Lack of change of cancellous bone volume with short-term use of the new immunosuppressant rapamycin in rats

Immunosuppressants have adverse effects on bone mineral metabolism in animal and human studies, with corticosteroids producing low-turnover osteopenia, and cyclosporin-A (CsA) producing high-turnover osteopenia. Rapamycin (RAPA) is a new immunosuppressant reported to be at least 10 times more potent than CsA, and acts via a different pathway to CsA and the other new immunosuppressant FK506. This study investigated the effects of RAPA on bone mineral metabolism in the rat. Forty-two, 10-week-old, male Sprague Dawley rats were divided into three groups, and treated according to the following protocol: group A (control) received RAPA vehicle by daily gavage for 14 days (n = 12); group B (high dose RAPA) received RAPA 2.5 mg/kg/day by daily gavage for 14 days (n = 15); group C (low dose RAPA) received RAPA 1.25 mg/kg/day by daily gavage for 14 days (n = 15). Rats were weighed and bled on days 0, 7, and 14 for measurement of blood ionized calcium, bone Gla protein (BGP), parathyroid hormone (PTH), and 1,25(OH)2D. Tibial bone histomorphometry was determined on day 14 after double-calcein labeling. Weight gain was similar in the two groups treated with RAPA compared with control animals. High-dose RAPA (group B) transiently depressed serum BGP levels on day 7, with elevated blood ionized calcium levels on day 7, and lowered 1,25(OH)2D levels on day 14. Serum PTH levels were unchanged. Low-dose RAPA (group C) did not affect calciotropic hormones.(ABSTRACT TRUNCATED AT 250 WORDS)

Maturation, capacitation, and metabolism of goat spermatozoa using magnetic resonance methods

The ability of intact cells to reduce spin labels has been utilized to characterize the activity of spermatozoa of goat. The kinetics of reduction of TEMPO has been found to be sensitive to the quantity, quality and state of epididymal maturation of the spermatozoa. Presence of alcohol caused activation and Gossypol acetic acid left sperm activity unaltered. Electron spin resonance (ESR) and 31P Nuclear magnetic resonance (NMR) indicate that the period of in vitro capacitation requires optimization. 31P NMR spectra indicate a good correlation with the progressive maturation of the cells.

Blood transfusion related HBV and HIV infection in a patient with SLE

We described the course of a young man with SLE who developed hepatitis B virus and human immunodeficiency virus infections through contaminated blood transfusion. He presented with severe SLE, improved on treatment and then developed hepatic failure which responded to conservative treatment. He now has AIDS and the SLE and HBV infection are quiescent.

Immunoglobulin deficiency

Twenty three patients with primary immunoglobulin(Ig) deficiency were seen during the last ten years. Nine had hypogamma globulinemia (hypo-Ig) and the rest, selective Ig deficiency. Most were in pediatric age group. There was preponderance of males with only one female. Clinical symptoms pertaining to gastrointestinal and sinupulmonary infections were most common. Complete absence of B cells was not observed in any patient with hypogammaglobulinemia. They could be typed as physiological in one patient, X-linked immunodeficiency in 2 patients and common variable immunodeficiency in the remaining six. Three patients with selective IgA deficiency were above 20 years of age. Two had only secretory IgA deficiency, confirmed by jejunal fluid examination and the rest had both secretory and serum IgA deficiency. Low IgM was seen in one patient. We see a spectrum of immunoglobulin deficiencies varying from subtle defects like absence of secretory IgA only, to severe depletion of all immunoglobulins. Therapy is still not ideal due to economic reasons.

Class specific antinuclear antibodies in systemic lupus erythematosus

The incidence and significance of class specific antinuclear antibodies (ANA), specially with relevance to clinical manifestations of arthritis, renal disease and serositis was studied in 40 patients of systemic lupus erythematosus by the indirect immunofluorescent method. Clinical activity was scored by Morimoto's scoring system. A significant correlation was obtained between IgD ANA and clinical activity of the disease and IgG ANA exhibiting lupus pattern of immunofluorescence and serositis.

Plasma membrane alterations of maturing goat (Capra indicus) spermatozoa: lectin-binding and freeze-fracture study

A qualitative and quantitative analysis of lectin-binding sites has been undertaken on spermatozoa recovered from different regions of the epididymis of the goat (Capra indicus) using fluorescein isothiocyanate-linked lectins (Bauhinia purpurea BPA, Concanavalin A Con A, Dolichos biflorus DBA, Maclura pomifera MPA, Arachis hypogaea or peanut agglutinin PNA, Glycine max or soyabean agglutinin SBA, Ulex europaeus UEA, and Triticum vulgaris or wheat-germ agglutinin WGA), in conjunction with scanning and transmission electron microscopy, and freeze-fracture techniques. Flow cytometric analysis has also been used to quantitize binding affinity. Spermatozoa from caput to cauda epididymidis show no significant variation in lectin-binding ability, but the samples removed from the corpus epididymidis contain a greater number of binding sites. The passage of spermatozoa through the epididymidis is accompanied by a redistribution of the plasma membrane lectin-receptors covering the sperm head and tail. Receptors for BPA, DBA, PNA and SBA are specifically restricted to the anterior region of the acrosome in caudal spermatozoa. Freeze-fracture replicas, examined to study changes in organisation of intramembranous particles of the plasma membrane during sperm maturation, reveal distinct changes in their distribution in the acrosome, post-acrosome and spermatozoon tail, especially in the corpus and cauda epididymidis.

