Tuberculosis of the female genital tract in patients attending an infertility clinic

Mycobacterium tuberculosis plays a major role in infertility, which is the commonest symptom of genital tuberculosis in women. From August 1987 to July 1988, 109 women presenting with infertility were investigated for tuberculosis. None had any other symptoms or signs of the disease. In all cases it was diagnosed by culture of M. tuberculosis in one or more of the 5 specimens (3 menstrual fluid specimens, endometrial tissue and peritoneal fluid) obtained from each woman. In addition Ziehl-Neelsen staining and histological examination were performed on all the specimens. Twenty-three patients (21%) had positive cultures for M. tuberculosis. Of the 26 positive specimens, 16 (69.6%) were menstrual fluid, 4 (17%) endometrial tissue and 6 (26%) peritoneal fluid (3 patients had more than one positive culture). Chest radiographs were normal in all cases. M. tuberculosis cultured in human tissue must be recognized as a pathogen and necessitates treatment. Selective screening procedures should be done to exclude genital tuberculosis as a cause of infertility.     

Outpatient anterior chamber lens implantation

100 outpatient and 143 inpatient intracapsular cataract extractions with anterior chamber lens implantation were examined 6 months post-operatively. 74 (74%) in the former and 107 (75%) in the latter achieved visual acuity greater than or equal to 0.5. Excluding non-surgical pathology, 93% in the outpatient group and 98% in the inpatient group had a visual acuity greater than or equal to 0.5 (P = 0.12). There were no significant differences in post-operative complications except for the incidence of cystoid macular edema. Six (6%) of the outpatient and 1 (0.7%) of the inpatient procedures had cystoid macular edema that resulted in a visual acuity below 0.5 (P = 0.02).     

In vitro modulation of cisplatin cytotoxicity by sparsomycin inhibition of protein synthesis

Inhibition of protein synthesis can alter cellular responsiveness to the classical anticancer drugs. The in vitro response of Chinese hamster ovary (CHO) cells to cisplatin with or without sparsomycin (Sm) was studied with the use of [3H]leucine and [methyl-3H]thymidine incorporation and clonogenic assay. Pretreatment of exponentially growing CHO cells with 1 microgram Sm/ml for 3 or 5 hours decreased [3H]leucine incorporation by 20% and resulted in significant resistance to cisplatin (P = .005). Sm in a concentration of 10 micrograms/ml reduced [3H]leucine and [methyl-3H]thymidine incorporation after 3 hours by 92 and 84%, respectively, and resulted in potentiation of the cisplatin cytotoxicity (P = .004). This effect was the same in the case of nonproliferating cells (P = .005), while protection due to Sm (1 microgram/ml) was seen only during cell proliferation. Simultaneous incubation and postincubation with Sm proved to have much less or no potentiating effect on cisplatin. The mechanisms of both protection and potentiation are still not clear, but our data indicate that Sm is a promising drug for further studies on the modulation of the cancer cell response to classical anticancer drugs.     

Subacute and chronic extradural haematomas

Over an 8-year period (1982-1989) 43 patients with subacute and chronic extradural haematomas were treated. The clinical picture of the patients, computed tomography (CT) as well as operative findings and prognosis were evaluated. The radiological picture as seen on CT was correlated with the time interval elapsing between initial trauma and surgery. Operative findings are discussed and the terms 'subacute' and 'chronic' are defined.     

Orbital CT in the management of blow-out fractures of the orbital floor

The CT-examinations of 15 patients with blow-out fractures of the orbital floor were reviewed. All patients were examined with coronal/semicoronal CT-imaging, and 7 patients also were evaluated with semisagittal projections. Only in one case the semisagittal images gave more information than coronal sections when using the classification of Gilbard et al. (1985) of the inferior rectus muscle/fracture relationship. The anterior and posterior fracture margins were better delineated with semisagittal imaging. Two patients exhibiting positive traction tests with hooked, and not entrapped muscles on CT still had diplopia 5 1/2 and 12 weeks after the trauma.     

