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1. Prognostic significance of retinopathy at presentation in adult acute leukemia

   Reddy SC, Quah SH, Low HC, Jackson N

   Ann. Hematol., 1998 Jan;76(1):15-8.

   PMID: 9486919

   Abstract

   Retinal changes are common in adult acute leukemia patients at presentation, but their prognostic significance is controversial. A 5-year study has been carried out with newly diagnosed acute leukemia patients aged 12-77 years. Seventy-seven cases (49 AML, 28 ALL) were studied prospectively for the presence of intraretinal hemorrhages (IRH), white-centered hemorrhages, cotton-wool spots, and macular hemorrhages. They were treated according to standard chemotherapy protocols, and then achievement of complete remission (CR) and the duration of overall survival (OS) were compared between the groups with and without these different retinal features. No association was found between the presence of any retinal abnormality and CR induction rate, although there was a trend to a lower CR rate among patients with IRH. The median OS of those with IRH was 72 days, compared with 345 days among those without IRH (p=0.002). A WBC at presentation greater than 50x10(9)/l and age greater than 40 years were also associated with shorter OS (p<0.0001 and p=0.0045, respectively). However, after regression analysis, IRH remained statistically significant as a poor prognostic indicator (p=0.01). We conclude that the presence of IRH is an indicator of poor prognosis in acute leukemia.

   MeSH terms: Acute Disease; Adolescent; Adult; Aged; Child; Humans; Leukemia/complications*; Leukemia/diagnosis; Leukemia/drug therapy; Leukemia/mortality; Middle Aged; Prognosis; Prospective Studies; Remission Induction; Retinal Hemorrhage/complications*; Survival Rate
2. Natural cryptic autoantibodies

   Cheng HM

   Autoimmunity, 1998;27(2):99-108.

   PMID: 9583741

   MeSH terms: Antibody Specificity; Antigens/immunology; Autoantibodies/immunology*; Autoantigens/immunology; Blood Proteins/immunology; Humans; Molecular Mimicry
3. Typhoid fever--important issues still remain

   Pang T, Levine MM, Ivanoff B, Wain J, Finlay BB

   Trends Microbiol., 1998 Apr;6(4):131-3.

   PMID: 9587187

   MeSH terms: Anti-Bacterial Agents/pharmacology; Drug Resistance, Microbial; Forecasting; Humans; Polysaccharides, Bacterial/immunology; Salmonella typhi/drug effects; Salmonella typhi/genetics; Typhoid Fever/diagnosis; Typhoid Fever/microbiology; Typhoid Fever/epidemiology*; Typhoid Fever/prevention & control; Typhoid-Paratyphoid Vaccines/immunology; Global Health
4. Use of antifilarial IgG4-ELISA to detect Brugia malayi infection in an endemic area of Malaysia

   Rahmah N, Anuar AK, Ariff RH, Zurainee MN, A'shikin AN, Fadzillah A, et al.

   Trop. Med. Int. Health, 1998 Mar;3(3):184-8.

   PMID: 9593356

   Abstract

   OBJECTIVE: To evaluate the usefulness of antifilarial IgG4 antibody assay in detecting B. malayi infection in a filaria endemic area in Malaysia.

   METHODS: A sandwich ELISA using B. malayi soluble antigen was employed to detect antifilarial IgG4 antibodies in serum samples of 330 individuals who comprised 88 healthy individuals from nonendemic areas, 15 B. malayi microfilaraemic cases, 22 individuals with soil-transmitted helminthiases, 9 elephantiasis cases and 196 residents from a B. malayi-endemic area. An O.D. value of > 0.420 at serum dilution of 1:400 was used as the cut-off point. This cut-off point was obtained by taking the mean optical density (0.252 + 4 S.E.) of 36 negative sera which had O.D. values greater than 0.1 at serum dilution of 1:400.

   RESULTS: All 15 microfilaraemic persons were positive for antifilarial IgG4 antibody. Non-endemic normals, soil-transmitted helminth infected persons and chronic elephantiasis cases were negative for antifilarial IgG4 antibody. Of the 196 individuals from the filaria endemic area, 37 (18.8%) demonstrated presence of antifilarial IgG4 antibodies; and only eight individuals (4.1%) were positive for microfilariae. All eight microfilaraemic individuals were also positive for antifilarial IgG4 antibodies.

   CONCLUSION: Antifilarial IgG4-ELISA could detect 4.6 times more positive cases than the microfilaria detection method. With appropriate cut-off values that eliminate cross-reactivities, this serological tool is very useful for Brugia malayi prevalence surveys and diagnosis.

   MeSH terms: Animals; Antibodies, Helminth/isolation & purification*; Antigens, Helminth*; Enzyme-Linked Immunosorbent Assay/methods; Filariasis/diagnosis*; Humans; Immunoglobulin G/blood*; Malaysia; Brugia malayi/immunology*; Brugia malayi/isolation & purification*
5. Type IV laryngotracheo-oesophageal cleft--management of a difficult airway

   Lim SK, Fadhilah T, Ibtisan I

   Paediatr Anaesth, 1998;8(4):337-40.

   PMID: 9672933

   Abstract

   Congenital laryngotracheo-oesophageal cleft is a rare anomaly which presents a challenge to the anaesthetists because of the potential problems of establishing and maintaining an airway. We report the anaesthetic management of a one-month old baby with complete or type IV laryngotracheo-oesophageal presenting for the repair of the defect. The management of the precarious airway is presented and the various techniques of managing the airway are reviewed.