Importance of bone marrow culture for diagnosis of Kala azar

Kala azar was diagnosed in 45 clinically suspected cases following bone marrow smear examination and in vitro culture of the aspirate. Bone marrow aspiration smear examination revealed amastigotes in 27 cases (60%). In vitro culture of the aspirate demonstrated leishmania parasites in 44 cases (97.8%). A total of 18 cases (40%) were negative for amastigotes in smear examinations but parasites could be demonstrated by culturing the same aspirates. The in vitro culture of bone marrow is necessary to diagnose Kala azar and is strongly recommended to be performed along with the bone marrow smear examination.

Morbidity of low-birthweight infants with intrauterine cocaine exposure

The effects of intrauterine cocaine exposure on 158 low-birthweight infants (500 g to 2500 g) were compared with 536 low-birthweight infants not known to be exposed to cocaine who were admitted to our neonatal intensive care unit. Univariate analyses indicated that drug-exposed infants had lower birthweights when compared with control infants. Frequency of necrotizing enterocolitis differed between the drug-exposed infants and controls (11% versus 6%). Frequency of severe respiratory distress syndrome, severe intraventricular hemorrhage, and bronchopulmonary dysplasia did not differ between groups of similar birthweight. We conclude that the most evident risks of prenatal cocaine exposure are low birthweight and increased incidence of necrotizing enterocolitis.

Comparative evaluation of HIV infected foreign students and Indian with AIDS in Chandigarh, India

Out of a total of 1,600 foreign students who came to India between June 1989 and October 1990, 22 were seropositive for HIV-1. Ten showed antibodies to all the gene products. Antibodies to gp160 and p24 were present in all the seropositives while antibodies to p53, p15/17 were significantly higher in healthy seropositives than in patients with full blown AIDS. Absence of antibodies to p15/17 and p53 thus appeared to be a more sensitive criterion of end stage disease than absence of anti- p24 antibodies. When seropositive samples from African students were checked for HIV-2 antibodies by ELISA, 13/22 were found to be positive. Further, 2/10 Indians with full blown AIDS were also strongly positive for HIV-2. These data could be of relevance for formulating future strategies for population-based screening for HIV-2.

Renovascular hypertension due to Takayasu's arteritis among Indian patients

Over a 16-year period, 205 patients with hypertension were shown to have a renovascular aetiology. Of these, 125 (61 per cent) had Takayasu's arteritis, 58 (28.3 per cent) had fibromuscular dysplasia, 16 (7.8 per cent) had atherosclerosis, five (2.4 per cent) had polyarteritis nodosa and one (0.5 per cent) had renal artery aneurysm. Among patients with Takayasu's arteritis, males were affected as commonly as females. The mean age of these patients at the time of detection was 26.8 +/- 8.6 years (range 5-52 years). Type I arteritis was seen in nine (7.2 per cent), Type II in 40 (32 per cent) and Type III in 76 (60.8 per cent) patients. The abdominal aorta was involved in 117 (93.3 per cent) patients. Takayasu's arteritis was associated with ulcerative colitis in two patients and with renal amyloidosis and focal segmental glomerulosclerosis with a nephrotic syndrome in one patient each. Surgical intervention consisting of bypass procedures, autotransplantation or nephrectomy was performed in 17 (13.6 per cent) and angioplasty in nine (7.2 per cent) patients. Cure and improvement in blood pressure was observed in 82.4 per cent and 77.8 per cent respectively. Adequate control of blood pressure was achieved with drugs only in 22 (22.2 per cent) patients. A definite cause and effect relationship could not be established between any infective or immunological disorder and Takayasu's arteritis. Takayasu's arteritis is a far more common cause of renovascular hypertension in Indian population than fibromuscular dysplasia or atherosclerosis, which are more common in the western population.

