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Introduction: We re-examined the per-region response amplitudes and delays obtained from multifocal pupillographic objective perimetry (mfPOP) after 10 years in 44 persons living with multiple sclerosis (PwMS), both to examine which parts of the visual field had progressed in terms of response properties and to examine if the baseline data could predict the overall progression of disease. Methods: Expanded Disability Status Scale (EDSS) scores were assessed in 2009 and 2019. Both eyes of each participant were concurrently tested at 44 locations/eye on both occasions. Several measures of clinical progression were examined, using logistic regression to determine the odds of progression. Results: At the second examination the 44 PwMS (31 females) were aged 61.0 ± 12.2 y. Mean EDSS had not changed significantly (3.69 ± 1.23 in 2009, 3.81 ± 2.00 in 2019). mfPOP delay increased progressively from inferior to superior regions of the visual fields while amplitudes demonstrated a temporal to nasal gradient. The mean of the 3 most delayed visual field regions was correlated with progression of MS by 2019 (p = 0.023). Logistic regression indicated a significant association between delay and odds of progression (p = 0.045): an individual with 3 regions at least 1 SD (40 ms) slower than the mean in 2009 had 2.05× (±SE: 1.43× to 2.95×) the odds of progression by 2019. A 1 SD shorter delay was associated with 2.05× lower odds of progression. Amplitude changes were not predictive of progression. Significance: mfPOP may provide a rapid, convenient method of monitoring and predicting MS progression.

The mechanism of bitemporal hemianopia arising as a result of chiasmal compression is unknown. In this study, we combined an ex vivo experiment and finite element modelling (FEM) to investigate its potential mechanism. A cadaveric human optic chiasm was scanned using micro-CT before and after deformation by inflation of Foley catheter, to simulate tumour growth from beneath. The geometry of the same chiasm was reconstructed and simulated using finite element analysis. Chiasmal deformations were extracted from the simulation and compared with those observed during micro-CT scanning. In addition, nerve fibre models examining variation in local fibre distribution patterns of the chiasm were incorporated to investigate the strain (deformation) distributions of the chiasm at an axonal level. The FEM model matched the micro-CT scans well both qualitatively and quantitatively. Compression of the chiasm induced high strains in the paracentral portions of the chiasm where the crossing optic nerve fibres are located. At an axonal level, the magnitude of strains affecting crossed fibres were greater than those affecting uncrossed fibres. The high strains in the paracentral portions of the chiasm, combined with the differences in strain between crossed and uncrossed nerve fibres, are consistent with a biomechanical explanation for the pattern of visual field loss seen in chiasmal compression.

A toxemia-like syndrome was induced in pregnant beagles by intraperitoneal inoculation of concentrates prepared from placentas of patients with preeclampsia-eclampsia and hydatidiform mole, which contained an agent, Hydatoxi lualba, that stained in a unique fashion with toluidine blue-O-. The pregnant dogs inoculated with either of these concentrates progressively developed hypertension, eyeground changes consistent with hypertensive retinopathy, proteinuria, disseminated intravascular coagulation, and hepatic dysfunction in addition to intrauterine growth retardation and intrauterine fetal death. Hepatic periportal hemorrhage and glomeruloendotheliosis, lesions usually seen in preeclampsia-eclampsia, were also noted to occur in pregnant beagles inoculated with these concentrates. A significant increased sensitivity to angiotensin II infusion was also noted. The toxemia-like syndrome did not develop in pregnant beagles when inoculated in a similar fashion with concentrates prepared from placentas from normal term pregnancies which were free of Hydatoxi lualba or in nonpregnant beagles inoculated with concentrates containing Hydatoxi lualba. Although the agent was not injected in pure form, the inoculation of concentrates containing Hydatoxi lualba appears to be required for the manifestation of the toxemia-like syndrome.

The development of a technique allowing prolonged culture in vitro of normal term human trophoblast facilitates examining what effects, if any, drugs commonly used in pregnancy may have on placental tissue. Dosages compatible with therapeutic blood levels of magnesium sulphate, methyldopa, hydralazine and phenobarbitone were tested individually in vitro on monolayer cultures of normal term trophoblast. Hydralazine and magnesium sulphate additions resulted in a 100 per cent loss of viability of trophoblast cells. Phenobarbitone caused an 8 per cent decrease in cell viability, while methyldopa caused only a 2 per cent decrease in cell viability.

Time-lapse photographic observations of normal human trophoblast in vitro were made possible through the development of a new technique that allows for prolonged trophoblast culturing without stromal growth. Y body fluorescence and determinations of human placental lactogen (hPL) were used to confirm the specificity and viability of the cells in culture. Epithelioid cells (cytotrophoblast) with agranular cytoplasm, binucleated moderately granulated cells, and multinucleated heavily granulated syncytial masses were observed. The cytotrophoblast was observed in mitosis, whereas the syncytium showed strand formation and reabsorption, along with mass movement of cells at time of confluency. This technique should stimulate a renewed interest in the in vitro studies of normal human trophoblast.

Two hundred one patients with high-risk pregnancy and 66 patients with term uncomplicated pregnancy underwent a nonstress test 7 days or less prior to delivery. The incidence of spontaneous fetal heart rate decelerations in the high-risk group was 5.5%. None of the fetuses in the normal group showed this finding. Among those infants presenting with spontaneous decelerations, there was an 18.2% mortality. Disturbances of intrauterine growth were found in 63.6% of cases. The possible metabolic mechanisms and clinical implications underlying this finding are discussed.

This is an initial descriptive report of observations of multiple forms of an organism found in patients with gestational trophoblastic disease and in patients with preeclampsia-eclampsia. The worm-like forms most frequently observed have an average length of 1.0 to 1.5 mm. Larva-like forms have an average length of 150 mu; primordial eggs and egg-like forms in developmental stages range from 7 to 43 mu in diameter; and sperm-like forms are 3.5 mu or slightly smaller in size. These forms have been observed in contact smears prepared from 3 ml samples of peripheral circulating blood from both groups of patients, from trophoblastic tumor tissue, from contact smears prepared from placentas of patients with preeclampsia-eclampsia, and from umbilical cord blood of infants delivered of patients with preeclampsia-eclampsia. The various forms of this organism share morphologic characteristics of several orders of helminths, i.e., hookworms, roundworms and tapeworms. The taxonomy of these forms has not yet been determined. Until the time of taxonomic classification, the various forms will be referred to as Hydatoxi lualba. We have experimental evidence that this organism has biologic activity in BALB/c mice and in beagle dogs.