SJOGREN'S SYNDROME PRESENTING AS A SEVERE SENSORY NEUROPATHY INCLUDING INVOLVEMENT OF THE TRIGEMINAL NERVE

Primary Sjögren's syndrome (SS) can be associated and maypresent with neurological complications. We describe a 32-year-oldwoman with a debilitating sensory neuropathy, including trigeminalnerve involvement which was the initial manifestation of thisdisease. KEY WORDS: Sjögren's syndrome, Sensory neuropathy, Trigeminal neuropathy     

Automated Optical Counting of Blood Platelets

We have evaluated the use of an opticalparticle counter to perform automatedplatelet counts on whole blood. Theerythrocytes were lysed by dilution ofwhole blood with 2 M urea and the remaining platelets and leukocytes wereenumerated by a darkfield microscopeoptical system that detects light diffractedby them. A suspension of fixed humanplatelets available commercially washighly satisfactory for standardization.The method gave accurate and reproducible platelet counts, comparable withthose of electronic particle counting onvenous blood and substantially morereliable platelet counts on thrombocytopenic and finger-puncture blood samples. We believe that errors resultingfrom the electronic method were causedby technical difficulties of sample handling and not to an intrinsic error in electronic counting. By using the automatedoptical method we found no significantdifference between the platelet counts ofcapillary and venous blood, althoughcapillary platelet counts had twice thevariability of venous counts. The opticaltechnique has important advantages overelectronic platelet counting, and itssuperiority appears to be due to the ability to count platelets in diluted wholeblood rather than in plasma. It shouldprove especially useful in performing thelarge numbers of platelet counts onthrombocytopenic and finger-punctureblood samples that are increasingly important for management of patients receiving chemotherapy.

Submitted on April 20, 1971 Revised on May 21, 1971 Accepted on May 25, 1971     

EFFECTS OF THE ACID-BASE STATE UPON THE TEMPERATURE COEFFICIENT OF pH OF BLOOD

When gaseous exchange is avoided, a change in temperature ofoxygenated blood alters its pH. Within the range of values forPco₂ at 38°C of 25 and 130 mm Hg, and base excess of +10and –14 m.equiv/l., we have found this effect to be dependentupon the respiratory state, there being an approximately linearinverse relationship between the temperature coefficient ofpH and the log Pco₂. Changes in metabolic state produced bythe addition of acid or alkali did not significantly affectthis relationship. The slope and position of pH: log Pco₂ bufferlines are altered by changes in temperature. At reduced temperaturesthe buffering capacity is increased, so that the addition ofacid or alkali gave rise to smaller changes in pH. However,in view of the increased solubility of carbon dioxide, alterationsin Pco₂ produced greater changes in pH. In the presence of ametabolic acidosis, reduction in temperature gave a shift tothe right of the buffer line.     

Benefits of HLA typing a family with diabetes

ABSTRACT. A boy whose father and three sisters have insulin dependent diabetes mellitus, presented with anxiety symptoms related to his developing a similar disorder. Haplotype segregation analysis based on HLA typing of the family revealed which of the parents' haplotypes were most likely to be associated with the susceptibility gene for diabetes. As the boy did not inherit either of these haplotypes, his risk of developing diabetes is not increased. Explanation of these findings resulted in a decrease in his anxiety and his relationship with other family members improved. This family study demonstrates how HLA typing of families with diabetes can have practical benefits for non-affected members.     

Disodium cromoglycate: laboratory studies and clinical trial in allergic rhinitis

The ability of disodium cromoglycate (DSCG) to block allergic responses in the nasal airways was investigated in two ways. The effect of DSCG on antigen-induced airways resistance changes in sensitive subjects was investigated in the laboratory. DSCG in a dose of 10 mg applied to each nostril was shown to block the expected reaction in 71 % of subjects and a 1 mg dose in 47%. Protection was conferred against antigen challenge for a period of about 6 hr by the 10 mg dose. A clinical trial of DSCG (10 mg) in seasonal allergic rhinitis was carried out using a double-blind cross-over design. Analysis of the results showed significant DSCG protective effects against lower respiratory tract symptoms and a significant antihistamine sparing effect. Analysis of part of the trial period when antigen challenge was uniformly high showed significant DSCG protective effects against sneezing, nasal discharge and nasal obstruction. Nasal application of DSCG is considered to be a promising alternative therapeutic approach in allergic rhinitis.     

EFFECTS OF PROLONGED NITROUS OXIDE ON WOUND HEALING

The effect of long-term nitrous oxide treatment on wound healingwas assessed in rats using wound tensiometry, to assess woundstrength in surgical incised wounds, and estimation of the rateof healing of a small area of full thickness skin loss. No effecton wound strength could be detected in animals treated for threedays with 25 or 60 per cent nitrous oxide. Similarly, no significantdifference was present in the rate of healing of the area offull thickness skin loss after two days treatment with nitrousoxide.     

Anaesthetic pollution in the dental out-patient surgery

Five factors influencing pollution in the dental surgery are considered. Despite leakage from round the mask and from the mouth, scavenging can remove the majority of expired anaesthetic. The effectiveness of scavenging can usefully be monitored with a Wright respirometer. Spillage of anaesthetic vapour at induction and at the end of anaesthesia must be avoided. In addition to scavenging, pollution levels are minimised if a Boyle's type machine is used and excessive fresh gas flow avoided. Room ventilation, e.g. extract fans in windows, is vital in reducing pollution levels in the surgery. Room size and non-uniformity of ventilation must also be considered.