Responses to hypoxia and hypercapnia in infants of substance-abusing mothers

Because infants of substance-abusing mothers (ISAM) have an increased risk of sudden infant death syndrome and have abnormal sleeping ventilatory patterns, we studied the effects of mild hypoxia during quiet sleep on ventilatory pattern, heart rate, and arousal in 23 healthy ISAM (mean +/- SEM: 9.0 +/- 0.49 weeks of age) and 15 healthy, similarly aged, control infants. Hypercapnic challenges were performed in six ISAM and eight control subjects. Hypoxic arousal responses were elicited by rapidly decreasing inspired oxygen tension to 80 mm Hg for 3 minutes or until arousal occurred. Failure to arouse to hypoxia occurred in the majority of infants in both groups. All infants had a fall in end-tidal carbon dioxide tension during hypoxia, suggesting that each had a hypoxic ventilatory response. However, the fall in end-tidal carbon dioxide tension was significantly less in the ISAM (mean +/- SEM: -4.0 +/- 0.3 vs -8.0 +/- 1.0 mm Hg), suggesting blunted ventilatory responses to hypoxia. Periodic breathing occurred during 9.5% of hypoxic challenges in control infants compared with 37% in ISAM (p = 0.056). Heart rates were significantly higher in the ISAM before, during, and after hypoxic challenges. Hypercapnic challenges (inspired carbon dioxide tension of 60 mm Hg for a maximum of 3 minutes) resulted in arousal in all infants; however, ISAM required a significantly longer exposure to hypercapnia before arousal (mean +/- SEM; 116 +/- 7.8 vs 79 +/- 13.9 seconds; p < 0.02). We conclude that ISAM have an impaired repertoire of protective responses to hypoxia and hypercapnia during sleep, and that this may play a role in their increased risk for sudden infant death syndrome.

Humoral antibody response in Leishmania tropica infection

A small epidemic of Leishmania tropica infection was detected in Rajasthan, India. Most cases were in the 21-25 years age group and were possibly related to outdoor activity. Nearly one third of the patients had more than five lesions, the maximum number of lesions being confined to the face, neck and extremities. As determined by ELISA, 90% cases had leishmania antibodies with an OD range of 0.8-1.1. The serum of 60% of patients was positive by CIEP against L. tropica promastigote soluble antigen. By immunofluorescence, 96% persons were positive when L. tropica promastigotes were used as the substrate. The prevalence of infection with L. tropica appears to be much higher than that reported earlier.

Detection of leishmania antigen in kala azar patients using monoclonal antibodies

Twenty-one monoclonal antibodies were produced against promastigote antigens of Leishmania donovani. Five monoclonal antibodies (Hyb.17, 6, 5, 4 and 2) identifying molecules associated with various L. donovani antigenic determinants ranging from 42-116 kDa were selected as 'capture antibodies' and compared with specific anti-leishmania antisera for detection of circulating leishmania antigens in kala azar patients' sera in a competitive-enzyme-linked immunosorbent assay system (ELISA). The anti-leishmania antisera could detect circulating antigen in 30% of kala azar cases while out of the five monoclonals, Hyb.17 could effectively detect circulating leishmania antigen in 85.4%. The efficacy of Hyb.6 was however low (31.7%). The antigens recognized by these monoclonal antibodies in the western blot assay could possibly represent the ones circulating in sera of patients suffering from kala azar. A cocktail of these monoclonal antibodies may be more useful than the conventional polyclonal antisera in detection of circulating antigen for clinical diagnosis of kala azar.

Secondary immune defects in non-Hodgkin's lymphoma

Changes in the humoral, cellular and phagocytic components of the immune system were investigated in 44 biopsy proven, untreated patients of non-Hodgkin's lymphoma (NHL). There was significant decrease in the total lymphocyte number, their subsets (T and B) and the T helper (T mu) population. Impaired leukocyte migration inhibition response and DNA synthesis following stimulation by phytohaemagglutinin were noted. Significant reduction of serum IgA was found in patients of both diffuse and nodular NHL. Phagocytic activity and nitroblue tetrazolium (NBT) reduction were unaltered, but chemotaxis was significantly reduced and bactericidal activity showed variable results.

Effect of combined deficiency of fat and vitamin A on N-nitrosodiethylamine-induced lung carcinogenesis in mice

The present investigation shows the effect of combined dietary deprivation of fat and vitamin A on N-nitrosodiethylamine (NDEA) induced lung carcinogenesis in male Swiss NMRI mice. Lung tumors were induced by three intragastric administrations of NDEA (80, 80, 40, mg/kg body wt.) in normal saline with a gap of 4 weeks between each administration. The tumor incidence and tumor burden in control animals were found to be 39.1 and 3.9%, respectively. Fat deficiency decreased the tumor incidence to 30.4% and tumor burden to 3.7%. On the other hand, vitamin A deficiency increased them to 95.6 and 6.8%, respectively. Fat deprivation in the diet of animals fed with vitamin A deficient diet decreased the tumor burden and tumor incidence to 59.0 and 4.0%, respectively which were still more than in the control animals. This study suggests a protective role for low intake of fat in vitamin A deficiency.

Human sperm surface mapping with lectins

Ten fluorescein isothiocyanate (FITC)-linked lectins [Bauhimia purpurea, Concanavalin A, Dolichos biflorus (DBA), Griffonia simplicifolia I, Griffonia simplicifolia II, Maclura pomifera, Arachis hypogea (PNA), Glycine max, Ulex europaeus (UEA) and Triticum vulgaris agglutinin] have been used to study their binding features on the human ejaculate spermatozoa. Qualitative changes in the labeling pattern have been observed in unfixed and acetone-treated spermatozoa. Furthermore, ultrastructural localization of some of the colloidal gold-linked lectins, namely PNA, UEA and DBA, has been attempted to delineate the binding domains of the specific sugars on the sperm surface. It needs to be emphasized that flow-cytometric methods employed in our study, which provide quantitative slant to qualitative data, should be utilized to evaluate the functional status of the spermatozoa.

