Radiological case of the month. Congenital pyloric atresia in Down syndrome.
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Biomedical subjects
Publications and source records attributed to S B Patel.
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Pulmonary lesions following paraquat poisoning are believed to be almost invariably fatal. The three patients reports here survived despite persistent radiological change. One of the patients died after taking a larger dose of paraquat one year later, and at necropsy histological changes attributable to the two episodes of paraquat poisoning were apparent.
Clostridia rarely cause pleuropulmonary infections in the absence of trauma. We report a case of intermittent bowel obstruction, clostridial bacteraemia and pneumonia with a fatal outcome. Only 16 cases have previously been reported. Clostridial infection of the lung has many features of an acute pneumonia and is almost always associated with a pleural effusion. Most cases are caused by Clostridium perfringens, though infections with other species have been reported. The prognosis is generally more favourable than in clostridial infection secondary to aspiration pneumonia or complicating empyema.
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This paper presents a brief review of markers and their potential uses in the study and treatment of affective illness. Some of these include the use of markers as aids in: diagnosis, selection of medication, prediction of relapse, and prediction of suicide. The use of combinations of markers to improve accuracy and the use of markers during the well-state will be discussed. A review of the literature suggests some promising candidates as markers of affective illness including the serotonin metabolite, 5 HIAA; 3H-imipramine platelet binding; REM induction using M-1 muscarinic agonists; and melatonin. Finally, a strategy using gene mapping techniques as a possible method of detecting additional markers is presented.
Nuclear DNA is probably organized into loops by attachment to a sub-structure in vivo. When HeLa cells are lysed in Triton and 2M NaCl the resulting nucleoids contain naked DNA which is supercoiled so the loops must remain intact. We have attempted to identify sequences responsible for attaching these loops to the nuclear sub-structure by progressively detaching DNA with various nucleases. Fragments at the 5' end of the ribosomal RNA locus, and a variety of transcribed and repeated sequences, are shown to lie relatively close to attachment points. This implies that sequences cannot be arranged randomly. However no "attachment sequence" could be identified.
A method using crude cellular mixtures is described which permits identification of polypeptides and DNA fragments forming specific complexes. Our procedure incorporates elements of both 'Southern' and 'protein' blotting and combines, in two dimensions, the resolving power of a denaturing protein gel with that of an agarose DNA gel. Conditions for 'crossing' have been established using the lambda repressor-operator system: the specific complex can be detected by crossing total protein from bacteria overproducing the repressor with a mixture of total genomic fragments from a lysogen.
One hundred and sixty-eight patients with rheumatoid arthritis (RA) and 87 patients with degenerative arthritis (osteoarthritis, OA) were questioned regarding appendicectomy and tonsillectomy surgery. Thirty point four % of patients with RA and 33.3% of those with OA had had a tonsillectomy preceding the onset of their arthritis. Preceding appendicectomy had been performed in 18.5% of RA and 32.2% of OA patients. These results do not support the hypothesis either of inherent or acquired susceptibility to infection in patients with RA.
Twenty-eight patients with acute non-lymphoblastic leukemia (ANLL) were started on induction chemotherapy consisting of Cytosine Arbinoside (Ara C) and 6 thioguanine (TG). Daunorubicin (DNR) was used selectively in 20 of 28 patients who failed to respond by day 14 to the Ara C and TG combination. Seven patients, or 25%, achieved complete remission (CR) without requiring DNR during remission induction. The overall response rate was 89% (64% CR and 25% PR). The median duration of survival for the CR group was 578 days. 189 days for the partial remission (PR) group (P = .02). Patients in the age groups of 18--40 years and with acute myelomonocytic leukemia subtype had the best response rate. There was no difference in the survival of the DNR treated group of complete responders as compared to DNR non-treated group. These results suggest that even though the majority of patients do require DNR for the remission induction, a significant number, perhaps as high as 25% of previously untreated patients, will achieve remission without the use of DNR. A significant minority of patients, therefore, be spared the toxicity of DNR early in the course of their disease.
