Diagnosis of extradural hematoma by brain scan

Brain scanning has made possible the recognition of an extradural hematoma resulting from head injury in three patients who had no lateralizing neurological signs. We recommend that, when time permits, scanning be considered as a preliminary step in diagnostic studies after head injury.     

Pattern of renal amyloidosis in Indian patients.

Two hundred and thirty-three patients with renal amyloidosis were studied in an attempt to identify the incidence and pattern of the disease in northern India. The incidence of amyloidosis was 1.01% of 6431 post-mortems and 8.4% of 1980 renal biopsies from patients who presented with clinical evidence of glomerular disease. Two hundred and three patients (87.1%) had secondary amyloidosis, 22 (9.4%) had primary amyloid and 8 patients (3.5%) had amyloidosis associated with multiple myeloma. Tuberculosis of various organs was the commonest predisposing disease accounting for 59.1% of secondary amyloidosis, followed by chronic suppurative lung disease in 24.1%. Rheumatoid arthritis, chronic osteomyelitis and lepromatous leprosy were seen in a small percentage of patients (2 to 8%). Proteinuria of varying degree was present in all the 233 patients and 12.9% of them had a daily protein excretion of more than 10 g. Post-mortem examination of 65 patients with renal amyloidosis showed that 75.3% also had amyloid deposit in the spleen, 63% in the liver, and 50.8% in the adrenals. Clinical evidence of disappearance of proteinuria was observed in 3 patients with secondary amyloidosis; in 2 of them, the regression of amyloidosis was confirmed by serial renal biopsy performed 3 and 5 years after the initial diagnosis.     

Brainstem auditory evoked responses in coma due to meningoencephalitis

ABSTRACT— Prognosticating the outcome of an unconscious patient continues to pose a serious challenge to the clinicians. BAERs are the latest addition to neurological diagnostic aids for predicting the outcome of coma. The relative value of BAERs in predicting the outcome of 15 comatosed meningoencephalitis patients has been studied. The results points to a rôle of BAERs in the detection of brain stem dysfunction in a large majority of patients. However, when used as a prognostic indicant, the traditional bed-side clinical assessment (GCS and vestibulo-ocular cold caloric response) still holds a slight advantage over advanced technology. BAERs may have a place in assessing brain stem dysfunction in neurologic conditions where an adequate clinical assessment may not be possible.     

Plasma pseudocholinesterase: A potential marker for early detection of obesity

Plasma pseudocholinesterase activity, body weight and food intake showed significantly higher values in obese (ob/ob) mice than their lean littermates starting at the age of 35 days. The enzyme activity also showed a good positive correlation with age, body weight and food intake in all the mice from this age. Analysis of the data also indicated that between 35 and 58 days of age, pseudocholinesterase activity appeared to be more sensitive than body weight measurements in predicting obesity. Diabetic (db/db) mice on restricted diet, showed no significant difference in plasma pseudocholinesterase activity between the pre and post restricted blood samples. In contrast, diabetic mice on a non-restricted diet showed a significant increase in enzyme activity during the same interval of time. This suggests a relationship between hyperphagia, pseudocholinesterase and obesity.     

Carbon disulphide tetratogenicity and postnatal effects in rat

Pregnant albino rats were exposed to carbon disulphide vapour in concentrations of 50, 100 or 200 $\text{mg}\text{m}{}^3$throughout gestation. Two successive generations (F₁ and F₂) were studied.Concentration levels of 100 and 200 $\text{mg}\text{m}{}^3$ produced marked dose-related impairment in the prenatal development of the F₁ progeny, with increase of early embryonal lethality, reduction in foetal weight and a high incidence of malformations affecting mostly the brain and limbs. Postnatal viability, body weight, lipid and energy metabolism and behaviour were also impaired. Behavioral deviations were observed even at 50 $\text{mg}\text{m}{}^3$.After reaching sexual maturity the F₁ rats were mated within their experimental groups, but no further carbon disulphide exposure was applied. The adverse effects on progeny were still detectable in the F₂ generation. Structural abnormalities of the same type as those found in the F₁ at 100 and 200 $\text{mg}\text{m}{}^3$ exposure were observed in their progeny and, postnatally, statistically significant behavioral changes were observed in the progeny of all test groups.     

Responsiveness of glycosyltransferases to thyrotropin in a serum-free culture of porcine thyroid cells

Administration of thyrotropin to porcine thyroid follicles, obtained in a serum-free chemically defined medium, provoked marked increases in the activities of several glycosyltransferases involved in protein N-glycosylation. The coincidence of these effects with a previously demonstrated enhancement of thyroglobulin production renders a relationship between these events likely. The most important stimulation was for peptide oligosaccharyltransferase (3-fold). Among the enzymes involved in the synthesis of the lipid oligosaccharide donor, Dol-P glycosyl- and mannosyltransferases were increased 1.5-fold, and Dol-P N-acetylglucosaminylphosphotransferase only 1.15-fold. As regards terminal glycosyltransferases, asialofetuin sialyltransferase was increased 2-fold and ovomucoid galactosyltransferase only 1.2-fold. There was a continuous release of the latter two enzymes into the culture medium.     

Dermatoglyphics in leprosy

In the present study, dermatolyphic parameters were analysed in the handprints of 25 LL/BL, 25 TT/BT and 25 healthy persons, by printer's ink method. Frequency of loops, were more on right hand and whorls were more on left hand in LL patients as compared to normal healthy controls. In TT the whorls were less frequent than in controls. The a-b ridge count in LL patient has shown insignificant difference from control while the same in TT was significantly decreased (P less than 0.05). Distance between distal wrist crease and axial triradius was significantly decreased in LL as compared to normal (P less than 0.05), whereas no such decrease was observed in TT patients.     

Squamous cell carcinoma complicating chronic discoid lupus erythematosus (CDLE)

Occurrence of squamous cell carcinoma with some unusual clinical features is described in two female patients.     

Late results of the Royal Free Hospital prospective controlled trial of prednisolone therapy in hepatitis B surface antigen negative chronic active hepatitis.

A long-term follow-up of at least 10 years or until death of 44 patients taking part in a controlled prospective trial of prednisolone therapy in hepatitis B antigen negative chronic active hepatitis (lupoid hepatitis) has been performed at the Royal Free Hospital, London. Patients presenting between 1963 and 1967 were randomly allocated into control and treatment groups. Ten year life table survival curves showed a significantly improved survival in the treatment group where 63% of patients were alive at 10 years compared with only 27% in the control group (log rank test, P = 0.03). The median survival in the treatment group was 12.2 years compared with 3.3 years in the control group. The mean duration of treatment was 4.5 years. Age, presence of antinuclear factor, cirrhosis, or level of serum transaminases at presentation did not appear to affect survival. Male patients if untreated had a poorer prognosis than females (P = 0.02). The natural history of chronic active hepatitis appeared from clinical, biochemical, and histological findings to be from an active hepatitis or cirrhosis to inactive macronodular cirrhosis. Prednisolone therapy significantly improved survival by reducing mortality in the early active phase of the disease.