ELISA for diagnosis of tuberculosis

Antigen A 60 of Mycobacterium bovis is a cell wall antigen with almost complete cross reactivity with antigen A 60 of Mycobacterium tuberculosis. This antigen was used for the ELISA technique for 100 cases suspected of childhood tuberculosis to evaluate the usefulness of the method in the diagnosis. The positivity rate in pulmonary tuberculosis was 65.1%, in central nervous system tuberculosis 50.0% and in the miscellaneous group 76.4%. The overall positivity was 61.0%, proving the utility of the method for diagnosis.

Production and properties of crude enterotoxin of Pseudomonas aeruginosa

Pseudomonas aeruginosa CTM-3 was found to be the most potentially enterotoxigenic strain out of the 12 isolates recovered from milk, as a high fluid length ratio, i.e. F/L (1.1) in rabbit gut and a strong permeability response in rabbit skin (38.5 mm2 necrotic zone) was obtained with this culture. No clear-cut relationship between the two tests was observed. Six of the ethidium bromide (300 micrograms/ml) cured variants of this culture completely lost their ability to produce enterotoxin indicating the possible involvement of a plasmid in enterotoxin synthesis. The crude enterotoxin from P. aeruginosa CTM-3 was completely inactivated in 15 s at 72 degrees C. However, it was fairly stable at pH values in the range 4.5-7.5. Both pepsin and trypsin inactivated the enterotoxin activity at a concentration of 40 micrograms/ml. Organic acids, formalin and hydrogen peroxide had no significant effect on the enterotoxin activity. The need for further investigations with purified preparations is emphasized.

Alpha-fetoprotein in germ cell tumors. An immunohistochemical study

Total 40 cases of testicular and ovarian germ cell tumors and one case of extragonadal germ cell tumor were studied for the presence of alphafetoprotein (AFP) by indirect immunoperoxidase technique. All seminomas (7 cases) and teratomas (13 cases) were negative for AFP; while 85% of the pure embryonal carcinomas, (E.C.) all pure yolk sac tumors (Y.S.T.) (7 cases) and all embryonal carcinoma and yolk sac components in mixed tumors were AFP positive. Immunostaining of tumor marker appeared to help only in differentiating seminomatous and nonseminomatous tumors and hence does not provide any additional information for classification of these tumors.

Extraosseous giant cell tumour of lung

A rare case of Extraosseous Osteoclastoma like giant cell tumour of the lung is presented.

Variation in the behaviour of enterotoxigenic Staphylococcus aureus after heat stress in milk

The survival of several strains of Staphylococcus aureus after heat stress in different menstrua was not logarithmic and F-values were determined to express their resistance to heat. Of the strains tested, Staph. aureus 234 (enterotoxin B) was the most heat resistant and Staph. aureus 790 (enterotoxin E) was the most heat sensitive. Buffalo milk gave the best protection to all the strains of Staph. aureus against heat, followed by cow's milk; phosphate-buffered saline gave the least protection. Soyabean casein digest agar gave maximum recovery of survivors followed by brain heart infusion and Baird-Parker medium. At 50 degrees C there was no marked variation in coagulase production by the surviving strains but at 55 and 62.5 degrees C there was complete loss of coagulase activity. There was a decreased deoxyribonuclease (DNase) production by all the strains of Staph. aureus after heat stress. Heat-treatment at 55 and 62.5 degrees C resulted in loss of enterotoxin production by all the survivors except S6 and 234, the surviving cells of which still produced enterotoxin B after heat treatment at 55 degrees C. Most of the survivors regained lost characteristics such as coagulase, DNase and enterotoxin production after four to five passages through BHI which suggests that subculture of Staph. aureus recovered from heat-processed milk is necessary to avoid false results.

Viral hepatitis and pregnancy in Kuwait

The frequency and severity of viral hepatitis among pregnant and non-pregnant women in Kuwait was studied from 1980 to 1984. 542 female hepatitis patients were investigated, of whom 52 (9.6%) were pregnant. 35 of the 52 (67.3%) cases of viral hepatitis in pregnancy were due to hepatitis B virus while 11 of 52 (21.2%) and 6 of 52 (11.5%) had acute hepatitis non-A, non-B (NANB) and hepatitis A virus infections, respectively. The frequency and severity of viral hepatitis among the pregnant women was similar to that among non-pregnant women. Hepatitis did not have a deleterious effect on pregnancy and no death was recorded. Fulminant acute NANB hepatitis was seen in only one patient, who recovered completely.

Amyloid goiter--a case report

A rare case of Amyloid Goiter in association with leprosy is reported.

Role of scrape cytology in rapid intraoperative diagnosis. Value and limitations

The diagnostic applications of frozen sections and imprint cytology are well known. A study was conducted to evaluate the role of scrape cytology, which is a modification of imprint cytology, in the rapid intraoperative diagnosis of tumors. For 249 surgical specimens studied by scrape cytology, the diagnostic accuracy was 98.4% and the false-positive rate was 0.4%. The method is rapid, easy, reliable and does not require special instruments or set ups. The diagnostic accuracy was better than reported for imprint cytology or frozen sections alone. Scrape cytology is advocated as a routine intraoperative procedure, especially where frozen section facilities are not available. While not meant as an alternative to frozen sections, scrape cytology can be an excellent adjunct to that technique.

The appearance of the pyramidal lobe on thyroid scintigraphy

The standard nuclear medicine textbooks describe the pyramidal lobe of the thyroid as arising from the upper part of the thyroid lobes. Anatomy and surgical texts however describe it as a thyroglossal tract remnant and state that it arises from the isthmus. Review of 150 thyroid scintigrams confirms that on scintigraphy the pyramidal lobe does appear to originate from the upper pole. We have used single photon emission tomography to demonstrate the true origin of the pyramidal lobe by removing overlying thyroid tissue. We suggest that the pyramidal lobe arises from the isthmus and the appearances on scintigraphy are due to the lower part of the lobe being obscured behind the main thyroid lobe.

Improving appointment-keeping by patients new to a hospital medical clinic with telephone or mailed reminders

A randomized trial of telephone and mailed reminders was conducted to assess their effect in reducing the rate of failure to keep appointments among patients new to a general medical clinic. Only 10% of the patients who received a telephone call and 12% of those who received a letter failed to keep their appointments compared with 20% of the control group (p less than 0.05). The most common reason given for failure to keep the appointment was lack of awareness of the appointment. Thus, telephone or mailed reminders can lower the rate of failure to keep appointments and result in greater satisfaction by patients and health care personnel.

Study of lymph node biopsies in lepromatous leprosy patients under treatment

A study of lymph node biopsies from lepromatous leprosy patients undergoing treatment was carried out for one year in 1978-79 in the Department of Pathology, Government Medical College, Nagpur. Total 20 lymph node biopsies were studied, out of them, 12 were accompanied with skin biopsies. Typical lepromatous granulomas and presence of lepra bacilli were observed in 18 out of 20 lymph nodes, although this change was not constantly present in skin biopsies. Five out of twelve skin biopsies were bacteriologically negative. From this study, it is inferred that lymph node biopsies may be more helpful for follow up of patients after treatment.

Renal abnormality in leprosy

Adequate kidney biopsy was studied in 54 cases of leprosy, of which 45 were of lepromatous leprosy, 4 of tuberculoid type and 5 belonged to borderline type of leprosy. Membranous glomerulonephritis (31.5%) was the commonest type of glomerular lesion followed by mesangioproliferative glomerulonephritis (11.1). It is concluded that renal lesions can occur in any type of leprosy. Reaction of renal tissues to M. leprae could be due to various local immunologic or physiological factors.