Immunogenicity of deglycosylated zona pellucida antigens and their inhibitory effects on fertility in rabbits

Influence of carbohydrates on the immunogenicity and immunocontraceptive potential of zona pellucida glycoproteins has been investigated in rabbits. Porcine zonae pellucidae, following deglycosylation with trifluoromethane-sulfonic acid, retained significant immunogenic potential, as shown by the ability to generate antibodies which cross-reacted with the heterologous antigen. Antibody response, however, was much stronger against the native zona glycoproteins, thereby suggesting that both carbohydrate and protein moieties contribute to the overall immunogenicity of the zona pellucida antigens. Contraceptive efficacy of active immunization with the deglycosylated zona antigens, when evaluated by mating experiments, demonstrated inhibition of fertility in all immunized rabbits. Normal ovarian functions were disrupted in these animals, as revealed by the reduction in ovarian weights and gross impairment of folliculogenesis. Flushing of the oviducts of the immunized animals yielded a markedly reduced number of ova ovulated in response to hCG administration, none of which were fertilizable. Results collectively suggest that active heteroimmunization with deglycosylated zona pellucida antigens is effective in reducing fertility in rabbits.

Histopathological studies in relation to protection induced by using MDP as an adjuvant in malaria

Different immunomodulators were tried for their efficacy to protect against the lethal infection of Plasmodium berghei in mice. Since MDP was the most effective non-FCA adjuvant imparting a significant degree of protection, histopathological studies were undertaken in mice protected by using this adjuvant in comparison with mice suffering from acute malaria. The malarious mice revealed abnormalities of the liver, spleen and kidney, whereas these abnormalities were minimal in the MDP-immunized mice. The results are consistent with the degree of protection induced by MDP, and are significant with respect to the effectiveness of the non-FCA adjuvant in causing minimal histopathological abnormalities.

Circulating immune complexes in cerebrospinal fluid of patients with tuberculous meningitis

Circulating immune complexes (ICs) were isolated from cerebrospinal fluids (CSFs) of patients with tuberculous meningitis (TBM), non-tuberculous neurological diseases by a polyethylene glycol (PEG) precipitation method. Mycobacterium tuberculosis antigen 5 was detected in CICs of 30% patients with TBM, by sandwich ELISA. CIC level decreases during antituberculosis chemotherapy and therefore its detection can provide a method to monitor the therapeutic schedule in patients with TBM.

Cystic disease of the liver following prenatal and perinatal exposure to aflatoxin B1 in rats

Experiments were designed to elucidate the differences, if any, in the liver histology induced by aflatoxin B in newborn and adult animals. The transfer of toxic metabolites from pregnant rats to their litters was confirmed by thin layer chromatography of liver homogenates in the latter. Extensive cystic lesions of the biliary and hepatic type developed only in young animals. Multifocal hepatic necrosis, bile ductular proliferation, areas of altered hepatocytes, neoplastic nodules and hepatocellular carcinoma constituted the total spectrum in both adult and newborn animals. Increased susceptibility to the toxins early in life appears to be responsible for this intriguing phenomenon. These aspects may have a bearing on the genesis of childhood liver disease.

Immunohistochemical demonstration of mycobacterial antigens in intracranial tuberculoma

Mycobacterial antigens have been demonstrated immunohistochemically in the paraffin sections of 10 intracranial tuberculous granulomas and the results were compared with the detection of acid fast bacilli by conventional Ziehl-Neelsen method. In none of the 10 specimens, acid fast bacilli were demonstrated while mycobacterial antigens were characterised as diffusely staining granular brownish-pink material within the cytoplasm of giant cells and macrophages. In 14 specimens of granulomatous lesions due to non-tuberculous aetiology, immunohistochemical stains were negative for mycobacterial antigen. Thus demonstration of mycobacterial antigen will be not only useful in establishing mycobacterial aetiology of a caseating intracranial granuloma but also can be used as an alternative method to the conventional Ziehl-Neelsen method.

Immune status in ataxia telangiectasia

Immune status of 22 patients of ataxia telangiectasia was studied over a period of 8 yr (mean age of patients: 9.5 +/- 3 yr; 9 of 22 were siblings). Low T-cell number was observed in 14 of 19 patients but the response to PHA challenge done in 10 patients was normal and migration inhibition to BCG antigen was positive in 6 of 6 patients. IgM defect was seen in 2 out of 18 patients and serum IgA was deficient in 10 out of 18 patients. Salivary IgA was also absent in these children. Four children had high spontaneous NBT reduction. None of the patients had lymphoma, leukemia or any other malignancy at the time of presentation. Candida killing was normal in all patients. The presenting feature related to the CNS in almost all children and gross infections were not seen.

