Laboratory transmission of lymphatic filariasis by vector mosquitoes

Aedes togoi and Ae. aegypti were used to examine the transmission potential of Brugia pahangi to one of its natural hosts, the domestic cat. Although a larger proportion of microfilariae taken in by Ae. togoi developed into infective larvae, the total number of B. pahangi larvae recovered from a cat exposed to Ae. aegypti was larger than from a cat exposed to Ae. togoi. Factors influencing the transmission dynamics included: development of microfilariae to infective larvae; survival of mosquitoes; willingness to take repeated blood meals; and proportion of infective larvae that egress from mosquitoes during the feeding process. From 19 to 25% of infective larvae were transferred to a susceptible host. The feasibility of using a Brugia-cat model to do comparative vector efficiency studies was demonstrated.

An unusual ganglion communicating with hip joint resembling a femoral hernia. Case report

A rare case of a ganglion communicating with the hip joint was encountered in a 72-year-old man who presented a reducible soft mass over the left femoral triangle. This mass, clinically considered to be a femoral hernia, proved to be a ganglion after excision. We report the clinical course of this case with the suggestion that caution should be given to the patient's subtle symptoms while herniography may be helpful for differential diagnosis of this rare condition.

Cavernous hemangioma of the retina and agenesis of internal carotid artery with bilateral oculomotor palsies

Cavernous hemangioma of the retina is an unusual vascular hamartoma. It is recognized as a neuro-oculo-cutaneous syndrome. Association with systemic abnormalities is extremely rare. This report describes an 18-year-old man who presented with retinal cavernous hemangioma of the left eye and bilateral oculomotor palsies since early childhood. Cerebral angiography showed agenesis of the right internal carotid artery. Because of this unusual combination, we feel justified to report this case.

Experimental infection of subperiodic Brugia malayi in laboratory rats with emphasis on evaluation by four techniques

Infective larvae of subperiodic B. malayi from South Kalimantan (Borneo), Indonesia collected from laboratory-raised Ae. togoi mosquitoes after feeding on infected mongolian gerbils (Meriones unguiculatus) were inoculated subcutaneously into the groin areas of 15 SD and 36 LE rats. Blood was examined weekly by membrane filtration and thick smears starting 10 weeks post-infection. Microfilariae were found in 3 SD and 4 LE rats, the mf infection rate of 20% and 11% respectively. The prepatent period was significantly shorter in the SD rats (99-112 days) than those in the LE rats (110-153 days). The patent period was longer in the LE rats (208-703 days) than in the SD rats (236-543 days), and the mf density was similar (17.5 mf/20 c.mm blood against 16 mf/20 c.mm blood). At necropsy, 6 (3 female and 3 male) adult worms were recovered from 3 of 6 SD rats and 12 (9 female and 3 male) adult worms from 4 of 20 LE rats; all worms were found in the testes. The results of xenodiagnostic, histochemical staining and measuring spicules and protuberances, demonstrated clearly the difference between both species of Brugia. All dissected Ar. subalbatus mosquitoes exposed to B. pahangi became infected (100%), but none of those to subperiodic B. malayi were infected (0%). The mf of both species of Brugia in thick films stained with naphthol-AS-TR-phosphate showed that the excretory and anal pores of subperiodic B. malayi mf exhibited acid phosphatase activity and only a little activity was seen in other parts; while B. pahangi mf showed heavy diffuse acid phosphatase activity along the entire length of the body.(ABSTRACT TRUNCATED AT 250 WORDS)

Isolation of the Lyme disease spirochete from mammals in Minnesota

Lyme disease spirochetes were isolated from the kidneys of two Peromyscus spp. trapped in Minnesota in September and October 1983. No spirochetes were isolated from white-tailed deer (Odocoileus virginianus), red backed voles (Clethrionomys gapperi), or shrews (Sorexy cinereus and Blarina brevicauda). This is the first report of the isolation of the Lyme disease spirochete from the midwestern United States and isolations from these animals, which were free of ticks, suggest that the Lyme disease spirochete may persist in animal organs for months.

Chronic subdural haematoma in the CT scan era

One hundred and fifty patients with chronic subdural haematoma were studied with respect to clinical features, investigation and outcome. Those patients aged 65 years and over did not differ significantly in either outcome or clinical features from the rest. The outcome in this series of patients, managed after CT scanning became the standard method of investigation, was no better than in previous studies. The only factor which did influence outcome was the level of responsiveness on admission. The overall mortality in this study was 6 per cent. CT scanning does not therefore result in improved results in patients with chronic subdural haematoma; this may rather depend upon better selection of patients for CT scanning.

