Upper respiratory infection and sinusitis are the most important predisposing factors for periocular infection. Streptococcus species are the predominant causative agents. Both diseases can usually be successfully treated with intravenous antibiotics, but some patients may require surgery to control extensive infection.

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ABSTRACT. Objective. The activity of lysosomal enzymes is increased in the cerebrospinal fluid of bacterial meningitis, suggesting that inflammation may cause leakage of lysosomal enzymes into the extracellular fluid. Our objective was to study the activity of 3 lysosomal enzymes in cell-free peritoneal fluid of patients with peritoneal inflammation.Methods. The ␤-galactosidase, ␤-glucuronidase, and ␣-mannosidase activity (nmol 4-methylumbelliferone/ mL/h); the total, polymorphonuclear, and mononuclear cell number; and chemical parameters were determined in the peritoneal fluid of 26 patients with culture-positive acute bacterial peritonitis, 13 patients (under antibiotic treatment) with culture-negative bacterial peritonitis, 6 patients with acute mesenteric lymphadenitis, and 26 control subjects who were operated on for surgical conditions without peritoneal inflammation.Results. The median ␤-galactosidase activity in the culture-positive bacterial peritonitis, mesenteric lymphadenitis, and controls was 175 (range: 63-2210), 50 (range: 37-56), and 16 (range: 8 -32), respectively. The ␤-glucuronidase was 488 (range: 79 -998), 53 (range: 27-98), and 15 (range: 3-22), respectively. The ␣-mannosidase was 801 (range: 100-3172), 78 (range: 33-157), and 41 (range: 16 -63), respectively. The differences of the enzyme activities among the groups of the subjects studied were significant, with the exception of the ␣-mannosidase activity between mesenteric lymphadenitis and controls. There was no significant correlation between the enzyme activities and the cytologic or chemical parameters studied.Conclusions. The elevation of the lysosomal enzymes' activity in the peritoneal fluid of patients with bacterial peritonitis seems to be a reliable index of peritoneal infection. Of the enzymes studied, the ␤-glucuronidase and ␤-galactosidase activities provide the best means for diagnosing bacterial inflammation of the peritoneal cavity. T he precursors of the lysosomal enzymes are synthesized on ribosomes, 1 and their subsequent maturation and targeting to the final destination in lysosomes are directed by a sequence of recognition signals localized on the enzymes' molecule. [2][3][4] Approximately 5% to 20% of the mature lysosomal enzymes are secreted into the extracellular fluid before their delivery to lysosomes; subsequently, a portion of these enzymes bind to mannose 6-phosphate receptors on the surface of the cells, are internalized, and are delivered to lysosomes. 5 This secretion-recapture mechanism functions as a salvage pathway. In cultured skin fibroblasts, the salvage pathway accounts for the delivery of 5% to 20% of the total lysosomal enzymes in the lysosomes. 5 Inflammation could affect the final packaging or the secretion-recapture mechanism of the lysosomal enzymes, thus resulting in a leakage of these enzymes into the extracellular fluid. Also, during inflammation, there is an increased rate of phagosome formation; close contact between the plasma membrane and phagosome membrane results in membrane fusion and...

Contrast sensitivity defects are detected in patients with insulin-dependent diabetes mellitus. These defects may represent an early dysfunction of the retina, visual pathway, or both in patients with insulin-dependent diabetes mellitus who do not show any signs of diabetic retinopathy.

Ocular surface disorder of these patients was characterized by goblet cell loss and conjunctival squamous metaplasia. Our findings were correlated positively with the variable age. Epithelial damage by toxic reaction and disorder of tear quality and quantity are implicated as important factors in the pathogenesis of the ocular surface disease in beta-tha patients.