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| Scand J Rheumatol, 1975, 4(4), 221 - 4 Questionable effects of Myocrisin in experimental arthritis in rabbits; Reimann I et al.; In 18 rabbits arthritis was induced in one knee joint by injection with 0.2 ml 3% ovalbumin 4 weeks after sensitization by 3% ovalbumin and 2 mg/ml tubercle bacilli suspended in Freunds incomplete adjuvant . Half of the rabbits were treated with Myocrisin 4 mg i.m . once a week during the experimental period lasting 4-5 months . At killing, both knee joints were examined macroscopically and microscopically . In all rabbits a distinct synovitis was found in the injected knee joint . Histologically, the changes were most pronounced in the rabbits not treated with Myocrisin . An activity index of the synovial membrane changes in the Myocrisin-treated and untreated cases was calculated to 6.3 and 3.6 respectively . Some changes were also found in the uninjected knee joints of 50% of the rabbits . In contrast to some other works, this preliminary investigation suggests that antigen-induced experimental arthritis is suppressed by gold . We feel that this model of experimental arthritis may be suitable for trying out the effect of various drugs. Ann Chir Gynaecol Fenn, 1975, 64(4), 203 - 8 Cavernotomy in renal tuberculosis . Seven cases . Review of the literature; Steinbock A; During the period 1957--1973 the author treated 7 cases of renal tuberculosis where cavernotomy was performed . Some views presented in the literature concerning the development and the detrimental effects of renal cavities are discussed . The diagnosis is purely radiological . Because of impaired renal function, drip infusion urography is recommended for such cases . The indication for operation is an isolated focus near the renal surface containing active tuberculosis with presence of tubercle bacilli . Vascular circulation is impaired locally and renal function diminished . This consitutes a latent danger for the host . The present findings are discussed and compared with results from the literature. Pol Arch Weter, 1975, 17(4), 609 - 21 {Diagnosis of Johne's disease}; Karpinski T et al.; The authors carried out clinical observations and allergical, bacteriological and serological investigations of 73 dairy cows in a herd affected with paratuberculosis . Durings 18 months, clinical signs of the disease were noted in 2 animals only . It was found that the allergic test with the use of johnin had a limited diagnostic value and made it possible only to suspect the disease in the herd . Avian tuberculin had higher potency than johnin and gave, in most cases, stronger allergic reactions in animals infected with M . johnei that the homologous preparation . Bacterioscopic and cultural examination of the faeces with the use of Stuart's serum-agar medium had a significant diagnostic value because they made it possible to detect the excretion of Johne's bacilli before the clinical signs could be observed . The complement fixation test gave positive results in animals with the clinical symptoms of the disease, or when pathological lesions in the intestines were pronounced . In most of the cows investigated, the pathological changes of the ileocecal valve, characteristic for paratuberculosis, appeared earlier than the positive results of the complement fixation test. Natl Inst Anim Health Q (Tokyo), 1975 Summer, 15(2), 86 - 93 Articular lesions in experimental Erysipelothrix insidiosa infection in rats; Sakuma S et al.; Articular lesions were studied in the extremities and vertebral column in murine erysipelas infection . Pathologic alterations found in those different joint systems were essentially the same in character . In the early stage of infection, phlegmon-like inflammation was observed in the periarticular loose connective tissue . Abundant fine Gram-positive bacilli were free in inflamed edematous tissue . Then, active serofibrinous exudation and emigration of leukocytes occurred in the synovial membrane, articular cartilage, annulus fibrosus, and nucleus pulposus with the development of the disease . These exudative changes disappeared gradually . Instead of them, proliferation of synovial cells accompanied by dense infiltration with lymphocytes and plasma cells became conspicuous . At the same time, chondro- and osteoclastic activity occurred in the joints of the extremities or regions adjacent to the intervertebral disk . Capsular and subchondral pannus often resulted from an excessive proliferation of granulation tissue . In the late stage, they synovial membrane and granulation tissue underwent fibrosis, adhesion and ossification . Finally, these changes resulted in fibrous or bony ankylosis and deformation . Gram-positive bacilli were hardly detected in histological preparations derived from