Serodiagnosis of Indian kala-azar: evaluation of IFA, ELISA and CIEP tests

The sensitivity and specificity of three serological tests viz. indirect immunofluorescent antibody test (IFAT), enzyme linked immunosorbent assay (ELISA) and counterimmunoelectrophoresis (CIEP) for the diagnosis of Indian kala-azar were evaluated. Of the 209 patients in whom Leishmania donovani parasite could be demonstrated in bone marrow, 207 (99.04 per cent) could be diagnosed with IFAT, 203 (96.6 per cent) with CIEP and 208 (99.5 per cent) with ELISA. None of these serological tests was positive in 40 healthy individuals and 10 patients each with tuberculosis, toxoplasmosis and malaria. In only one out of 10 patients with malaria ELISA alone gave false positive result. Of the 119 patients who had clinical features simulating kala-azar but were negative for Leishmania donovani in bone marrow and responded to treatment other than that for Indian Kala-azar, IFAT, CIEP and ELISA were false positive in three (2.5 per cent), nil and three (2.5 per cent) cases, respectively. The use of serodiagnostic tests like ELISA for mass screening and CIEP in less well equipped peripheral laboratories is suggested.

Demographic features of sporadic acute hepatitis as determined by viral hepatitis markers

The demographic features of acute x sporadic viral hepatitis as diagnosed by specific markers of viral infection in four different cities in north and north-east India, were examined. Of 405 patients examined, 26 per cent had HB,Ag, 5.9 per cent IgM-anti-HAV antibody, and 8.4 per cent IgM-anti-HBc antibody. Hepatitis B occurred more frequently in male patients (76 per cent) compared to hepatitis A (54 per cent), and in the young adult age group (21-30 years), compared to the latter, which occurred predominantly in children (0-10 years). By using tests to detect HbsAg and IgM-anti-HBc antibody, this study found that hepatitis B accounted for 3 per cent and 8.8 per cent of clinically detected acute sporadic hepatitis in patients less than and older than 10 years of age respectively, which is in contrast with previously-reported rates from India. This study also suggests that many of the infections thought to have been due to HBV, may be due to NANB hepatitis virus. This study emphasizes the importance of specific laboratory tests to draw epidemiologic conclusions regarding hepatitis.

Comparison between indirect fluorescent antibody and Weil-Felix tests for detecting antibodies against rickettsia

Comparative evaluation of indirect fluorescent antibody test (IFAT) and Weil-Felix test (WFT) was carried out for detecting rickettsial antibodies in 102 patients with pyrexia of unknown origin (P.U.O.), 20 brucellosis cases and 20 normal healthy controls (N.H.C.). Of 102 sera of cases with P.U.O., antibodies against rickettsia could be detected in 11 (10.7 per cent) cases by IFAT and in 10 (9.8 per cent) cases by WFT, but amongst these 10 sera, antibodies could be detected only in six by IFAT. All 20 brucella positive sera were negative for rickettsia by IFAT but by WFT in 6 sera antibodies against rickettsia could be detected and 20 N.H.C. sera were negative by both the tests. Thus the advantages of IFAT over WFT in detecting antibodies against rickettsia in terms of sensitivity and specificity make it a more reliable test.

Correlation of HPV antigen and type of genital warts with atypia

Five clinical types of genital warts were identified, studied histopathologically and stained for human papilloma virus (HPV) antigen. HPV antigen was found in all degrees of koilocytosis and it was present more often in the hyperplastic warts than in other types of genital warts. However, as reported earlier, the presence of HPV antigen did not decrease proportionately as the degree of atypia increased.

An association of acute myeloid leukaemia and multiple myeloma: a case study

A case of denovo presentation of acute myeloid leukaemia with multiple myeloma is reported in a 32 years old male. He presented with pancytopenia and aleukaemic leukaemia. Bone marrow examination revealed presence of acute myeloid leukaemia and sheets of plasma cells. Serum electrophoresis showed a M protein which was characterised to be Ig lambda with decrease in normal immunoglobulin levels.

Use of in vitro method to assess different brands of anti-leishmanial drugs

Reports in the literature indicate the use of animal models for testing newer anti-leishmanial drugs in vivo. However, in certain established cell lines and macrophages in vitro models have the advantage over the in vivo system of simplicity and speed with which the results can be obtained. A simple in vitro system using peritoneal exudate macrophages of BALB/c mice infected with Leishmania donovani promastigotes has been tested for its use in determining the efficacy of several new drugs. Two well-established drugs, amphotericin B and sodium stibogluconate, as expected, could kill the intracellular parasites effectively. Two relatively new drugs not routinely used against leishmania, rifampicin and metronidazole at concentrations of 20 micrograms/ml and 10 micrograms/ml, respectively, were also able to kill the intracellular leishmania parasites effectively. Critical factors for drug testing in vitro have been elucidated: the most important being the temperature of incubation after infection.

Assays for lupus anticoagulant: the sensitivity of different assays

Fifty patients with systemic lupus erythematosus were studied for the presence of lupus anticoagulant using three different assays--kaolin clotting time, platelet neutralization test, and tissue thromboplastin inhibition test. Lupus anticoagulant could be detected in seven cases (14%) with the use of one test in cases with a partial prothrombin time with kaolin more than five seconds greater than normal. The detection rate rose to 20% (10 cases) when using all three tests, so a panel of three assays could identify lupus patients apparently at risk for thrombotic complications.

