-fold increase above controls after exposure to 0.8 p.p.m. of ozone for 20 days. Both the 0.5- and 0.8 p.p.m. exposure groups had significantly (p< 0.05) increased numbers of inflammatory cells within proximal alveoli at all time periods. Morphometric analysis applied to transmission electron microscope micrographs demonstrated that the arithmetic mean thickness of the air-blood barrier was 1.20 /+- 0.13 micrometer. (mean /+ standard deviation) in controls; 2.92 /+- 0.92 micrometer. and 2.17 /+ 0.18 micrometer. in rats exposed to 0.8 p.p.m. of ozone for 20 or 90 days, respectively. The increased thickness was accompanied by an increase in the relative volume of the interstitium. These results indicate that centriacinar lesions induced by ozone diminish with continued exposure, but that significant morphologic alterations do persist through 90 days of exposure at the 0.5 and 0.8 p.p.m. levels but not at the 0.2 p.p.m. ozone level.

Characteristics and effect of antiinflammatory drugs on adriamycin-induced inflammation in the mouse paw

A subplantar injection of 5--100 micrograms adriamycin in the mouse hind paw produced a biphasic inflammatory response. The first phase peaked at 2 h while the second, more severe phase peaked at four to five days. The magnitude of inflammation was dose related. Administration of [EH]adriamycin revealed that 78% of the drug was lost from the paw within one day. The loss of the remaining drug followed a biphasic decay curve. The first-phase half-life was 1.2 days, and the second-phase half-life was 16.0 days. Vascular permeability, as measured by the leakage of intravenously administered [125I]albumin, was increased between day 4 and day 8. Pathologically, the paw had mild edema and hemorrhage by 4 h after adriamycin injection. The most severe pathological response was seen at 5 days with diffuse inflammation characterized by edema of the dermis, cellular debris, and mononuclear inflammatory cells. By 10 days the inflammatory response was still present but the edema was milder. The antihistamine diphenhydramine, an H1-blocker, inhibited the first phase of inflammation at the highest dose tested but had no effect on the second phase of inflammation. The antihistamine metiamide, an H2-blocker; the antiserotonin drug, p-chlorophenylalanine; and the antiinflammatory drugs, aspirin, hydrocortisone, and ibuprofen failed to antagonize adriamycin-induced inflammation at 2 h or 5 days after adriamycin injection. Indomethacin reduced the inflammation after 5 days but only at toxic dose levels.

A working in-house computer system for a general ophthalmology practice

The authors describe their computer system, which was designed to support all of the information needs of their office and utilize the capabilities of the computer in every aspect of the practice. The system is now intricately involved in both clerical and medical activities. Problems of implementation were alleviated by the participation of the physicians and staff in designing the portions of the system with which they would be working; thus, the system is tailored to fit the needs of each individual.

Acute respiratory bronchiolitis: an ultrastructural and autoradiographic study of epithelial cell injury and renewal in rhesus monkeys exposed to ozone

The pathogenesis of acute respiratory bronchiolitis was examined in rhesus monkeys exposed to 0.8 ppm ozone fpr 4--50 hours. Epithelial injury and renewal was qualitatively and quantitatively characterized by correlated techniques of scanning and transmission electron microscopy as well as by light-microscopic autoradiography following labeling with tritiated thymidine. Extensive degeneration and necrosis of Type 1 epithelial cells occurred on the respiratory bronchiolar wall during the initial 4--12 hours of exposure. Increased numbers of labeled epithelial cells were present in this region after 18 hours of exposure, and the highest labeling index (18% was measured after 50 hours of exposure. Most (67--80%) of the labeled cells and all the mitotic epithelial cells (22) observed ultrastructurally were cuboidal bronchiolar epithelial cells. Of the labeled epithelial cells, 20--33% were Type 2 epithelial cells. After 50 hours of exposure the respiratory bronchiolar epithelium was hyperplastic. The predominant inflammatory cell in respiratory bronchiolar exudate was the alveolar macrophage. Monkeys that were exposed for 50 hours and allowed to recover in unozonized air for 7 days had incomplete resolution of respiratory bronchiolar epithelial hyperplasia. The results indicate that Type 1 epithelial cells lining respiratory bronchioles are the cell type most sensitive to injury and that both cuboidal bronchiolar epithelial cells and Type 2 epithelial cells function as stem cells in epithelial renewal.

Argon laser iridotomy in primary angle-closure or pupillary block glaucoma

This paper describes the use of a pulsed argon laser to perform iridotomies in 87 patients. Diagnosis include: primary angle closure glaucoma, narrow angle in the fellow eye of patients with primary angle glaucoma, pupillary block, and after incomplete surgical iridectomies. Laser iridotomy was achieved in 79% of patients. Blue eyes were slightly more difficult to penetrate. Success was almost 100% in those with pupillary block. Penetration was most difficult in patients with primary angle closure glaucoma (64%), but more easily accomplished in the fellow eyes of such cases (87%). In 13 patients surgical peripheral iridectomy was performed on one eye while the other eye was treated with laser iridotomy. No apparent significant long term differences were noted between the two eyes of the same individual. Complications of laser iridotomy include corneal burns, pupil distortion, synechia formation, lenticular opacities, iritis, marked pigment dispersion, sudden rise in intraocular pressure, and retinal burns. At this time a longer follow-up is required before it can be stated that a laser PI is more advantageous than a surgical PI. However, the laser's simplicity and ease of administration appear to warrant its continued use at this time.