animals in the chronic stage when proliferative change was predominant in the articular lesions. Scand J Infect Dis, 1975, 7(1), 29 - 33 Bacteremia: the significance of outside versus inside hospital origin; Skansberg P et al.; 168 patients with bacteremia seen in 1965-1969 were studied with regard to mortality rate, age and sex distribution, sources of infection, predisposing factors and infecting organisms . Special attention was drawn to outside hospital originating bacteremia vis-a-vis hospital-acquired bacteremia . In general, the results obtained were essentially in agreement with earlier experiences elsewhere . The most striking observations were, firstly, the grave prognosis associated with hospital-acquired bacteremia and, secondly, the dominant role played by gram-negative bacilli. Can J Otolaryngol, 1975, 4(1), 168 - 76 Laryngeal tuberculosis in an age of chemotherapy; Brodovsky DM; Twenty-one cases of laryngeal tuberculosis were found while surveying 1,383 patients with pulmonary tuberculosis, giving an incidence of 1.5 per cent . All had abnormal chest films and tubercle bacilli in their sputum . Symptoms were variable . Patients with pain were relieved within seven days of triple therapy . All but one patient's laryngeal appearance was normal after two months' therapy. Scand J Immunol, 1975, 4(7), 735 - 40 Experimental murine leprosy . IX . Antibodies against Mycobacterium lepraemurium in C3H and C57BL mice with murine leprosy and in patients with lepromatous leprosy; Closs O et al.; Sera from C3H and C57BL mice infected with Mycobacterium lepraemurium (MLM) and from human leprosy patients were examined for antibodies against MLM by a crossed immunoelectrophoresis (CIE) technique . Altogether antibodies against six or seven MLM antigens were found in the mouse sera . After a small inoculum of MLM, C3H mice produced more antibodies than C57BL mice . After a large inoculum both strains produced about the same amount of antibodies but showed qualitative differences in their response patterns . A serum pool from patients with lepromatous leprosy contained antibodies against six MLM antigens; five of these were identical with the antigens against which antibodies were found in infected mice . C57BL mice that had lost their delayed-type hypersensitivity to MLM during the course of a disseminated infection showed a fairly strong antibody response to three antigens and a weak response to three others . Since almost the same spectrum of antibodies, although in lower titres, could be demonstrated in C57BL mice with intact delayed-type hypersensitivity to the bacilli, these antibodies did not seem to interfere with the expression of cell-mediated immunity. Pathol Microbiol (Basel), 1975, 42(2), 103 - 9 Peripheral nervous system involvement in experimental tuberculosis; Mauss H; Following intravenous injection of mycobacteria in the mouse the bacilli are regularly found in the peripheral nervous system after the 5th day . The peripheral nerves and autonomic ganglia are involved at the level of the perineural cells and the sheath of Schwann . When the organisms are of low virulence (BCG, Mycobacterium intracellulare) the development of the nodules is limited . In the case of a virulent strain (Ravenel) extensive granulomas are found but epitheloid cells, always found in other organs, are constantly absent . In animals previously immunized, the bacilli seem to implant themselves as in the controls, but multiply more slowly; the nodules are more infrequent and the lymphoid infiltration appears earlier with the multiplication of interstitial cells. Microbios, 1975, 12(47-48), 41 - 50 Cytochrome pigments in Mycobacterium leprae isolated from armadillos (Dasypus novemcinctus L.); Kato L et al.; The bacilli were isolated from granulomata harvested from armadillos . Cytochrome systems in whole cell suspensions as well as in cell-free extracts were examined spectrophotometrically . The intact cells contained cytochromes of the a+b3, b and c type which were found to be present mainly in the reduced form . The cytochrome systems in cell-free extracts of M . leprae were in the oxidized form but contained the same type of cytochromes as the intact bacteria . The presence of cytochromes was easily detectable in the anaerobically-reduced (no substrate added) as well as in the dithionite- or succinate-reduced minus O2-oxidized difference spectra . The dithionite-reduced plus CO minus reduced difference spectra exhibited cytochromes a3 and o monoxide binding pigments. Int J Lepr Other Mycobact Dis, 1975 Jan-Mar, 43(1), 55 - 7 A comparative evaluation of bacteriologic and morphologic indices of Mycobacterium leprae in skin, lymph node, bone marrow, nerve and muscle; Kaur S et al.; This study elicits the comparative evaluation of the Bacteriologic Index (BI) and