Bronchopulmonary sequestration associated with aspergilloma, with special reference to the finding of radionuclide venoangiography

A case of intralobar bronchopulmonary sequestration associated with aspergilloma was reported. It was suggested by radionuclide venoangiography and aortic cineangiography. The diagnosis was confirmed by subsequent pathologic examination of the lobectomized lung tissue. The pulmonary perfusion scan with 99mTc-MAA showed a perfusion defect in the right lower lung field. Perfusion defect could also be traced in the same anatomical location in the pulmonary phase of radionuclide venoangiography with 99mTc-pertechnetate. However, the area of perfusion defect was visualized as hot area, when the injected radionuclide was pumped into the aorta after its first pass through the lung. The radionuclide venoangiography can efficiently detect abnormal systemic blood supply of the lung tissue. It can be an useful method for suggestive diagnosis of bronchopulmonary sequestration.

Gonadal dose measurement in diagnostic nuclear medicine using thermoluminescent dosimeters

Instead of using the Medical Internal Radiation Dose Committee (MIRD) concept to calculate the gonadal dose during diagnostic examination using radiopharmaceuticals, measurements of gonadal doses using thermoluminescent dosimeters were studied. The results obtained are comparable with that calculated using the MIRD concept. Five frequently used examinations were investigated, viz., liver, brain, thyroid, bone scintigraphy and cholescintigraphy. The calibration of thermoluminescent dosimeters are fully described, and the experimental techniques are also fully presented.

Effect of aging on common bile duct diameter: a real-time ultrasonographic study

Using a high-resolution real-time scanner, a technique has been established in our laboratory for visualizing the entire extrahepatic bile duct with multiple longitudinal oblique approaches and, if necessary, several transverse scans through the pancreatic head. To determine the normal size of the extrahepatic bile duct and to evaluate the effect of aging on the duct diameter, 256 healthy subjects and patients without hepatobiliary disease were examined using this technique from January to August, 1982. The entire extrahepatic duct was detected in 203. The inner diameter of the widest point of the duct varied from 1 mm to 10 mm, and was found to be age-dependent (r = 0.60, P less than 0.001). It is concluded that, based on the visualization of the entire extrahepatic duct echographically, the normal inner diameter of common bile duct can be up to 10 mm, and there is a mild change of duct size with age.

[Preliminary report on the susceptibility of mosquitoes to Brugia pahangi]

A comparative study on the susceptibility of eight species of four genera of mosquitoes to Brugia pahangi was carried out. Aedes aegypti (Liverpool strain), Aedes togoi, Armigeres subalbatus and Mansonia uniformis (Taiwan strains) were found with the third-stage larvae 14 days after feeding on infected rats (Sprague-Dawley). The remaining of Aedes aegypti, Aedes albopictus, Aedes pseudoalbopictus, Culex p. fatigans and Culex annutus (Taiwan strains) were found refractory to infection. To determine the infectivity of the four susceptible species, the mosquitoes were fed on the same rat (mf. density 70/20 cmm blood). They were dissected and examined 14 days later. Significantly higher numbers of infective-stage larvae per infected mosquito were found in Armigeres subalbatus (42.6), Aedes togoi (8.8), Aedes aegypti (Liverpool strain) (7.6) and Mansonia uniformis (3.3).

[Skin tests in asthmatic patients in Taiwan]

During the 22-year period from February, 1961 to December, 1982, 3550 asthmatic patients who visited the Taipei Municipal Chung-shing Hospital were skin tested with 35 allergens. The following results were obtained: The patients showed high skin reactivity to only inhaled allergens with positive rates in the order of 90.2% for house dust, 79.9% for candida, 73.0% for alternaria, 71.7% for aspergillus, 65.5% for cladosporium, 58.4% for tatami, 54.5% for penicillum and 52.3% for ragweed. While the sex had no influence on the incidence of skin test positivity, the positive rate peaked at around 20 to 30 years of age and decreased gradually thereafter. There was a significant correlation between PK titer and antigen threshold (r = +0.68). Although the healthy controls also showed positive skin reaction to house dust, none of them had an antigen threshold of higher than 16 (i.e. 16,000 X final dilution). Therefore an antigen threshold of 16 was suggested to be used as the cut point for the diagnosis of house dust allergen.

