Usefulness of exploratory burr holes in the management of severe head injury

The authors performed burr hole exploration for the diagnosis of intracranial haematomas in 110 consecutive patients with severe head injury. Burr hole revealed extra-axial mass lesions in 61 patients and 49 patients had negative exploration. Post-mortem study showed that only a very few clots were missed by routine burr holes. The study indicated that diagnostic burr hole exploration was a sensitive method for detecting extracerebral mass lesions in centres where CT scanning facilities were not available.

CD1-positive epidermal Langerhans cells in skin reactions to autologous peripheral-blood-derived mononuclear cells in leprosy patients

A comparison was made on the characteristics of the infiltrates, the number and distribution of CD1-positive epidermal Langerhans cells (LC) at the sites of skin reaction induced by autologous peripheral-blood-derived mononuclear cells (PBMC) in leprosy patients. Clinically and histologically, the skin reaction was well expressed in tuberculoid patients as compared to lepromatous patients, erythema nodosum leprosum (ENL) patients and contacts. The quantum of lymphocytes in the infiltrates was maximal in the tuberculoid patients and it was minimal in lepromatous and ENL patients. The number and distribution of LC in the tuberculoid patients was significantly higher in the PBMC-inoculated sites as compared to control sites over 24 h. In contrast, no difference in the number and distribution of LC was noticed in the lepromatous and ENL patients. These observations indicate that the lymphocytes of tuberculoid patients in contrast to lepromatous leprosy patients are capable of sustenance in the local micro-environments of the skin and an effective interaction may be possible between LC and PBMC.

Post traumatic amnesia and alcohol dependence

Post-traumatic amnesia was found to be prolonged in those who were alcohol dependents prior to the head injury. A comparison with controls who were matched for age and severity of head injury indicated that the PTA in the alcoholics was significantly longer. The pathophysiologic changes in the alcoholic brain that could explain such variations are discussed in the light of recent findings.

Paramnestic delusions following head injury

Paramnesic delusions are rare psychiatric sequelae after head injury. In a follow-up of 346 patients only three such cases were seen. Case histories of those patients with a follow-up for eighteen months, their clinical features, psychometric evaluations etc. are described, followed by a discussion into their genesis and persistence.

Delusional disorders after head injury

Delusional disorders have been fundamental to the behaviour problems seen in patients during the early recovery phase of head injury. One hundred and twenty three patients admitted in the Trauma Ward were followed up and the nature and types of the delusions were studied. Their emergence in relation to cognitive recovery and the significance of other factors, such as pre-traumatic personality, alcohol abuse, severity of injury etc., in the genesis of such delusions are presented.

CD1 positive epidermal Langerhans cells in indeterminate leprosy

Langerhans cells (LC) in the skin lesions of 10 untreated indeterminate leprosy patients were defined by indirect immunofluorescence using monoclonal antibodies. No difference was observed in the numbers and distribution of epidermal LC in the indeterminate lesions and controls. However, the infiltrates of these lesions contained CD1+ cells. Most cells in the infiltrates HLA DR antigens.

Alcohol abuse and recovery after head injury

The clinical observation of a turbulent recovery phase in the alcohol abusers among the head injured patients was studied. Various parameters of severity such as duration of hospital stay, length of coma, post-traumatic amnesia, focal neurological deficits, presence of fracture and the behaviour problems during recovery were studied. Behaviour problems and the length of hospital stay were found to be more in the abuser group than in the control population. It is concluded that the behaviour problems contribute to the disturbed recovery process in these patients.

Role of outer membrane proteins in immunity against murine salmonellosis--1. Antibody response to crude outer membrane proteins of Salmonella typhimurium

The humoral immune response to crude outer membrane proteins (comp) of S. typhimurium in mice has been characterized. Maximal and quicker antibody response was observed when 50 micrograms of comp was injected intraperitoneally. The comp of smooth C5 strain of S. typhimurium evoked antibody response to both lipopolysaccharide (LPS) and proteins. Absorption of these sera with LPS coated erythrocytes eliminated the antibodies to LPS completely, while the antibody level to protein was left unaltered. The comp from rough mutant (lacking O-specific chain of LPS) of S. typhimurium elicited antibodies to proteins but not to LPS. These results indicate the concomitant production of antibodies to Salmonella outer membrane proteins also. The significance of such antibodies in protection and diagnosis has been discussed.

The prebiological paleoatmosphere: stability and composition

In the past, it was generally assumed that the early atmosphere of the Earth contained appreciable quantities of methane (CH4) and ammonia (NH3). This was the type of atmosphere believed to be the most suitable environment for chemical evolution, the nonbiological formation of complex organic molecules, the precursors of living systems. Photochemical considerations suggest that a CH4-NH3 dominated early atmosphere was probably very short-lived, if it ever existed at all. Instead, an early atmosphere of carbon dioxide (CO2) and nitrogen (N2) is favored by photochemical as well as geological and geochemical considerations. Photochemical calculations also indicate that the total oxygen column density of the prebiological paleoatmosphere did not exceed 10(-7) of the present atmospheric level.

An analysis of lumbar intervertebral disc prolapse

Clinical findings and operative results of 212 operated cases of disc protrusion are analyzed in this paper. The maximum age incidence is between 21 and 40 years. In our series disc prolapse was most common between the L4-L5 disc space, mostly on the left side, whereas the L5-S1 is more common in white people. Anthropologic differences may account for the discrepancy. A careful search should be made for disc protrusion by flexing the spine and also exploring the intervertebral foramen during surgery.

Ozone and Temperature Trends Associated with the 11-Year Solar Cycle

Evidence is presented which suggests that trends in the ozone concentration and stratospheric temperature, reported between the early 1960's and 1976, are to a large extent due to solar ultraviolet flux variability associated with the 11-year solar cycle. Radiative-convective-photochemical simulations of ozone and temperature variations have been made with a solar ultraviolet flux variability model. Results for temperatures and ozone concentrations, when compared with published data, show good agreement.

Ulcerative systematized porokeratosis (Mibelli)

An unusual clinical variant of porokeratosis (Mibelli's disease) appeared in a patient soon after birth; the lesions were widely distributed mostly on the right half of the body. Spontaneous recurrent ulcerations occurred over certain sites. The right foot was grossly deformed as a result of atrophic scarring after ulcerations. Biopsy specimens of the classical lesion showed cornoid lamella. It is suggested that the term "ulcerative systematized porokeratosis" be used to describe this clinical variant of porokeratosis.

Lumbar stenosis

We have analyzed the clinical features, radiologic, myelographic and operative findings in 11 cases of lumbar stenosis. Adequate decompressive laminectomy is necessary in these cases to relieve the symptoms.

A giant schwannoma of cauda equina

A case of giant schwannoma occurring in a woman 23 years of age with deformity of the foot developing at the age of five years is reported. The gross radiological changes of increased interpedicular distance and erosion of the posterior surface of the vertebra suggested the massive size of the tumour (6'' x 21/2'' x 11/2''). Successful surgical excision of such a large size schwannoma has not been reported previously.

Maduromycosis of the brain. Case report

A rare case of a gas-containing brain abscess due to verified maduromycosis is described. Blackish material over the abscess cavity revealed the fungal elements. The pus from the abscess contained Streptococcus hemolyticus and Klebsiella organisms.

General paresis in the psychiatric department of a general hospital in India

Thirty-four first admissions between the years 1964 and 1970 into the Department of Psychiatry, Erskine Hospital, Madurai, South India, who were diagnosed as general paresis formed the material for this prospective study. Diagnosis was based on clinical and positive blood and CSF serology, and on Lange's paretic reaction in the CSF.