Morphologic Index (MI) of the skin, lymph node, bone marrow, nerve and muscle tissues of 15 untreated leprosy patients . The findings of comparable or even higher BI's and MI's in lymph nodes than skin are of considerable interest, especially the presence of a significant percentage of viable bacilli during reaction states when MI of skin and nerve tissue was found to be negative . Evaluation of the BI's and MI's of lymph nodes has been suggested to be of utmost importance for follow-up studies of patients being treated with antileprosy drugs. Int J Lepr Other Mycobact Dis, 1975 Jan-Mar, 43(1), 16 - 20 Separation of Mycobacterium lepraemurium from the subcutaneous tissues of the rat; Kato L et al.; In an effort to obtain cell suspensions free from blood cells which interfere in spectrophotometric studies, a method was devised by which relatively large quantities of whole cell suspensions of M . lepraemurium are obtained for experimental purposes . We have routinely employed this procedure which is quite reliable, technically simple, moderate in equipment requirements, and in a matter of five minutes it can be ascertained whether or not the preparations are free from contaminants which render the purified bacillary suspensions unsuitable for studies involving spectrophotometric technics . However, in this procedure, certain points are essential in order to obtain large quantities of purified bacillary suspensions . It is important to homogenize the lepromata for only a few seconds at brief intervals . Excessive homogenization may cause considerable damage to the bacilli and it may be difficult to separate the bacilli from the host tissues . It is also important to use transparent bottles and tubes during centrifugation as the material can be seen and thus each fraction can be separated easily . Very few bacilli are lost in the discarded material and we have repeatedly obtained 2.5 to 3 gm wet weight of M . lepraemurium from one leproma weighing 25 gm to 30 gm. Int J Lepr Other Mycobact Dis, 1975 Jan-Mar, 43(1), 1 - 13 Acid mucopolysaccharide metabolism in leprosy . 3 . Hyaluronic acid mycobacterial growth enhancement, and growth suppression by saccharic acid and vitamin C as inhibitors of beta-glucuronidase; Matsuo E et al.; A series of pilot studies are presented utilizing mouse and human infections with M . leprae and mouse infections with M . lepraemurium relating to the previously reported finding that hyaluronic acid seems to be a major nutrient substrate for these bacilli . The "feeding" of hyaluronic acid to the bacilli enhanced the growth of M . leprae in mouse abdominal walls and increased the Morphologic Index of M . lepraemurium infection . Saccharic acid, an inhibitor of beta-glucuronidase previously reported as present in these leprosy bacilli, caused marked regression of advanced M . lepraemurium infection, inhii . Ascorbic acid (vitamin C), also an inhibitor of beta-glucuronidase, given at a level of 1.5 gm/day for 4.5 months to one lepromatous patient without other treatment and for up to 24 months to four other lepromatous patients receiving DDS, was accompanied by lesion regression and changes in bacillary morphology similar to those seen in the inhibitor treated mice . If these observations are confirmed the possible use of beta-glucuronidase inhibitors as a useful adjunct to other leprosy therapy is raised as is also the likelihood of developing new therapies. J Hyg Epidemiol Microbiol Immunol, 1975, 19(1), 126 - 34 New concepts on tetanus immunization: naturally acquired immunity; Veronesi R et al.; Comments were made on misinterpretations concerning the natural resistance and natural immunization against tetanus . Arguments were given explaining why the disease itself did not determine adequate immunity . When, however, adequate conditions appear, tetanus toxin is known to stimulate the immune system and produce detectable humoral antibodies . Various possibilities resulting from the postulated harboring of tetanus bacilli by the human body and their eventual toxin production were analyzed and related to the human tetanus pathology . The existence of natural immunization was unquestionably demonstrated by presence of protective levels of tetanus antitoxin in the blood of the majority of 59 surveyed subjects considering that none of them had ever received any tetanus toxoid and most of them never received a single shot of any drug . The results of this survey originated a few arguments that may support the answer to some still intriguing phenomenona such as: 1 . The relatively small number of cases of overt disease among people and animals born and living in large tetanus-risk regions all over the world . 2 . The existence of "poor responders" and "good responders" to the primary tetanus toxoid stimulus . 