T cell lymphomas in north Indian adults: Clinical features, diagnosis and treatment outcome in 20 patients

Malignant diseases of T lymphocytes in adults are uncommon. Special difficulties arise both in establishing a diagnosis and in therapy. We describe our experience with 20 patients admitted to the Nehru Hospital, Chandigarh between 1980 and 1989. They had mycosis fungoides (8), Lennert's lymphoma (3), lymphoblastic lymphoma (8) and human T Iymphotrophic virus 1 related adult T cell lymphoma (1). All patients had advanced disease at the time of presentation and were prescribed chemotherapeutic regimens which they could afford. Their outcome was poor; most patients died within a year of first being seen. Treatment of patients with T cell lymphomas in India is hampered by the late presentation of patients and the cost of the newer, more effective chemotherapeutic regimens.

Elevated plasma norepinephrine levels in infants of substance-abusing mothers

Infants of substance-abusing mothers (ISAM) have significant growth and neurodevelopmental abnormalities. The origin of these abnormalities is unknown. We postulated that ISAM have increased sympathetic nervous system tone and altered catecholamine levels. Therefore, we measured plasma norepinephrine, epinephrine, and dopamine levels and the number and receptor affinity of beta-adrenoreceptor binding sites on lymphocytes and alpha-adrenoreceptor binding sites on thrombocytes in 22 otherwise healthy ISAM (age, 2.1 +/- 0.5 months; mean +/- SD) and 15 healthy controls (age, 2.5 +/- 0.8 months). Norepinephrine levels in venous blood were 1.8-fold higher in ISAM than in control infants (6.30 +/- 3.85 nmol/L vs 3.55 +/- 2.45 nmol/L). There were no differences in plasma epinephrine or dopamine levels. There were no differences in the number of binding sites or receptor affinity for beta- and alpha-adrenoreceptors. We conclude that ISAM have elevated circulating norepinephrine levels compared with controls. We speculate that this is associated with increased sympathetic nervous system tone in ISAM and that the absence of adrenoreceptor down-regulation may create catecholamine suprasensitivity.

Correlation between culture of Mycobacterium tuberculosis and detection of mycobacterial antigens in cerebrospinal fluid of patients with tuberculous meningitis

A retrospective study was done to correlate culture of Mycobacterium tuberculosis and detection of mycobacterial antigen in cerebrospinal fluid (CSF) by an inhibition enzyme-linked immunosorbent assay (ELISA). M. tuberculosis was cultured from CSF of 14 out of 70 patients with a clinical diagnosis of tuberculous meningitis (TBM). Mycobacterial antigens were demonstrated in CSF specimens by inhibition ELISA in all 14 culture-positive patients with antigen concentrations of 14.5-295 ng/ml (mean 158.8 ng/ml). Thus there was positive correlation between the detection of mycobacterial antigen and isolation of M. tuberculosis. Based on this observation, 56 CSF specimens from culture-negative patients with clinically diagnosed TBM were examined for mycobacterial antigen and the data were compared with those from culture positive patients. ELISA gave positive results in 38 specimens, with antigen levels of 12.5-280 ng/ml (mean 152.6 ng/ml). In 70 CSF specimens from patients with non-tuberculous neurological disease (control group), ELISA results were negative. Thus, detection of mycobacterial antigen in CSF specimens by inhibition ELISA had a specificity of 100% and a sensitivity of 67.8% for the diagnosis of TBM and is of potential value in the laboratory diagnosis of TBM.

Zoonoses in India

Intimate and prolong contact between man and animal facilitates the transmission of various communicable diseases between them. These diseases (zoonoses) are more prevalent in developing countries especially in the rural areas. These diseases virtually stunt the economic and social growth also. Lack of authentic data and awareness regarding the occurrence of these diseases and their true impact on public health have acted as major obstacles in instituting adequate and effective control measures. The information available regarding the current status of few important zoonoses in India is being presented in this paper.

Use of adjuvants in modulating the behaviour of Plasmodium berghei

Different adjuvants were assessed for their role in conferring protection against the rodent malarial parasite P. berghei and compared with the classical Freund's complete adjuvant (FCA). Pretreatment of mice with trehalose dimycolate (TDM) mixed with antigen (Ag), sulpholipids (SL) mixed with Ag, muramyl dipeptide (MDP) alone, liposomes containing Ag and phosphomannoinositides (PIM) mixed with Ag were ineffective in conferring protection. However, MDP given with squalane (Sq) and Ag, MDP with incomplete Freund's adjuvant (IFA) and Ag, palmitoyl-MDP with Sq and Ag, aluminium hydroxide adsorbed Ag, and FCA with Ag were effective in conferring varying degrees of protection to mice. Complete protection in rats was obtained with MDP mixed with Sq and Ag, and FCA mixed with Ag, and a partial protection with liposomes containing Ag.

