Application of ferrokinetic investigation for differential diagnosis in bone marrow hypoplasia and their clinical relevance

In this study, erythropoietic activity of bone marrow has been evaluated by ferrokinetics. For that purpose, the data of radioiron disappearance from plasma and its ultimate incorporation in red blood cells after the injection of about 10 muCi of 59Fe tagged autologous plasma, were analysed and fitted to the sum of three exponentials, using a non-linear least square SAAM-25 program on UNIVAC-1108 computer. A function representing time-activity relationship, was constructed. The functional physiological model of iron metabolism, proposed by Cavill and Ricketts, was used to calculate various ferrokinetic parameters in terms of coefficients and exponents of the time-activity function. After identifying the parameters that could be used as indices of erythropoietic activity of bone marrow, the study was repeated in six patients after they had undergone myelostimulative therapy. A distinct correlation was found between ferrokinetic observations and clinical and biochemical findings. It has been demonstrated that in histologically diagnosed cases with bone marrow hypoplasia, a further differentiation between pure aplasia and those with hypoplasia together with ineffective erythropoiesis was possible. This discrimination which is clinically very important, is only possible by means of kinetic investigations.

Endophthalmitis after trabeculectomy

Two cases of late endophthalmitis after trabeculectomy surgery are described. Despite intensive antibiotic therapy, the visual end result in both cases was poor. The incidence of endophthalmitis after trabeculectomy, according to this report is similar to that after Scheie's procedure, but less than that after trephination. A possible cause of endophthalmitis is the anterior dissection of the superficial scleral flap into the cornea.

Adriamycin cardiotoxicity: early detection by systolic time interval and possible prevention by coenzyme Q10

Recent work suggests that adriamycin (ADM) cardiotoxicity results from the depletion of coenzyme 10 (CoQ10) activity in myocardial mitochondria. CoQ10 is indispensable in the bioenergetics of coupled respiration of oxidative phosphorylation. It exists naturally in mitochondria, especially in the myocardium. Bertazzoli et al have reported a decrease in ADM-induced cardiotoxicity by CoQ10 both in vivo and in the in vitro isolated rabbit heart. The systolic time interval (ATI) (pre-ejection period/left ventricular ejection time ratio) has been shown to increase (indicating cardiac dysfunction) with increasing doses of ADM. We have noted a gradual increase in the STI in eight of ten patients receiving 200-500 mg/m2 of ADM. Two of these eight patients had congestive heart failure (CHF) at doses of 200 and 350 mg/m2. The continued daily oral administration of 50 mg of CoQ10 beginning with the first dose of ADM resulted in a decreased incidence of cardiac dysfunction, and a gradual increase in STI occurred in only two of eight patients receiving 200-400 mg/m2 of ADM. CHF was observed inone patient at a dose of 350 mg/m2. It is suggested that CoQ10 was nontoxic and did not affect the antitumor activity or modify the ADM-induced bone marrow toxicity. A prospective randomized study comparing ADM with and without CoQ10 is in progress.

Chromosomal abnormalities in protein-calorie malnutrition

Cytogenetic studies were carried out in five children suffering from moderate to severe protein calorie malnutrition and five healthy controls, using direct preparations of bone marrow using conventional techniques. In the control group there were two abnormalities out of 152 plates analyzed, and in the malnutrition group there were 16 out of 186. This difference is statistically significant, P less than 0.005, implying that chromosomal abnormalities are more frequent in protein calorie malnutrition.

Effect of periodic deworming on nutritional status of ascaris-infested preschool children receiving supplementary food

The weight for age of 154 undernourished preschool children in an ascaris-infested community receiving supplementary food was monitored for a year. 74 children were given tetramisole every 4 months, while 80 controls were given placebo. The prevalence of ascaris (roundworm) infection and the severity of protein-energy malnutrition were the same in the two groups at the onset of the study. Stool-positive rates for ascariasis came down significantly in the experimental group during the year, but eradication of the worm was not possible owing to constant re-exposure. Nutritional status remained unaltered in the controls but improved strikingly in the treated children 8 and 12 months after the start of the study. Periodic deworming should form a part of the supplementary feeding programme if malnutrition is associated with ascariasis in the community.

Atrial septal defect due to blunt thoracic trauma

The case report of an atrial septal defect with right-to-left shunting in an adult following blunt chest trauma is presented. To our knowledge a successfully repaired traumatic atrial septal defect has not been previously reported in the English-language literature.

Cyproterone acetate: I. Microquantity releasing device of cyproterone acetate and its failure in inducing functional sterility in male rats

Prasad and his coworkers emphasized that microquantities of cyproterone acetate (CPA) when continuously available developed functional sterility in male rats by interfering the epididymal physiology. In our experimental rats either 2 or 3 capsules containing CPA as per the specification of Prasad were implanted subcutaneously and left for 300 and 250 days, respectively. Fertility test was made every month and it was observed that all the experimental animals were able to impregnate female rats throughout the experiment. Excepting the epididymis the weight of testes and other accessory glands did not differ from the controls in the animals which had 2 CPA capsules for 300 days; On the other hand, the animals which received 3 CPA capsules for 250 days showed significant reduction in weight of all the acessory glands including the testes.

Platelet function in leprosy

In a group of 50 leprosy patients, platelet function tests were found to be abnormal in 44. More than half the patients showed significant impairment in platelet adhesiveness and aggregation to collagen which correlated best with increase in serum IgM levels. ADP-induced aggregation of platelets was not a major defect and Pf-3 availability was reduced only in a fourth of the patients. In vitro incubation of collagen with plasma from leprosy patients significantly reduced its ability to clump normal platelets. This appears to be the first report of defective platelet function in leprosy, and it is thought that such changes may in part be due to increased IgM globulins in the blood and/or to alterations in the collagen brought about thereby.