3 . The age distribution of tetanus showing evident prevalence among newborns and children . 4 . The wide individual variations in the clinical picture of human tetanus as indicated by the localization and limitation of the symptoms and their severity. Am J Hosp Pharm, 1975 Jan, 32(1), 35 - 44 Chemotherapy of infections in cancer patients: a review; Sim SK; The factors altering host-defense mechanisms and the nature and significance of the resultant infections in cancer patients by a wide variety of invasive organisms are described . The principle and method of selection of antimicrobial agents as therapy in initial empiric treatment of presumed infection in febrile cancer patients, as well as therapeutic agents fothe therapy of infections by specfic organisms, are discussed . Special emphasis is placed on the more recently developed agents for the therapy of infections by Pseudomonas and other gram-negative bacilli. Acta Pathol Microbiol Scand {A}, 1975 Jan, 83(1), 59 - 68 Experimental murine leprosy . 4 . The gross appearance and microscopic features of the local infiltrate after subcutaneous inoculation of C3H and C57/BL mice with mycobacterium lepraemurium; Closs O et al.; Mice with the inbred strains C57/BL and C3H were inoculated subcutaneously on the thorax with M . lepraemurium . In C57/BL mice a firm, raised, sharply defined nodular infiltrate developed 4 weeks afterwards, while in the C3H strain of the infection produced a soft, flattened infiltrate with ill-defined margins, which did not become palpable until 10 weeks after inoculation . A limited spread of the infection occurred early in both strains, but apparently multiplication of the microorganisms was very restricted in C57/BL mice; progressive, disseminated growth of the bacilli was observed in the C3H strain only . In C57/BL mice the granulomatous reaction, developing 4 weeks after inoculation and leading to abcess formation, ulceration and scar formation, apparently inhibited both local multiplication and further spread of the bacilli . In C3H mice no host reaction was detected and the bacilli appeared to grow unrestrictedly . In some C57/BL animals, decrease in host resistance occurred during the infection, causing reactivation of the local lesion and an apparently rapid proliferation of bacilli . Observations regarding the lesions in superinfected animals indicated that a systemic immune reaction develops in the C57/BL strain about 4 weeks after inoculation, whereas this does not occur in the C3H strain. J Immunol, 1975 Jan, 114(1 Pt 2), 354 - 9 Migration inhibitory factor and type II interferon in the circulation of mice sensitized with mycobacterial components; Salvin SB et al.; Migration inhibitory factor (MIF) and type II interferon were released into the circulation after mice had been sensitized i.v . with a bacillus of Calmette and Guerin (BCG) cell-wall-in-oil vaccine and then challenged four weeks later with 50 mg old tuberculin . At least two components of BCG, protein (PPD) and lipid (P-3), have been identified which are essential for the type of sensitization in which mediators are released after appropriate challenge . The route of sensitization had a marked effect on the development of delayed footpad reactions, release of lymphokines, and resistance to infection with virulent tubercle bacilli . Sensitization by the subcutaneous route tended to induce more pronounced delayed footpad reactions, whereas the i.v . route of sensitization was associated with maximum release of mediators . A close correlation existed between the conditions of sensitization that resulted in maximum production of lymphokines (MIF and Type II interferon) and those that caused protection against aerosol challenge with a virulent strain of Mycobacterium tuberculosis. Infect Immun, 1975 Jan, 11(1), 57 - 64 Growth of mycobacterium bovis (BCG) in T lymphocyte-depleted mice; Collins FM et al.; BCG Montreal (10-6 viable bacilli) injected intravenously into adult thymectomized, irradiated, and bone marrow-reconstituted (THXB) C57Bl times C3H F1 hybrid mice induced a progressive systemic infection which killed 95% of the animals within 60 days . Control mice infected with this dose of BCG did not die . The infected THXB mice failed to develop detectable levels of tuberculin hypersensitivity although they did show considerable Arthus (3 h) reactivity . The BCG-infected THXB mice lost weight progressively, and the root spleen and root lung indices increased substantially as the infection proceeded . None of the THXB mice developed an antibacterial immune response to the systemic BCG infection, and this was reflected by the continued persistence of macroscopic lung granuloma in these animals . The BCG-infected control mice developed as many surface tubercles as did the THXB animals, but the granulomas rapidly regressed