Candida retinitis in bare lymphocyte syndrome

Bare lymphocyte syndrome (BLS) is a rare, severe combined immunodeficiency characterized by lack of expression of HLA A, B and C antigens and the absence of B2 microglobulins. Patients with BLS exhibit functional deficiency of both T and B cells resulting in bacterial as well as viral and fungal infection. Ophthalmic findings in this group of disorders have not been reported. We present a case of candida retinitis in a terminally ill 5-year-old girl with BLS.

Functional constituents of the active site of human neutrophil collagenase

A series of chemical modification reactions has been carried out to identify functional constituents of the active site of human neutrophil collagenase. The enzyme is reversibly inhibited by the transition metal chelating agent 1,10-phenanthroline, and inhibition is fully reversed by zinc. Removal of weakly bound metal ions by gel filtration inactivates collagenase, and activity is fully restored on immediate readdition of calcium. The enzyme is unaffected by reagents that modify serine, cysteine, and arginine residues. However, reaction with the carboxyl reagents cyclohexylmorpholinocarbodiimide and Woodward's Reagent K lowers the activity of the enzyme substantially. Acetylimidazole inactivates the enzyme, but activity is completely restored on addition of hydroxylamine. The enzyme is also inactivated by tetranitromethane, indicating that it contains an essential tyrosine residue. Acylation of collagenase with diethyl pyrocarbonate, diketene, acetic anhydride, or trinitrobenzenesulfonate inactivates the enzyme, and activity is not restored on addition of hydroxylamine, indicating the presence of an essential lysine residue.

Ocular findings in the facioauriculovertebral sequence (Goldenhar-Gorlin syndrome)

We reviewed the ocular findings in 57 consecutive patients with the facioauriculovertebral sequence (Goldenhar-Gorlin syndrome). Epibulbar choristomas were detected in 18 cases (32%), a much lower occurrence than reported previously. Various motility disorders (11 cases, 19%), blepharoptosis or narrow palpebral fissures (seven cases, 12%), eyelid colobomas (six cases, 11%), and lacrimal drainage system anomalies (six cases, 11%) were more frequent than previously noted. These ocular findings were more common in the patients with epibulbar choristomas. Of the various features of the Goldenhar-Gorlin syndrome (skin tags, microtia, hemifacial microsomia, and vertebral anomalies), only skin tags correlated positively with the laterality of epibulbar choristomas. Preauricular and facial tags represent choristomas, explaining their association with epibulbar choristomas and the laterality they share.

Keshan disease: an endemic cardiomyopathy in China

Keshan disease is an endemic cardiomyopathy in China. Morphologically, the condition is characterized by multifocal necrosis and replacement fibrosis of the myocardium, resulting in acute or chronic heart failure. Some patients with Keshan disease show the clinical features of congestive (dilated) cardiomyopathy, but the pathologic features of the two conditions are different. The etiology of Keshan disease remains unknown. It is likely that numerous agents work synergistically to cause the disease.

Mesangial IGM in minimal change glomerular disease: a clinicopathological study in a Malaysian population

During a 6 yr period, 105 (69%) of 153 patients in whom a histological diagnosis of minimal change glomerular disease was made had renal biopsy tissue suitable for immunofluorescence examination. Thirty seven (35%) patients showed glomerular mesangial deposits of IgM. All the patients presented with the nephrotic syndrome. We found no significant difference in age and sex prevalence, presentation, response to therapy and glomerular morphology between IgM positive and IgM negative groups. This study suggests that there is no necessity to categorize IgM positive minimal change glomerular disease as a separate entity.

Mechanism of NaCl secretion in rectal gland tubules of spiny dogfish (Squalus acanthias). III. Effects of stimulation of secretion by cyclic AMP

Segments of rectal gland tubules (RGT) the spiny dogfish (Squalus acanthias) were perfused in vitro to study the cellular mechanism by which NaCl secretion is stimulated. Transepithelial PD (PDte), transepithelial resistance (Rte), the PD across the basolateral membrane (PDbl), the fractional resistance of the lumen membrane (FR1), and the cellular activities for Cl-, Na+, and K+ (alpha cell x) were measured. In series 1 the effects of stimulation (S) (dbcAMP 10(-4, adenosine 10(-4), and forskolin 10(-6) mol x 1(-1) on these parameters were recorded and compared to nonstimulated state (NS). PDte increased from -1.9 +/- 0.2 mV to -11.0 +/- 0.9 mV (n = 51). PDbl depolarized from -86 +/- 1 to -74 +/- 1.4 mV (n =52), Rte fell from 29 +/- 2.8 to 21 +/- 2 omega cm2 (n = 23), and FR1 fell from 0.96 +/- 0.005 to 0.79 +/- 0.04 (n = 9). alpha cell K+ was constant (123 +/- 13 versus 128 +/- 17 mmol x 1(-1) (n = 6), but alpha cell cl- fell significantly from 48 +/- 4 to 41 +/- 3 mmol x 1(-1) (n = 7). alpha cell Na+ increased from 11 +/- 2.1 to 29.5 +/- 6.6 mmol x 1(-1) (n = 4). In series 2 the conductivity properties were examined by rapid K+, and Cl- concentration steps on the basolateral and luminal cell side respectively in NS and S states. In NS-segments reduction of bath K+ led to a hyperpolarization of PDbl with a mean slope of 28 +/- 1.3 mV/decade (n = 9) (as compared to 19 mV/decade for S-state).(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired cutis laxa and multiple myeloma