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Quantitative and qualitative electron microscopic studies were performed on the mitochondria of leukemic myeloblasts in 3 patients with myeloblastic leukemia and in 3 patients with myelomonoblastic leukemia. In addition, to confirm the presence of virus-like particles within mitochondria and better understand the interaction between the virus and mitochondrion, a rat embryo tissue culture infected with MSV-MLV (Moloney sarcoma virus-Moloney leukemia virus) was selected for detailed electron microscopic examination. Significant quantitative differences between normal and leukemic human mitochondria were not observed. However, qualitative abnormalities were found in the human leukemic mitochondria and in the tissue culture material. These abnormalities included variable forms of the leukemic mitochondria (twisted, tear-drop and irregular shapes), fewer cristae, disrupted mitochondria with virus-like particles, smaller granules in greater abundance, mitochondrial DNA, and contact between the mitochondrion and the nucleus. The tissue culture material revealed similar changes, but showed more virus particles which were located outside the cells, in intracytoplasmic sacs and within the mitochondria. In addition two striking features were observed in the tissue culture material not seen in the human material: a) Budding from the outer mitochondrial membrane into the mitochondrial matrix and b) virus particles attached to the cristae. Since mitochondria are important organelles in the glycolytic-oxidative phosphorylation pathways, perhaps all of us engaged in cancer research should take a closer look at the Warburg effect and carefully consider extranuclear factors operating in oncogenesis.
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Quantitative and qualitative electron microscopic studies were performed on the leukemic cells of 3 patients with stem cell leukemia, 6 patients with acute lymphoblastic leukemia, 7 patients with acute monoblastic leukemia, 3 patients with acute myeloblastic leukemia and 7 patients with acute monomyeloblastic leukemia. Significant quantitative differences were noted between some of the leukemic cells in heterochromatin:euchromatin ratios, cell size, granules per cell, amount of endoplasmic reticulum and the number of polyribosomes. Qualitative abnormalities which were found in some cells of all the leukemic groups were observed. These abnormalities included nuclear pockets, deep nuclear indentations (usually not the stem cell), nucleosomes, dilated perinuclear spaces, centrioles located in nuclear pockets (not in the stem cell or lymphoblast), accumulation of microfibrils (greatest in the monoblast and myeloblast), disrupted mitochondria with virus-like particles (none in stem cells), smaller granules and mitochondrial DNA, glycogen, and myelin whorls. The presence of the smaller granules in disrupted mitochondria and the resulting clear areas is probably related to the deranged carbohydrate metabolism of these cells. The presence of virus-like particles within mitochondria may be extremely important, but requires much more investigation. Some of the above findings may offer clues to further investigation of the acute leukemic cell.
BACKGROUND: Most studies on knowledge, attitude and practice regarding contraceptives have been conducted in rural areas and urban slums. In this study, a mixed urban population was surveyed. SUBJECTS: Two thousand parous women from different social and educational backgrounds residing in the metropolis of Mumbai (Bombay), Maharashtra were included in the study. RESULTS: Fifty per cent of illiterates, semi-literates and highschool educated, and 80% of college-educated couples said that they had no gender preferences for their children, but actual practice belied this. Regardless of the level of education, 25%, 75% and 95% of all couples were sexually active by 6 weeks, 3 months and 6 months after childbirth. Awareness regarding the availability of various contraceptives increased with education; 20% of all graduate couples used condoms or the rhythm method immediately after marriage. After the birth of their first child, 80% of educated couples used spacing methods whereas even after the birth of their third child more than 50% of the uneducated did not. The major complaint of the intrauterine device users was menorrhagia and abdominal pain, while that of pill users was nausea, giddiness and headache. Spacing methods were popular among the educated, and terminal ones among the uneducated. Steroidal contraceptive pills were not popular with any group, regardless of the level of education. CONCLUSION: Education was the main variable in the decisions regarding the family size, spacing interval, contraceptive awareness, its use immediately after marriage and during the postpartum period.