in size and numbers in the normal mice . The lung changes correlated with the amount of tritiated thymidine incorporated by the lung cells in the later stages of the BCG infection . T cell depletion depressed the early splenic peak normally seen in BCG-infected controls, but, on the other hand, there was a progressive increase in lung counts in the THXB mice as the infection progressed and this late peak was not seen in the control animals . The significance of these findings is discussed in relation to the development of antituberculous immunity by BCG-infected mice. Vet Med Nauki, 1975, 12(8), 82 - 8 {Differentiation in culture of Bacillus species isolated from semicanned meat}; Petrova L; Studied were the cultural, morphological, and biochemical properties of a total of 50 strains of aerobic spore-producing organisms of group I of the genus, Bacillus isolated from semicanned meat . Comparative investigations were carried out following four procedures (5, 7, 8, 14) . Fifty per cent of the bacilli studied were determined as Bac . licheniformis, 26 per cent -- as Bac . subtilis, 20 per cent -- as Bac . pumilus, and 4 per cent -- as Bac . cereus . Data showed that the results obtained can serve to work out a schematic pattern for the quick differentiation of bacilli. Int Arch Allergy Appl Immunol, 1975, 49(5), 585 - 96 Skin reaction, inhibition of macrophage migration, and lymphocyte transformation with tuberculin active peptide (TAP) and arabinogalactan obtained from tubercle bacilli; Niinaka T et al.; Arabinogalactan purified from heat-killed tubercle bacilli failed to elicit a delayed type of skin reaction and had no ability to induce in vitro lymphocyte blast formation in sensitized guinea pigs . It was, however, inhibitory to migration of bronchoalveolar washing cells by the indirect test, but not by the direct test, and capable of eliciting an immediate type of skin reaction and anaphylaxis when injected into sensitized guinea pigs . Tuberculin active peptide (TAP) was active in all of in vitro and in vivo cell-mediated immune responses, but not in immediate responses. Dev Biol Stand, 1975, 29, 331 - 8 {Comparative dose-effect relationship of a tuberculin standard on guinea pig sensitivity, using living and dead tuberculosis bacilli}; Augier J et al.; The sensitization of guinea pigs utilized for tuberculin titration may be obtained by a BCG primo-vaccination followed by an inoculation of live, virulent Myc . tuberculosis . This method, which results in a sub-evolutive form of tuberculosis, gives a satisfactory sensitization level but has the disadvantage of utilizing animals which are germ carriers and therefore dangerous . A method has been tested employing killed germs (Jamaica strain) coated with Freund's complete adjuvant H37Ra which utilizes animals presenting no danger in handling . The results of 105 titrations made on 453 guinea pigs during two years show that the reactions obtained are clear, easy to read and remain stable over a long period (F equals 0.1) . The comparison of values thus obtained shows that in the case of killed bacilli in relation to live bacilli: the mean dimensions of the reaction with 5, 10 and 20 IU are significantly more important (P is less than 0.0001) and the dose-response slope is significantly steeper (P is less than 0.01) which offers more precise results . Sensitization by killed germs therefore offers the double advantage of handling non-dangerous animals and obtaining results which are more precise and easier to read. Int Arch Allergy Appl Immunol, 1975, 48(5), 680 - 90 Effect of T-cell depletion on the growth of BCG in the mouse footpad; Collins FM et al.; The growth of Mycobacterium bovis (BCG Montreal) and M . tuberculosis Erdman was determined in normal and T-cell depleted (THXB) mice when injected subcutaneously into a hind footpad . The bacilli multiplied only to a limited extent within the footpad itself but the infection quickly spread to the draining popliteal lymph node to eventually reach the liver, spleen and lung . The amount of systemic growth seen in the THXB mice was 10-100 times greater than in the normal controls, all of which developed a tuberculin hypersensitivity and an immune response in 14-18 days . T-cell depletion completely inhibited the expression of tuberculin sensitivity by the infected host as well as ablating the antituberculous response against both the vaccinating BCG population and a superinfecting Erdman challenge inoculum . Incorporation studies in the THXB mice indicated a striking reduction in cell division within the draining lymph node but there was an unexpected elevation in the level of incorporation by the lung cells as the BCG infection progressed . The significance of these findings is discussed in relation to the possible use of the BCG footpad model