We report a patient with acquired cutis laxa and multiple myeloma, and the possible association between the two conditions is discussed.

Scabies and systemic lupus erythematosus

There is little information in the literature concerning scabies in patients with systemic lupus erythematosus. Scabies in our five patients appeared to be more severe than usual, and two of them developed crusted scabies, probably on an immunologic basis.

Perfusion of isolated tubules of the shark rectal gland. Electrical characteristics and response to hormones

Both the mammalian thick ascending limb of Henle's loop and the shark rectal gland actively transport Cl against an electrochemical gradient by mechanisms involving hormone-sensitive NaCl transport. In contrast to mammalian renal tubules, individual tubules of the shark rectal gland previously have not been perfused in vitro. Using a combination of renal slice and microdissection techniques we were able to isolate and perfuse single rectal gland tubules without the use of enzyme treatment. Single tubules consistently generated lumen-negative transepithelial voltages (Vt) of -1.8 mV when perfused and bathed with identical shark Ringer's solution. The addition of cyclic AMP, vasoactive intestinal peptide (VIP), and adenosine to the bath increased Vt to -7.5, -9.0, and -4.3 mV, respectively (all P less than 0.02 compared with paired controls). Each stimulation could be reversed by addition by furosemide to the bath. The adenosine response was inhibited by theophylline, a specific inhibitor of adenosine receptors. The tubules had a low transepithelial electrical resistance of 12-26 omega X cm2 and exhibited a transepithelial permselectivity for small cations. These results indicate that tubules of the rectal gland can be perfused in vitro and have receptors for VIP and adenosine. Cyclic AMP and secretagogues hyperpolarize the membrane consistent with electrogenic chloride transport, and these effects are reversed by furosemide, an inhibitor of coupled sodium-potassium-chloride co-transport. The response of Vt to cyclic AMP and furosemide, the transepithelial electrical resistance, and the cation selective permeability of tubules are remarkably similar to measurements in perfused mammalian thick ascending limbs.

Lupus nephritis and lupus band test

Twenty-seven patients with histologically confirmed lupus nephritis were studied to identify the incidence of lupus band and its significance to histological patterns of nephritis and complement levels. It was found that the kidney involvement is 2.5 times more frequent in lupus band positive patients. The association of a positive lupus and low C3 level signifies the presence of diffuse proliferative glomerulonephritis rather than membranous glomerulonephritis. The results, together with earlier reports, are discussed.

Idiopathic inhibitor of factor VIII and its treatment by immunosuppression

A patient with idiopathic inhibitor to factor VIII is reported. Treatment with cyclophosphamide and factor VIII (given simultaneously) produced a good clinical response with disappearance of the inhibitor.

Schistosoma japonicum-type infection in Malaysia--report of the first living case

The first living patient with a Schistosoma japonicum-type infection who presented with the nephrotic syndrome is reported in detail. It is not clear whether the nephrotic syndrome was due to the schistosome infection or to the deposition of hepatitis B antigen and antibody complexes. This is the tenth case of schistosomiasis reported from aborigines in Malaysia and a sylvatic source of infection is suggested.

Mesangiocapillary (membranoproliferative) glomerulonephritis and rheumatoid arthritis

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Acquired toxoplasmosis in Malaysia

Two cases of acquired toxoplasmosis in asymptomatic Malaysian patients are described. In both instances the diagnosis was first made on the finding of the Piringer-Kuchinka reaction in excised lymph nodes from these patients and serological studies further confirmed the presence of hihg toxoplasmic antibody titres. The characteristic histological features of toxoplasmic lymphadenitis are discussed. Diagnosis and management of the disease are briefly reviewed with emphasis that the importance of diagnosing this disease goes beyond the establishment of a mostly self-limiting, clinically unimportant protozoan infection.