   MeSH terms: Abnormalities, Multiple/surgery*; Anesthesia, General/methods*; Esophagus/abnormalities*; Humans; Infant, Newborn; Intubation/methods; Intubation, Intratracheal; Larynx/abnormalities*; Male; Trachea/abnormalities*
6. Tuberculoid granulomatous lesion of the pharynx--review of the literature

   Sharma HS, Kurl DN, Kamal MZ

   Auris Nasus Larynx, 1998 May;25(2):187-91.

   PMID: 9673733

   Abstract

   Pharyngeal involvement in tuberculosis is rare and is usually secondary to pulmonary tuberculosis. We report a very rare case of chronic granulomatous pharyngitis, which later turned out to be due to primary tuberculosis of the pharynx. The clinical presentation, diagnosis, treatment and complications of this rare clinical entity are presented.

   MeSH terms: Adult; Humans; Male; Pharyngeal Diseases/diagnosis*; Pharyngeal Diseases/pathology; Pharynx/pathology; Tomography, X-Ray Computed; Tuberculoma/diagnosis*; Tuberculoma/pathology; Tuberculosis, Pulmonary/diagnosis; Tuberculosis, Pulmonary/pathology
7. Stability of strain genotypes of Burkholderia pseudomallei from patients with single and recurrent episodes of melioidosis

   Vadivelu J, Puthucheary SD, Drasar BS, Dance DA, Pitt TL

   Trop. Med. Int. Health, 1998 Jul;3(7):518-21.

   PMID: 9705184

   Abstract

   The constancy of strain genotypes of multiple isolates of Burkholderia pseudomallei from 13 patients with melioidosis was examined by BamHI ribotyping and pulsed-field gel electrophoresis (PFGE) of XbaI digests of DNA. Seven of 8 patients with single episodes of melioidosis each yielded genetically identical isolates and only one of five patients with recurrent episodes was infected with a new strain clearly distinct from the original primary strain. Variation was observed in PFGE patterns of primary and relapse isolates of another patient but this was insufficient to define genetically distinct strains. We conclude that most patients with single or multiple episodes of melioidosis retain a single strain.

   MeSH terms: Genotype; Humans; Melioidosis/microbiology*; Recurrence; RNA, Bacterial/genetics; RNA, Ribosomal/genetics; Serotyping/methods; Restriction Mapping; Electrophoresis, Gel, Pulsed-Field; Burkholderia pseudomallei/classification; Burkholderia pseudomallei/genetics*; Burkholderia pseudomallei/isolation & purification
8. Genetic dynamics of Salmonella typhi--diversity in clonality

   Pang T

   Trends Microbiol., 1998 Sep;6(9):339-42.

   PMID: 9778724

   MeSH terms: Humans; Phenotype; Salmonella typhi/genetics*; Salmonella typhi/pathogenicity; Genetic Variation*; Virulence/genetics; Virulence/immunology; Electrophoresis, Gel, Pulsed-Field; Genome, Bacterial
9. Gaining access through a calcified pulp chamber: a clinical challenge

   Ngeow WC, Thong YL

   Int Endod J, 1998 Sep;31(5):367-71.

   PMID: 9823142

   Abstract

   Dental pulp is prone to dystrophic mineralization; this mineralization can be so extensive that the entire root canal system is obliterated. As a result, root canal treatment can become a difficult if not impossible task. This article presents the endodontic management of a tooth with an obliterated pulp chamber and associated with a discharging sinus in a teenage patient. The role of a calcium hydroxide lining to induce mineralization and cause the obliteration of the pulpal space is also discussed.

   MeSH terms: Adolescent; Calcium Hydroxide; Chelating Agents; Dental Fistula/etiology; Dental Pulp Calcification/complications; Dental Pulp Calcification/etiology; Dental Pulp Calcification/therapy*; Edetic Acid; Female; Humans; Incisor; Maxilla; Periapical Abscess/etiology; Peroxides; Root Canal Therapy; Urea; Waxes; Tooth Injuries/complications; Root Canal Preparation/methods*
10. Retropharyngeal abscess: recent trends

    Sharma HS, Kurl DN, Hamzah M

    Auris Nasus Larynx, 1998 Dec;25(4):403-6.

    PMID: 9853664

    Abstract

    Retropharyngeal abscess (RPA) is relatively rare today. A study of 17 cases of RPA treated at our hospital in the past 10 years showed a shift in the disease from children below 6 years of age (41%) to older children and adults (58%). Upper respiratory tract infection (URTI) was found to be the commonest (52%) aetiological predisposing factor in all age groups. Other aetiological factors were septicaemia (11%) in children below the age of 6 years and trauma due to foreign body (35%) in the older children and adult age groups. Klebsiella, Staphylococcus and Streptococcus were the commonest species of microorganisms grown from pus. The changing clinical trends, microbiology, choice of antibiotics, usefulness of radiology, and complications of this potentially fatal illness are discussed.

    MeSH terms: Adolescent; Adult; Anti-Bacterial Agents/therapeutic use; Bacterial Infections/complications; Child; Drug Resistance, Microbial; Female; Foreign Bodies/complications; Hospitals, University; Humans; Malaysia; Male; Microbial Sensitivity Tests; Radiography; Respiratory Tract Infections/complications; Retrospective Studies; Causality; Age Distribution; Retropharyngeal Abscess/drug therapy; Retropharyngeal Abscess/etiology*; Retropharyngeal Abscess/microbiology; Sepsis/complications