for studies of leprosy immunity. Am J Med Technol, 1975 Jan, 41(1), 30 - 2 Use of Tergitol-7 agar in the clinical laboratory; Alexander J et al.; Tergitol-7 agar has been utilized in the author's laboratory for eight years and has been found the superior medium for the rapid isolation, separation and identification of gram negative bacilli found in a clinical setting. Immunol Commun, 1975, 4(6), 565 - 77 Mitogenic and adjuvant activity of a methanol extraction residue (MER) of tubercle bacilli on mouse lymphoid cells in vitro; Ben-Efraim S et al.; The mitogenic and adjuvant effect in vitro of MER (methanol extracted residue of tubercle bacilli), on Balb/C and nu/nu immunocompetent cells was examined and compared with the effect of PPD, LPS, DS, PHA and ConA . MER activated DNA synthesis in spleen cells of Balb/C and nu/nu mice and in blood cultures of Balb/C . The stimulation of DNA synthesis by MER in spleen cells was not macrophage dependent . Bone marrow and 1ymph node cells were slightly stimulated while thymus cells were not affected . Both MER and PPD enhanced the in vitro immune response of Balb/C mice to SRBC and to TNP (trinitrophenyl) hapten . MER, LPS and PPD enhanced the immune response of nude spleen cells to SRBC in vitro. J Clin Microbiol, 1975 Jan, 1(1), 30 - 6 Practical aerobic membrane filtration blood culture technique: development of procedure; Sullivan NM et al.; The advantages of a membrane filter system for blood culturing have been realized for many years . Lysing of the blood prior to filtration is a convenient way to proceed, but previously described lysing procedures result in loss of certain organisms, particularly gram-negative bacilli . Four concentrations of Triton X-100 and sodium carbonate were studied in vitro, and their lysing and antibacterial properties were observed . A solution of 0.08% Na2CO3 and 0.005% Triton X-100 was found to have the least antibacterial effect and gave consistently good lysis and filtration times (under 3 min) . An 8.3-ml amount of blood added to 190 ml of this concentration of lysing solution, filtered through three 47-mm membrane filters (0.45-mum pore size), led to recovery of 85% or more of various aerobic and facultative organisms in studies of artificially seeded blood. Rev Ig Bacteriol Virusol Parazitol Epidemiol Pneumoftiziol Pneumoftiziol, 1975 Jan-Mar, 24(1), 23 - 8 {Circumstances concerning the diagnosis of tuberculosis in a pneumology department}; Untearu G et al.; The analysis of a group of 67 patients hospitalized for various bronchopneumopathies, in whom evidencing of the tuberculosis bacilli led to the diagnosis of pulmonary tuberculosis allows to emphasize the increased efficiency of bacteriological detection by repeated bacilloscopy and successive cultures . They also stress the necessity of increased attention for pneumopathies that develop over the age of 50 years . The frequency of errors, predominantly stemming from the base network (territorial polyclinics), most of the confusion being made with suppurative broncho-pneumopathies, makes necessary the dispensarization of this category of patients in antituberculous units . The 56 new cases and the 11 cases in whom re-positivation was detected illustrate the possibilities of the bacteriological diagnosis and the contribution of a section of pneumology in the detection of pulmonary tuberculosis. Microbios, 1975, 12(49), 119 - 24 Uptake of radioactive DOPA by Mycobacterium leprae in vitro; Harris EB et al.; Our previous studies demonstrated that Mycobacterium leprae contains a characteristic o-diphenoloxidase which converts a variety of phenolic compounds to quinones in vitro . This enzyme was not present in any other mycobacteria tested . The results reported here deal with the uptake and binding of radioactive DOPA by M . leprae . The leprosy bacilli incubated with tritium-labelled DOPA, readily took up the substrate . The binding of DOPA by the bacilli was markedly inhibited by diethyldithiocarbamate . The organisms also bound tritiated norepinephrine . Mycobacterium phlei which does not oxidize phenolic substrates failed to bind DOPA . Cultures of melanocytes which contain o-diphenoloxidase took up tritiated DOPA . Catecholamine metabolism is known to be important in myocardial cells . Cultures of turtle-heart cells did not oxidize DOPA to quinone; however, these cells bound the labelled substrate . A cell line of fibroblasts derived from armadillo skin neither oxidized nor took up DOPA . The results indicate that, like melanocytes and turtle-heart cells, M . leprae probably possesses specific receptor sites for the binding and subsequent metabolism of phenolic substrates. Contemp Neurol Ser, 1975, 12, 17 - 28 Leprosy--histopathologic aspects of nerve involvement; Weddell GM et al.; The most striking single feature