Neurofibrosarcoma following radiotherapy for ankylosing spondylitis

Twenty-six years after radiotherapy to the spine for ankylosing spondylitis a patient developed a neurofibrosarcoma initially around the left sacroiliac joint. It is likely that this was a long-term complication of the radiotherapy.

Double-stranded RNA antibodies in systemic lupus erythematosus

Antibodies to viral double-stranded RNA (ds RNA) have been found in 40% of patients with systemic lupus erythematosus (SLE) and 14-5% of patients with rheumatoid arthritis. These antibodies were diagnostically more specific SLE than those directed against artificial polynucleotides, poly I:C and poly A:U. Although not disease specific, high titres of antibody to ds viral RNA were found almost exclusively in SLE. Serial studies failed to show that RNA antibody levels correlated with disease activity. Although of considerable interest in experimental studies on the pathogenesis of SLE, ds viral RNA antibodies are of little clinical significance in the management of SLE.

Antibodies to double-stranded (native) DNA in active chronic hepatitis

Sera from 36 patients with active chronic hepatitis were studied for the presence of antibodies to double-stranded (native) DNA. These antibodies are a specific antinuclear antibody previously shown to have a high degree of specificity for systemic lupus erythematosus. Fifteen of the 36 patients (42%) were found to have levels of antibody usually only reported in systemic lupus erythematosus and higher than those seen in a control population. Anti-DNA antibodies were not found in a group of 22 patients with other forms of liver disease.

Studies on the control of antibody synthesis. IX. Effect of boosting on antibody affinity

The effect of boosting on antibody affinity was studied in a haptenic system. Generally, boosting results in the prompt synthesis of high affinity anti-hapten antibody. However, repeated boosting frequently leads to a decrease in the amount and affinity of the serum antibody. Repeated boosting with hapten on a carrier different from that used for priming selectively stimulates synthesis of the highest affinity anti-hapten antibody and does not result in a decrease in affinity. Priming with soluble antigen without adjuvants results in the synthesis of low affinity antibody. After such priming, boosting stimulates low affinity antibody synthesis and repeated boosting leads to a moderate increase in antibody affinity.

Acute knee joint rupture after yttrium 90 injection

Two cases of acute rupture of the knee joint are reported after the intra-articular injection of radioactive yttrium 90. It is suggested that this may be a complication of intra-articular radioactive injections.

Respiratory complications of relapsing polychondritis

Gibson, G. J. and Davis, P. (1974).Thorax, 29, 726-731. Respiratory complications of relapsing polychondritis. The respiratory function of a patient with relapsing polychondritis is described. He had severe airflow obstruction due to disease of both the extra and intrathoracic large airways. Evidence of small airways disease was lacking. The airflow obstruction was probably due to a combination of structural narrowing and an enhanced dynamic effect. Despite the severity of his disease the patient's exercise capacity was only slightly reduced but he developed carbon dioxide retention on exercise. Involvement of the airways is a common feature of this rare disease and demands full physiological and radiographic assessment if tracheostomy or other surgical procedure is contemplated.

Tuberculous arthropathy

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Lymphosarcomatous arthropathy

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Immunological studies on the mechanism of gold hypersensitivity reactions

Immunological studies were performed on 12 patients with rheumatoid arthritis who developed reactions to gold. IgE levels were found to be raised in 10 of 11 patients tested at the time of the gold reaction, returning to normal on stopping therapy. Two of 12 patients with gold reactions had positive in-vitro lymphocyte transformation responses to gold.It is suggested that dermatological side effects in particular are mediated by a type I hypersensitivity response.

Criteria for classification of S.L.E

Of 38 patients with systemic lupus erythematosus (S.L.E.) followed in this clinic during the past two years raised levels of anti-DNA antibodies were found in 36. The recently proposed criteria for the classification of S.L.E. were met in 33 of these 36 patients. Three patients with raised DNA antibody titres and some of the features of S.L.E. did not meet the criteria for a classification of S.L.E.

Tryptophol formation by Zygosaccharomyces priorianus

Zygosaccharomyces priorianus converted L-tryptophan to tryptophol and to small quantities of indole-3-acetic acid. Neither tryptophol nor indole-3-acetic acid was metabolized when added separately to growing cultures. The possible intermediacy of indole-3-pyruvic acid, indole-3-acetaldehyde, and tryptamine in the degradation of L-tryptophan was tested by feeding these compounds to Z. priorianus and Saccharomyces cerevisiae. Indole-3-pyruvic acid and indole-3-acetaldehyde were converted to tryptophol and indole-3-acetic acid, with the latter accumulating only in small amounts. Tryptamine was converted to its N-acetyl derivative by these organisms. A qualitative study was made on the metabolism of L-phenylalanine, L-tyrosine, and L-5-hydroxytryptophan by these organisms. Like L-tryptophan, these amino acids were metabolized to their respective alcohol and acid derivatives. Of a large number of organisms tested, the yeasts possessed the highest capacity for degrading L-tryptophan to tryptophol.

Jaundice after multiple halothane anaesthetics administered during the treatment of carcinoma of the uterus

Halothane is thought to cause hepatitis after multiple exposures in certain susceptible patients. Patients undergoing repeated anaesthetics for insertion of radioactive implants for gynaecological neoplasia appear to be particularly at risk. We are reporting three cases in which hepatitis has followed multiple halothane anaesthetics, and discuss them with reference to our present knowledge of this complication.

Infections of Scribner and Brescia arteriovenous shunts

The incidence of infections of Scribner shunts and Brescia fistulae in patients receiving intermittent haemodialysis was compared. In both groups infection was most commonly due to Staphylococcus aureus and was associated especially with carriage of this organism on the skin of the limb where the shunt or fistula was sited. The incidence of local infection was much less with the Brescia fistula but this was accompanied by a relatively higher incidence of septicaemia.

Ellipse discrimination: a psychophysical task useful for studying incidental stimulation

An ellipse discrimination with four distinct levels of difficulty was developed which provided a wide range of alternative responses rather than a binary choice. S‘s task was to judge in which of 6 clock orientations the minor axis of the ellipse was oriented. Although this procedure was evolved as propaedeutic to studying the effects of incidental, “subliminal,” unbeknown stimulation on such a discrimination, it should prove useful in other contexts whenever a difficult ellipse discrimination is required.

The pH tolerance of Daphnia pulex (Leydig, emend., Richard)

The survival time and reproduction of female Daphnia pulex in solutions varying in pH have been observed. Dilute sodium hydroxide or sulfuric acid solutions were added to four different diluent waters: distilled water, aerated tap water, aerated and filtered tap water from an aquarium containing dace minnows, and McIntyre River water. D. pulex (initially up to 72 hours old) survived for the duration of the experiment (32 hours) in river water within a pH range of 6.1–10.3; in aquarium water within a pH range of 4.3–10.4; only at pH 6.4 and pH 7.6 in distilled water; and in none of the solutions using aerated tap water. The dissolved oxygen content was measured at the beginning and end of every experiment and was found never to fall below 6.2 p.p.m. Those individuals which survived were cultured in the laboratory and parthenogenesis was observed at pH values between 7.0 and 8.7.