Diagnosis of obstructive jaundice in infants: Tc-99m DISIDA in duodenal juice

Technetium-99m di-isopropylphenylcarbamoylmethylimidodiacetic acid cholescintigraphy, together with measurements of radioactivity in duodenal juice, was used to evaluate 23 infants with prolonged obstructive jaundice. Four patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was distinct differentiation of biliary atresia from neonatal hepatitis when the time-activity curves were analyzed. In neonatal hepatitis the radioactivity in duodenal juice is obviously higher, peaking above 1500 cpm/100 microliter per mCi dose. In biliary atresia the pattern is flattened, with maximal activity below 500 cpm/100 microliter per mCi dose.

Interaction of nitroglycerin with human blood components

Nitroglycerin is rapidly lost from solution when incubated with red blood cells or whole blood. The assumption that the loss is enzymatic in nature may not be true, since no major metabolite is detected during this incubation. Explanation on the basis of a chemical reaction is also difficult, since the products of the chemical hydrolysis of nitroglycerin are the same as the metabolic products. After an initial rapid loss, nitroglycerin disappearance at 37 degrees follows an apparent first-order process in the concentration range of 10--480 ng/ml when incubated with washed red blood cells suspended in normal saline solution. The half-life for the reaction of the apparent first-order phase varies with the initial concentration and increases as the concentration increases (4 min at 10 ng/ml, 52 min at 480 ng/ml), suggesting a mixed kinetic mechanism. Metabolites of nitroglycerin (1,2- and 1,3-dinitroglycerin) react similarly to nitroglycerin in terms of an apparent initial, fast step, a secondary first-order dependence, and concentration-dependent rate effects; however, the rate of the reaction is much slower (t 1/2 = 33 min at 10 ng/ml) for the metabolite. These data suggest the possibility of a physical mechanism for the loss of nitroglycerin. Since the loss to red blood cells can be rapid, it seems that the mechanism should be delineated, and that the rate of disappearance be considered in an analysis of the pharmacodynamics of the drug.

Further studies on the susceptibility of new Taiwan foci of Oncomelania hupensis to geographic strains of Schistosoma japonicum

Two known colonies of O.h chiui in Alilao and of O.h. formosana in Changhua and four new foci of snails in Nantou, Chiayi, Hualien and Taitung on Taiwan were exposed each to 5 miracidia of Changhua Zoophilic strain and Chinese, Philippine and Indonesian anthropopilic or human strains of S. Japonicum. The results showed that all four new foci demonstrated various degrees of susceptibility to this parasite. Infectivity of Chinese strain of S. japonicum in 4 new foci of snails is reported for the first time. Changhua race of O. hupensis was also found slightly susceptible to Chinese strain of the parasite. The average infection rate to both zoophilic and human strains of S. japonicum was 39.0%, 14.5%, 10.8% and 9.8% for Taitung, Chiayi, Hualien and Nantou snails respectively. Susceptible snails now been found in 7 counties and if by chance human pathogenic strains of the parasite were accidentally introduced into Taiwan, a public health problem could possibly develop.

Nitroglycerin stability: effects on bioavailability, assay and biological distribution

The solution, absorptive, and adsorptive properties of nitroglycerin are related to problems encountered in the intravenous use of solutions of the drug and in its assay in biological tissues. Solutions of the drug in usual intravenous fluids are quite stable to hydrolysis under neutral conditions. Loss to plastic intravenous delivery set components by rapid adsorption and slower absorption processes present a significant clinical problem. Assay of the drug and its major metabolites is complicated by problems of extraction related to the solubility of nitroglycerin, its metabolites and substances in the plasma. Loss of nitroglycerin incubated with red blood cells is a very rapid process (half-life 4.0 min. at 10 ng/ml). The mechanism appears to be a physical process rather than an enzymatic one. The loss to blood cells and perhaps other biological materials should be considered in an analysis of the distribution of the drug.

[A case report of variant form of multiple myeloma]

Multiple myeloma is usually manifested with multiple destructive bone lesion, plasmacytosis and monoclonal protein. Here in we report a case of IgA (lambda) multiple myeloma with hepatomegaly and anemia but without bone lesions. Differential diagnostic points among lymphoma, amyloidosis, cancer and heavy chain disease are discussed.