of the clinical manifestations of leprosy is the very wide range of appearances shown by the skin lesions . These include the vague, hypopigmented macules of indeterminate leprosy; the large, sharply defined hypopigmented anaesthetic lesions of tuberculoid leprosy; the nodules and diffuse infiltration of lepromatous leprosy; and a wide range of plaques and annular lesions of the intermediate (borderline or dimorphous) types of disease . From superficial appearances it would be impossible to say that these were manifestations of the same infection . Moreover, histologically there is a similar wide range of appearances, including minimal lymphocyte infiltration around the neurovascular bundles in indeterminate leprosy; epithelioid granulomata with Langhans' giant cells and virtually no bacilli to be seen in tuberculoid cases; and in lepromatous leprosy, histiocytic infiltration occupying the whole thickness of the dermis, with massive parasitisation by Mycobacterium leprae, of which there may be up to 10-9 per gram of tissue . Strain differences have been recognised, but appear not to be responsible for this remarkable range of manifestations; they are caused by variations in the soil, not in the seed . Leprosy is almost unique among infectious diseases in the importance that host factors play in its development . The different clinical appearances shown by different types of leprosy can be graded into a continuous series, forming a spectrum from the single or scanty lesions of tuberculoid leprosy to the total body involvement o lepromatous; and the patient with leprosy can indeed truly be said to wear his skin lesions like medals displaying his capacity to resist Myco . leprate . The histopathologic features of the developed disease have a similar spectrum, from an epithelioid granuloma to infiltration with histiocytes that are full of bacilli and are ultimately converted to foam cells (Virchow cells)... Int Arch Allergy Appl Immunol, 1975, 48(1), 11 - 5 Further studies on the inheritance of responsiveness to pertussis HSF in mice; Ovary Z et al.; Inheritance of responsiveness to histamine-sensitizing factor of pertussis bacilli (HSF) was investigated in (C3H/HeJ times C57BL/6J)F1 hybrids, backcross progeny of this hybrid to C57BJ/6J parent (C3H/HeJ times DBA/2J)F1 hybrids, and in backcross progeny of this hybrid to DBA/2J parent . It was found that transmission is not by virtue of a single autosomal dominant gene, as has been postulated . Rather, inheritance of responsiveness to HSF is far more complex, probably involving polygenic transmission. Int J Lepr Other Mycobact Dis, 1975 Jan-Mar, 43(1), 32 - 5 Innervation of muscle in leprosy with special reference to the muscle spindle; Pandya SS et al.; The pattern of extrafusal and intrafusal innervation was studied in muscle biopsies from the flexor carpi ulnaris and biceps brachii muscles, which were clinically unimpaired . Smudginess and enlargement of the motor end plates were the most definitely abnormal feature of the extrafusal innervation pattern; the intrafusal fibers, on the other hand, were either unremarkable or showed increased tortuosity, beading and in more extreme cases of grossly complicated intertwining pattern . Bacilli were frequently found in the spindles, no component being spared . The study emphasizes the significant involvement of striated muscle in leprosy, a fact not revealed by clinical examination alone. Acta Derm Venereol, 1975, 55(2), 141 - 5 A case of pigmentary hair naevus (Becker); Svindland HB et al.; A healthy 14-year-old Norwegian male developed a typical Becker's naevus on the left shoulder and upper scapular region, about six months after an intracutaneous BCG-vaccination in the homolateral junction of the shoulder and upper arm . The evolution of the lesion had been modified by exposure to sunlight during the following six years, with partial fading of the hyperpigmentation . Biopsies taken from the centre and from the edge of the lesion at the age of 19 years showed the usual histological picture seen in cases of Becker's naevus, but focal areas within the periphery showed a chronic granulomatous infiltrate of lupoid pattern in the dermis, mainly follicular and perifollicular in distribution . Acid-fast bacilli were not demonstrable in the sections, and in culture no tubercle bacilli were isolated from a central and histologically non-specific site . The implications of the histological findings are discussed, stressing the possibility that Becker's naevus may be a form of cutaneous tuberculosis caused by BCG or other mycobacteria of low virulence, precipitated by ultraviolet light and possibly modified by immunological factors. Int J Lepr Other Mycobact Dis, 1974 Oct-Dec, 42(4), 399 - 411 Acid mucopolysaccharide metabolism in leprosy . 