[Measurement of the obstetrical pelvis by tomodensitometry (110 cases)]

We had studied in one year 110 cases of scano-pelvimetry, the clinical examination had not found a shrink pound in 41%, revealed by the sceno-pelvimetry. This method is more precisely than the classic pelvimetry, but more expansive. The simultaneous study of echography and pelvimetry had contributed to a better obstetrical decision.

Clinico-immunogenetic study on Egyptian multicase tuberculous families

Thirteen multicase Egyptian families (having more than one sib affected) with pulmonary tuberculosis have been studied. They include 26 parents (4 were tuberculous) and 53 sibs (30 tuberculous and 23 healthy). For all of them the following have been carried out: (a) Clinical, radiological, and bacteriological examination for diagnosis and evaluation of the disease severity; HLA-antigen determination using 9(A), 16(B) and 6(DR) antigens. The analysis of data revealed: (1) high incidence of tuberculosis among sibs in families having A2 B5 in their haplotypes compared to those having A2 X or B5 X--affected sibs with A2 B5 showed more severe manifestations than those having only one of the two antigens; (2) aggregation of HLA concordance among the sib pairs, both fully identical and haploidentical, while none of the sib pairs is non-identical; (3) Lod score studies showed linkage between the genetic control of susceptibility to pulmonary tuberculosis and HLA; (4) identity by descent study confirms the dominant pattern of transmission. The recommendation is that in a clinical setting of genetic counselling healthy individuals having either A2 or B5 antigens in their haplotypes should be vaccinated with BCG. Furthermore tuberculous patients having these HLA antigens should be managed aggressively, especially those having A2 B5 haplotypes in whom the disease is likely to run a severe course.

A reason for the cytolytic inefficiency of murine serum

Murine serum exhibits very poor haemolytic and bactericidal activity. We report that this is due, at least in part, to the presence of a potent, naturally occurring plasma inhibitor of the terminal complement sequence. The inhibitor is a heat-stable euglobulin. It is highly effective in suppressing haemolysis following complement activation on target erythrocytes with heterologous serum. It also inhibits C3-independent reactive haemolysis of guinea-pig erythrocytes with human C5b-9. Current evidence indicates that the inhibitory factor acts at the C5b-7 stage by preventing binding of the terminal complement complex to cells undergoing complement attack. In this respect, the inhibitor differs from the previously recognized regulators of the terminal complement sequence including plasma S-protein. The inhibitor does not protect C5b-7-laden cells from the action of C8 and C9, and also does not suppress formation of haemolytically inactive SC5b-9 in the fluid phase. The action of murine inhibitory factor is not confined to the red cell, and its presence can totally abolish the bactericidal activity of human serum on a sensitive, rough E. coli K12 strain.

A natural auto-inhibitory factor of the terminal complement pathway in serum of Ctenodactylus gondi

The serum of Ctenodactylus gondi, a Tunisian rodent, contains a unique inhibitor of the terminal complement pathway. The auto-inhibitor has been partially characterized as a heat-stable euglobulin that is slightly retarded on a DEAE-ion exchange column at pH 7 and elutes as a symmetrical peak on Sephacryl S-300 in the mol. wt region of approximately 200,000. The inhibitor acts by preventing attachment of cytolytic C5b-9 complexes to natural target cells. It does not appear to affect formation and function of C3-convertase, does not exert inhibitory effects at stages later than C5b-7 formation, and also does not prevent formation of SC5b-9 in serum. That the factor prevents attachment of C5b-7/C5b-9 to cells has been demonstrated in hemolysis model systems using sheep EA + human serum, and in the C3-independent reactive lysis system with the use of ELISA methods and quantitative assays with radioiodinated C8. Addition of partially purified inhibitory factor to human sera or to sera of other animal species abolishes the hemolytic activities of these sera. The inhibitory factor of Gondi serum is the first inhibitor of the terminal pathway which has been shown to be capable of preventing cytolysis of cells undergoing complement attack under physiological conditions. The presence of this factor is probably partially responsible for the remarkable susceptibility of C. gondi towards bacterial and parasitic infections.

Chordoma in the sella turcica

A chordoma is a slow-growing malignant tumour with a metastatic potential developing from notochord remnants. The incidence is about 1 % of all malignant bone tumours with a male to female ration of 1 : 1. Most patients are in their fifth to seventh decades but patients presenting with skull or vertebral tumours are younger. Chordomas have a protracted course and symptoms are usually present for more than 1 year. The symptoms related to the size and location of the tumour are varied: headache, increased intracranial pressure or cranial nerve involvement for sphenooccipital tumor, pain and neurologic symptoms for vertebral tumours and pain, mass, neurologic symptoms or rectal and bladder dysfunction for sacral and sacrococcygeal tumours. Intracranial chordomas have been described associated with Maffucci's syndrome, hemangiopericytomas, neurofibromatosis or tuberous sclerosis or presenting as a second primary malignant lesion [2].DOI: 10.3329/pulse.v3i1.6554Pulse Vol.3(1) July 2009 p33-34

Strongyloidiasis in the gastrointestinal biopsy

Strongyloides stercoralis is an intestinal nematode of humans. It is estimated that tens of millions of persons are infected worldwide, although no precise estimate is available [1].S. stercoralis is distinguished by its ability-unusual among helminths-to replicate in the human host. This capacity permits ongoing cycles of autoinfection as infective larvae are internally produced. Strongyloides can thus persist for decades without further exposure of the host to exogenous infective larvae [2]. Most infected individuals are asymptomatic, but under some conditions associated with immunocompromise, this autoinfective cycle can become amplified into a potentially fatal hyperinfection syndrome and disseminated infection [3]. Diagnosis of Strongyloides stercoralis is usually made by stool examination. Detection and diagnosis of strongyloidiasis in the gastrointestinal biopsy is relatively rare [4].DOI: 10.3329/pulse.v3i1.6551Pulse Vol.3(1) July 2009 p27-28