Sperm priming reveals specific autoreactive lymphocyte clones

Human spermatozoa from 18 donors were used to prime lymphocytes from 15 donors in a total of 60 different combinations. The sperm primed lymphocytes were tested in second culture against a total of 60 autologous and 180 allogeneic x-ray irradiated cells. We found that lymphocytes primed for 10–12 days in first culture with allogeneic spermatozoa showed highly significant responses in second culture to leukocytes autologous to the responder. The degree of autologous reactivity between specific subjects ranged from weak to significantly higher than the usual preferential primed lymphocyte typing reaction seen in a secondary mixed leukocyte culture reaction. These findings indicate that healthy human volunteers possess a set of self-reactive lymphocytes that can be detected by priming with allogeneic sperm in specific combinations.     

Cross protection against fowl typhoid immunisation trials and humoral immune response

Chicks were immunised with different vaccines intramuscularly at the age of eight weeks and challenged twenty one days later with 10 LD50 dose of virulent $\text{S. gallinarum}$ V intramuscularly. The percentage of absolute survivors were taken as the criterion to assess the potency of the vaccines. To assess the humoral response, sequential levels of antibodies by different tests were assessed before and after vaccination and after challenge.Live vaccines with adjuvants proved to be the best followed by live vaccines. Cross protection could be induced. Assessment of sequential levels of humoral immune response revealed involvement of agglutinins and bactericidal antibodies but such an involvement appears to be not essential for protection.     

Utilization of the 2017 diagnostic criteria for hEDS by the Toronto GoodHope Ehlers–Danlos syndrome clinic: A retrospective review

The new 2017 diagnostic criteria for hypermobile Ehlers–Danlos Syndrome (hEDS) provide a framework for diagnosing hEDS but are more stringent than the previous Villefranche criteria. Our clinical experience at the GoodHope EDS clinic was that the 2017 criteria left many highly symptomatic patients without a diagnosis of hEDS. We conducted a retrospective cohort study to confirm our clinic experience and assess the accuracy of the 2017 diagnostic criteria for hEDS in patients who had a previous hEDS diagnosis based on the Villefranche criteria. Our study found that 15% (n = 20 of 131) of patients with a prior diagnosis of hEDS met the 2017 diagnostic criteria, and many of the traits used to distinguish hEDS were not significantly more frequent in patients who met 2017 criteria versus those who did not. In both groups objective systemic manifestations were found less frequently than subjective systemic manifestations. Beighton score (BS) as assessed by primary care practitioner was found to be higher than assessment by EDS practitioner in 81% (n = 74 of 91) of cases. Generalized joint hypermobility was confirmed in only 46% (n = 51 of 111) of patients who had a previous diagnosis of hEDS. Higher BS did not correlate with increased number of systemic manifestations in our cohort. Common comorbidities of hEDS were found with similar frequency in those who met 2017 criteria and those who did not. Based on our cohort, the 2017 hEDS diagnostic criteria require refinement to improve its diagnostic accuracy.     

Evoked potential changes in ischaemic myelopathy

Somatosensory evoked potentials are employed in the intraoperative monitoring but there is paucity of information about the motor evoked potentials (MEP) in spinal cord ischaemia. Two patients aged 9 and 4 years developed paraplegia following surgery for coarctation of aorta. The aortic cross clamping time in these patients was 100 min and 30 min. respectively. The patient with longer clamping time had flaccid paraplegia and lower limb MEPs were not recordable; whereas the patient with shorter clamping time had spastic paraparesis and prolonged CMCT to right lower limb. The latter patient improved significantly. Tibial SEPs were normal in both the patients. Our results suggest that MEP may have a greater role than SEP in documenting and prognosticating ischaemic myelopathy.     

Closed pyloroduodenal digital dilatation as a complementary drainage procedure to truncal vagotomy

Out of a total of 300 consecutive cases of duodenal ulcer undergoing surgery, 51 patients were treated by truncal vagotomy and a closed pyloroduodenal digital dilatation. A peroperative assessment of the pyloroduodenal canal was carried out, and in patients with a mobile, supple duodenum showing minimal scarring a standard drainage procedure was not considered necessary. In these patients it was possible to perform a closed pyloroduodenal digital dilatation using the two thumbs to achieve an effective dilatation of 20-30 mm. Post-operative clinical evaluation (Modified Visick grading) and "special" barium meal revealed 86% of patients in Grade I and II at the end of two years (maximum follow-up 3.5 yrs.), with no evidence of lasting gastric stasis. The method is easy, safe and simple. It maintains the anatomical and physiological integrity of the pyloroduodenal ring thereby obviating the hazards of an "incontinent" stomach. Its main limitation appears to be its restricted selectivity and in the present series it could be carried out in about 17% of cases.     

Epidemiology of chronic suppurative otitis media and deafness in a rural area and developing an intervention strategy

Of 613 children evaluated in a village in Haryana 94 (15.3%) were observed to have chronic suppurative otitis media (CSOM). Fifty eight (61.7%) children had hearing impairment. CSOM contributed to 71.6% of the hearing impaired (58/81). On analysis of association of CSOM with literacy and socio-economic status of mothers, and age, sex, and upper respiratory tract infections (URI) in children positive correlation was observed only with URIs (P<0.001). Literacy and socio-economic status of the mothers did not correlate significantly with knowledge about treatment seeking, and ear cleaning practices, probably due to the narrow range of incomes and literacy levels. An intervention program consisting of play, demonstrations, health charts and slogans, and aural cleaning and antibiotic drops was introduced.