2 . Subcellular localization of hyaluronic acid and beta-glucuronidase in leprous infiltrates suggestive of a host-Mycobacterium leprae metabolic relationship; Matsuo E et al.; Electron- and light microscopic analyses were conducted on leprosy skin biopsies relative to the origin of hyaluronic acid, which has previously been observed to be distributed inversely in ratio to the degree of cell- mediated immunity . The present study investigated the subcellular localization of hyaluronic acid and its degrading enzyme in various types of leprosy . Hyaluronic acid in some lepromatous leprosy cases was shown to be accumulated in the limiting membranes of the phagosomes of lepra cells and Myco-bacteria leprae have beta-glucuronidase which plays a role in the degradation of hyaluronic acid . Contrariwise, in tuberculoid leprosy, beta-glucuronidase was detected in the lysosomes of epithelioid cells and giant cells . This result suggests that the origin of hyaluronic acid is in histiocytes and at the same time it might suggest that M . leprae is in competition with enzymes of epithelioid cells for hyaluronic acid, whereas reduced or absent beta-glucuronidase in lepra cells enable bacilli to utilize the AMPS as a nutrient. Am J Obstet Gynecol, 1972 Jul 15, 113(6), 789 - 92 The Budd-Chiari syndrome after pregnancy . Report of two cases and a review of the literature; Rosenthal T et al.; PIP: The authors emphasize that the association of Budd-Chiari syndrome with pregnancy has not been previously stressed in reports . The 2 cases reported followed at 3-month and 2-month intervals after delivery . Symptoms in each began with acute abdominal pain followed by distention . Livers were found to be markedly enlarged and ascites was present . Ascitic fluid contained no malignant cells or tubercle bacilli . Inferior venography showed changes in the veins in the liver and vicinity characteristic of the Budd-Chiari syndrome . Liver biopsies showed congestion only . These findings are considered to be caused by thrombotic obstruction of some of the veins and narrowing of others . Hypercoagulability of the blood plays an important role . This can occur in pregnancy and in women using oral contraceptives . During the past 2 years 8 cases of this syndrome have been described by others as occurring in young women taking oral contraceptives . A redisposing factor in the authors' cases may have been rheumatic fever in childhood which so damaged the venous endothelium as to favor later thrombosis . A reveiw of the literature reveals several cases of Budd-Chiari syndrome occurring shortly after delivery . Even in cases where the syndrome appeared a number of months after delivery, the 2 events seem related . It is interesting to note that in Chiari's original description the ascites appeared 5 months after delivery . Acta Cytol, 1970 May, 14(5), 239 - 42 Herpes genitalis in women attending Planned Parenthood of New York City; Wolinska WH et al.; PIP: A search for cytologic evidence of herpes genitalis in women attending centers of Planned Parenthood of New York City was undertaken to determine whether the choice of contraceptives could be playing a meaningful role in the transmission or manifestation of this disease . The study covered 2 1/2 years with correlated clinical data about contraceptives used . Cervical and vagina; cytology specimons were collected routinely at least once yearly . The affected cells are readily recognized in Papanicolaou stained specimens and have a high degree of diagnostic specificity . The disease is transmitted by direct conjugal contact . In some women it its affected by the menstrual cycle suggesting that hormonal factors have an influences . About 67,000 cytology specimens from 43,331 women were studied . Among these were 37 women with cytologic evidence of herpes (.09%) . Those who were most likely to have the disease were young, had few or no children and a low family income . Trichomonas vaginalis was also found in 25 of the women with herpes and monilia in 2 . The bacterial flora was mixed without Doderlein bacilli in most of the cases of herpes . Almost all the cases of herpes were discovered in the spring or early summer . Little difference was found between the women using different forms of contraceptive . The women using no contraceptives had a much higher rate of herpes (.3%) than any other group . There was no example of herpes in women with cervical cancer or carcinoma in situ . 2 had dysplasia before herpes was found but both had been treated and had no evidence of the previous dysplasia . It seems clear that the use of contraceptives does not add to the risk of herpes genitalis and may in some way lessen the risk . These data are within the range of reported cases from comparable clinics elsewhere .
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