Hemobilia as presenting manifestation of polyarteritis nodosa.

Polyarteritis nodosa (PAN) is a multisystem necrotizing inflammatory vasculitis of medium-sized muscular arteries. Hepatobiliary complications secondary to thrombosis or aneurysm formation in PAN are rare and are associated with poor outcome. We describe an 18-year-old man with PAN who presented with hemobilia secondary to rupture of a hepatic artery aneurysm, which was successfully managed with coil embolization followed by immunosuppressive therapy.     

Cervical cytology screening in Calcutta and adjoining areas with special reference to carcinoma of the uterine cervix

A total of 1232 female subjects including 100 prostitutes from Calcutta and adjoining areas in the age group of 21-70 years were screened for cervical pathology according to the method of Papanicolaou. Of 1232 examined, 815 were found to have smears with normal cellular cytology (66.15%). The others were grouped into dysplasia (18.4%) and inflammatory (15.4%) according to the cytomorphological characteristics of the exfoliated cells. The findings though revealed more cases of cervical dysplasia in women with early marriage, early childbirth, high parity and multiple sexual partners, it failed to support the smegma theory of cervical carcinoma. This study also showed a number of inflammatory cervical smears in women coming from low socio-economic group.     

Immune response, tolerance circumvention and autoantibodies in aging MRL/MP-lpr and MRL/MP-+ MICE

Isotype distribution was analyzed, as a function of age in MRL/Mp-lpr and MRL/Mp-+ mice. The mice were tested for: (1) “spontaneous” response to nucleic acid (2) induced response to alum-precipitated phosphorylcholine-rabbit gamma globulin (PC-RGG) (immunized animals) and (3) induced response to alum-precipitated PC-RGG after pretreatment with aggregate-free RGG (tolerizedimmunized animals). “Spontaneous” nucleic acid antibodies of isotypes, other than IgM, increased as animals became older. The quantity of RGG antibody declined as a function of the age at which animals were immunized. Young tolerized-immunized animals made less antibody of all isotypes than did immunized animals. In later life, resistance against tolerance induction developed. Aggregate-free RGG sensitized older animals and, thus, augmented the response to alum-precipitated PC-RGG. Up to the age of 20 weeks, spontaneous antibody and antibody of tolerized-immunized animals showed striking similarities in age- and strain-dependent changes of IgG2b and IgA isotypes. Results were discussed in terms of: (1) a defect in down regulation of immune responsiveness, which contributes to the initiation of autoimmunity and age-dependent resistance to tolerance induction; (2) regulatory mechanisms for isotype switching, which contribute to resistance to tolerance induction, whether naturally occurring or experimentally induced; and (3) age-related immunological changes which are inherent in the MRL/Mp genome, the mutant gene, lpr/lpr, accelerating the changes.     

Effects of riboflavin deficiency upon age-related changes in beta-adrenergic and adenosine receptor binding in rat adipocytes

The binding of (-)(3H)dihydroalprenolol (DHA) and (-)-N6-(3H)phenyl-isopropyladenosine (PIA) to beta-adrenergic and adenosine receptors, respectively, was determined in membranes of adipocytes isolated from riboflavin-deficient rats and age-matched, pair-fed controls for feeding periods of three to forty weeks. In normal chow-fed animals, the binding of both ligands to receptors markedly decreased in older compared to that in younger animals. In young, riboflavin-deficient animals, DHA binding diminished compared to that in age-matched controls. No further decrease in binding of DHA occurred in older, aged-matched, riboflavin-deficient rats. Riboflavin deficiency did not have any effect on PIA binding in either young or old animals. Thus, in riboflavin deficiency, beta-adrenergic binding in adipocyte membranes from young animals is reduced and the normal age-related decrease in this receptor binding does not occur. By contrast, the binding of PIA to adenosine receptors is lower in older than in younger animals regardless of riboflavin nutriture.     

Delay in emergence of mefloquine resistance in Plasmodium berghei by use of drug combinations

Blood induced Plasmodium berghei infection in Swiss mice was exposed during successive passages to melfloquine alone or melfoquine in combination with dapsone or primaquine or erythromycin, and the level of resistance to melfoquine in four sub-lines was compared at ED90 level. Treatment with mefloquine alone resulted in a 201.14 fold increase in resistance after 21 passages. Use of drug combination (melfoquine + dapsone) delayed the acquisition of resistance as shown by a marginal increase of ED90 by 5.76 fold after 34 passages. Similarly, there was a 17.84 fold increase of resistance after 32 passages involving exposure to mefloquine-primaquine and a 112.28 fold increase after exposure to melfoquine-erythromycin combination for 31 passages. The study emphasizes that rational drug combinations should be developed to protect the melfoquine against the emergence of resistance in P. falciparum cases.     

CT in complete congenital eventration of diaphragm with aplasia of lung.

Complete eventration of the diaphragm and pulmonary aplasia, though rare anomalies, should be considered in new-borns with respiratory distress. Such anomalous conditions occurring either alone or in combination elude diagnosis and pose problems for management. CT is a very effective, non invasive means of diagnosis which in the past depended largely on invasive procedures such as bronchography, angiography and thoracotomy.