Effect of doxorubicin exposure on cell-cycle kinetics of human leukemia cells studied by bivariate flow cytometric measurement of 5-iodo-2-deoxyuridine incorporation and DNA content

Cell kinetics of two human leukemic cell lines, Molt-4 and K562, following a 2-h exposure to doxorubicin, were studied. DNA flow cytometry provided static information that for both cell lines a dose-dependent accumulation occurred at the G2 + M compartment that disappeared in time. Kinetic information was provided by time-monitoring cells labeled with 5-iodo-2-deoxyuridine (IdUrd) by two-parameter flow cytometry, analyzing the IdUrd label and the DNA content. The cell-cycle time (Tc) of exponentially growing Molt-4 cells was determined to be 20 h. Twenty-four hours after a 2-h exposure to 0.25 micrograms/ml doxorubicin, the Tc had increased to 23 h; following exposure to 1.0 micrograms/ml, it increased to 33 h. Cell kinetics of K562 cells following doxorubicin exposure were monitored in time up to 4 days. The average Tc of exponentially growing K562 cells was determined to be 24.7 h. Twenty-four hours following 2-h exposure to 0.25 or 0.5 micrograms/ml doxorubicin, the Tc were determined to be 28 and 32 h, respectively. After an additional 2 days, the Tc were both determined to be 24 h. The dose-dependent, reversible cell-cycle delay that persisted at least 48 h should be taken into account as an additional mode for decrease of a (tumor) cell population doubling time after exposure to doxorubicin.     

Substance P augments the rate of vasodilation induced by calcitonin gene-related peptide in porcine ophthalmic artery in vitro.

Peptides may function as neurotransmitters liberated antidromically by sensory nerve fibres, provoking vascular responses having potential importance in some neurological disorders. Dose-response relaxation curves induced by substance P (SP) and calcitonin gene related peptide (CGRP) have been studied in porcine ophthalmic arteries in vitro. Both peptides induced vasodilation when tested separately (CGRP much greater than SP). Because of the putative interactions between such peptides in this vascular territory, a computerised system was also used for analysing over time the response to a single addition of either 10(-8) M CGRP, 10(-8) M SP or a combination of 10(-8) M SP + 10(-8) M CGRP. SP did not augment the maximum relaxation induced by CGRP alone, but increased significantly the rate of relaxation during the initial phase of the response. The effect induced by the SP+CGRP combination was stronger than the sum of the individual SP and CGRP-induced relaxations during the first 4 min of the response, which suggests a SP-CGRP synergism in this artery.     

Pulmonary diseases in patients infected with the human immunodeficiency virus in Zimbabwe, Central Africa

During the 11 month period up to 30 September 1987, 37 patients (26 male, 11 female, mean age 27 years) with respiratory symptoms who were human immunodeficiency virus (HIV) positive, were studied prospectively on 40 occasions to determine the cause of any pulmonary complications. HIV was heterosexually transmitted. Predominant symptoms were cough (89%), fever (89%), weight loss (83%), and dyspnoea (60%). Transnasal fibre-optic bronchoscopy (with bronchoalveolar lavage, bronchial brushings and transbronchial lung biopsies) was performed on 35 patients, twice on 3 patients. 'Tru-cut' lung biopsies were obtained from 2 patients who died before bronchoscopy. Pulmonary tuberculosis was the commonest disease, being found in one-third of the patients (12 of 37). Mycobacterium tuberculosis was cultured from 4; the remainder of the plates were contaminated. Pneumocystis carinii was present in 8 patients: as the sole pathogen in 3, with Streptococcus pneumoniae in 4, Staphylococcus aureus in 2, and one also had tuberculous lymphadenitis. Endobronchial Kaposi's sarcoma was seen in 6 of 7 patients with skin nodules. Bacterial pathogens isolated included Staph. aureus (5), S. pneumoniae (5), Klebsiella pneumoniae (2), Haemophilus influenzae (2), H. parainfluenzae (1) and Pseudomonas aeruginosa (1). Invading Aspergillus fumigatus was diagnosed by lung biopsy in one. No diagnosis was reached for 8 patients. It is concluded that in Central Africa pulmonary complications in AIDS patients are similar to those in Europe and North America but the incidence of different pathogens depends on the prevalence of pathogens in the community. M. tuberculosis is probably the commonest pathogen. This study has confirmed that P. carinii pneumonia does occur, but occurs less frequently.