Syphilis serology and human immunodeficiency virus positivity in Chandigarh

AIDS and other sexually transmitted diseases are interlinked. VDRL positivity may indicate that the individual has an increased risk of being HIV positive as the epidemiological risk factors for developing syphilis and AIDS are similar. We analysed 323 (5.8%) VDRL positive serum samples (out of 5592 screened) for HIV positivity. All were HIV negative. While syphilitic infection in India at present is not commonly associated with HIV infection, experience in other countries indicates caution.

ELISA of IgG antibody to Mycobacterium tuberculosis antigen-5, PPD in CSF in tuberculous meningitis patients

IgG antibody to M. tuberculosis antigen-5 and tuberculin purified protein derivative (PPD) was measured by enzyme linked immunosorbent assay (ELISA) in cerebrospinal fluid (CSF) specimens of 55 patients with tuberculous meningitis (TBM) and 55 patients with non-tuberculous neurological diseases (control group). The geometric mean antibody titre in CSF specimens of TBM patients was 82.4 with antigen-5 and 96.5 with PPD. In the control group, the geometric mean antibody titres for these antigens in CSF specimens were 4.6 and 10.8 respectively. The antibody titres did not show any correlation with tuberculin reactor status, duration of chemotherapy and IgG levels in CSF specimens in patients with TBM. At dilution end point 1:80, specificity of the assay was 100 per cent with antigen-5 and sensitivity of the assay was 70.9 per cent. False positivity observed in the control group with PPD antigen could be eliminated in 1:80 dilution in the assay with antigen-5. Antigen-5 is more specific than PPD antigen for the diagnosis of tuberculous meningitis.

Immunoelectrophoresis of mycobacterial antigens

Polyvalent antiserum to culture filtrate of H37 Ra M. tuberculosis was raised in rabbits. Monospecific antiserum was raised against M. tuberculosis antigen-5, prepared from the culture filtrates by immunoabsorbent affinity chromatography. On immunoelectrophoresis, antigen-5 demonstrated single precipitin arc against polyvalent and monospecific antisera. The culture filtrate antigen demonstrated multiple precipitin arcs against polyvalent antiserum and single precipitin are against monospecific antiserum. Antigen-5 could be isolated and characterized from the culture filtrate of H37 Ra M. tuberculosis. Immunoelectrophoresis could be one of the method to characterize the mycobacterial antigens prepared in the laboratory.

Prevalence of toxoplasma antibodies among women with BOH and general population in Delhi

One thousand and thirty-six serum samples obtained from women with bad obstetric history (BOH) were subjected to detection of toxoplasma antibody by indirect immunofluorescent antibody test (IFAT) using whole promastigotes of Rh strain of Toxoplasma gondii as antigen. Thirtyone (2.99 per cent) samples were found to be positive (titre greater than or equal to 1:64). Of these 31 patients' sera 27 (87.09 per cent) showed rising titre of antibody when second samples were drawn after 4 weeks. Two hundred serum samples from general population were also assayed and only 2 (1 per cent) were found to be having toxoplasma antibodies in titre of 1:64. The observations suggest low prevalence of toxoplasmosis in and around Delhi which is in consonance with the food habits of local people and their infrequent contact/association with cats.

IgG antibody to Mycobacterium tuberculosis antigen-5 in cerebrospinal fluid and its diagnostic application in tuberculous meningitis

IgG antibody to M. tuberculosis antigen-5 was detected by non-competitive ELISA in cerebrospinal fluid specimens (CSF), from 40 patients with clinical diagnosis of tuberculous meningitis and in 42 patients of non-tuberculous neurological diseases. The geometric mean antibody titer in CSF specimen for tuberculous and non-tuberculous groups were 156 and 8 respectively. The antibody titer in CSF specimens showed no correlation to IgG levels, tuberculin reactor status and duration of chemotherapy in patients with tuberculous meningitis. At a dilution end-point 1:40, the assay had a sensitivity of 84% and specificity of 92%. However at dilution end-point 1:80, the specificity of the assay could be increased to 100% but sensitivity of the assay decreased to 75%. IgG antibody detection against M. tuberculosis antigen-5 by non-competitive ELISA, described in this communication has potential application in the laboratory diagnosis of tuberculous meningitis, particularly in developing countries where the incidence and prevalence of tuberculous meningitis is still high. In culture-negative cases of tuberculous meningitis, non-competitive ELISA could be applied as an alternative diagnostic tool.

Non-organ specific & organ specific antibodies in rheumatoid arthritis

Fifty patients of rheumatoid arthritis clinically diagnosed (by ARA criteria) were studied for both non-organ specific [rheumatoid factor (RF), anti-nuclear antibodies (ANA), extractable nuclear antibody (ENA), granulocyte specific anti-nuclear antibody (GS-ANA), anti-smooth muscle antibody (SMA) and anti-mitochondrial antibody (AMA)] and organ specific, [anti-adrenal (AAA), anti-islet cell (ICA), antithyroid antibody (ATA) and anti-parietal cell (PCA)] auto antibodies. RF was positive in 80 per cent of patients. ANA was positive in 44 per cent of patients, ENA in 62 per cent, SMA in 20 per cent, AMA in 18 per cent and GS-ANA in 68 per cent. Of the organ specific antibodies, PCA was demonstrable in 28 per cent of the patients and none of the other antibodies were present. Circumstantial evidence indicates that ANA and GS-ANA are not synonymous but independent, cross-reacting entities and the presence of both increase the sensitivity (94%) of diagnosis of RA.

HIV-I antibodies in health and disease

Antibodies to human immune deficiency (HIV) virus were studied in 2000 individuals including cases of non-Hodgkin's lymphoma, systemic lupus erythematosus (SLE), leprosy, chronic renal failure on haemodialysis and patients attending STD clinics. A group of blood donors was also screened, ELISA kits provided by Wellcome Diagnostics were used. Results indicate that the ELISA values were far above the cut off figure in all except in a couple where the husband who had stayed in Uganda for several years, and had features of full blown AIDS died 4 months after the diagnosis. The spouse contacted AIDS within a relatively short incubation period and died within 6 months of diagnosis. The North Indian population thus appears to be free of this virus so far. This observation will be an important lead mark in the future epidemiology of HIV infection in India.

Sero-epidemiology of subacute sclerosing panencephalitis in Delhi

Between 1986 and early 1989, 47 patients of subacute sclerosing panencephalitis (SSPE) were referred to the National Institute of Communicable Diseases, Delhi from different hospitals of Delhi. They were 40 (87%) males and 7 (13%) females. The age at onset of illness ranged from 4 to 18 yr. Thirty (63.9%) patients gave history of measles attack in the first two years of life. All but one patient gave a past history of measles attack. Only one patient gave history of measles immunization. The titres of haemagglutination inhibiting antibodies to measles virus in serum in SSPE patients ranged from 1:8 to 1:2048 and in CSF from 1:4 to 1:256, while in control group, it ranged from 1:2 to 1:128 in serum and nil to 1:2 in CSF. The geometric means of haemagglutination inhibiting antibodies in serum and CSF of SSPE patients were 10 and 15 times higher than in the control group.

Cholera outbreak in Delhi--1988

Delhi experienced an outbreak of cholera during July-August 1988 which affected residents from all walks of life. A total of 1824 laboratory confirmed cholera cases were detected in two months period at I.D. Hospital, Delhi alone. The number of cholera cases in July-August 1988 was 5-10 times that of the same period during the previous years in the Capital. The outbreak was caused by Vibrio cholerae Ogawa biotype ElTor. Majority of the laboratory confirmed cases (about 74 per cent) were seen in children under the age of 15 years. Though the cases were spread all over Delhi, almost three-fourths of total cases were reported from two specific zones (Shahdara and Civil Lines). Most of the isolates were sensitive to all antibiotics tested. The proportion of isolates resistant to furazolidone during this outbreak was substantially higher than in previous years suggesting that the outbreak may have been caused by the introduction of a new strain rather than proliferation of endemic strain. The salient features of the outbreak are discussed.

Antigenic analysis of Cysticercus cellulosae by crossed immunoelectrophoresis & its role in immune diagnosis of neurocysticercosis

The antigenic composition of Cysticercus cellulosae cysts excised from infected pig and autopsied human brain was analysed by crossed immunoelectrophoresis with an intermediate gel technique using rabbit hyperimmune serum. Normal pork muscle and human brain antigen were used to differentiate parasite derived components from that of host. Attempts were made to look for the rich source of parasitic immunodominant antigens by analysing preparations of different parts of cyst namely scolex and fluid using rabbit hyperimmune serum. Twenty three antigenic components were identified in sonicate extract of porcine cyst, of which 15 were parasite derived. On comparison with antigens of whole cyst sonicate, scolex showed 10, cyst fluid 9 and human cyst sonicate 11 parasite derived antigens. Serum and cerebrospinal fluid (CSF) of neurocysticercotic patients reacted with 12 parasite derived antigens of porcine cyst sonicate (PCS) in a heterogenous manner. It was also noticed that human cyst sonicate (HCS) lacked 4 of the parasite derived antigens present in the PCS.

Auto-antibody profile in systemic lupus erythematosus

Thirty cases of systemic lupus erythematosus (SLE) were selected on the basis of revised ARA criteria (American Rheumatology Association) and their sera examined for the presence of various auto-antibodies. The male to female ratio was 1:5 and joint manifestations were the commonest mode of presentation. The frequency of various manifestations was found to differ between the two sexes. Renal lesions were observed in 9 (nine) cases. ANF was detected in 28 of the 30 cases and the diffuse pattern was the commonest (11 cases) (37.7%). Six cases had very high titres (a titre of more than 1:1280) of antinuclear factor. Antibodies to DNA were detected in 9 cases (30%). These patients tended to have more severe disease, with high titres of ANF and low complement levels. Presence of antibodies to DNA, however, could not be correlated with the severity of renal lesions. Anti Sm antibody was found in 8 cases (26.7%), anti nRNP antibody in 19 cases (63.3%) and antihistone antibodies in 22 cases (73.3%). Patients harbouring any of these three antibodies tended to have a milder clinical disease.