Skin biopsies from 100 patients with untreated lepromatous leprosy from Malaysia, India, Africa, and South America were examined with particular regard to pathological changes in intima, media, or adventitia of blood vessels and to the presence of leprosy bacilli in these layers. Bacilli were found in capillaries, venules, or arterioles in all cases, and in many instances they were present in endothelial lining cells or smooth muscle in large masses (globi). In several cases, solid-staining bacilli in endothelial lining cells were especially prominent. The findings are discussed in relation to a) the continuous bacteremia of lepromatous leprosy, b) the role of endothelial cells in phagocytosis, c) smooth muscle cells of the media as a site in which bacilli may persist, and d) the transmission of human leprosy by biting arthropods.
Material from 334 consecutive autopsies on Orang Asli subjects performed in the University Hospital, Kuala Lumpur between May 1967 and June 1978 was examined for amyloidosis. Nine positive cases were found, all in patients above 40 years of age, giving an age-corrected incidence of about 9%. In 6 cases, amyloidosis was probably secondary to tuberculosis. The remaining 3 cases exhibited a pericollagenous distribution characteristic of primary amyloidosis. Involvement of the heart and lungs was prominent. However, there were considerable similarities in the distribution and staining properties of the amyloid in the 2 groups. Though both the heart and kidney were frequently affected, the kidney was the most common organ to give rise to clinical symptoms. Infection probably plays a major contributory role in amyloidosis in the Orang Asli.
A record of all known cases of nasopharyngeal carcinoma in Malaysia is complete for 10 years from 1968 to 1977. Special efforts in case-finding were made in the State of Selangor where conditions are optimal. Age-adjusted incidence rates among Chinese males and females were 16.5 and 7.2 per 100,000, among Malay males and females 2.3 and 0.7 and among Indian males, 1.0. There were no significant changes in incidence rates over the 10-year period for sex and ethnic groups, or for Chinese subethnic groups. In Chinese subethnic groups, rates were highest among Cantonese, moderate among Khek and lowest among Hokkien and Teochiu. Standardized incidence ratios using Selangor as the standard population indicate considerable under-reporting in the less urban states of Malaysia, particularly among females. In Selangor, incidence rates were similar for urban and rural residents, but the frequency of cases was higher among Chinese working in industry and living in poor neighbourhoods.
The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 schoolchildren in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. The standard scores of the Chinese children averaged 118 in the DAM and 112 in the DAW tests. These scores were significantly better than the American standards. Malay children scored significantly lower than Chinese, and Tamil children scored lower again. The nutritional status of the children had no influence on the scores. Chinese and Tamil children scored better in the DAM than the DAW, while in Malay boys the reverse was true. Malay children tended to emphasise clothing in the DAM, but Chinese and Tamil children scored better on items relating to facial features and body proportions. The Goodenough-Harris draw-a-person tests are obviously not culture-free, but the causes of ethnic differences have not been elucidated.
MeSH terms: Child; China/ethnology; Ethnic Groups*; Female; Humans; India/ethnology; Intelligence Tests*; Malaysia; Male; Projective Techniques*; Sex Factors; United States
We report for the first time from Malaysia a patient with Peutz-Jeghers syndrome complicated by successive intussusceptions requiring extensive small bowel resection. Our experience is compared with that of other authors by a review of the literature highlighting important points in the diagnosis and management of complications in Peutz-Jeghers syndrome.
No population-based cancer registry exists in Malaysia; thus our main sources of incidence data were biopsy series. We determined the frequency of cancers by body site, sex, and ethnic group from biopsy records of the Division of Pathology of the Institute for Medical Research in Kuala Lumpur for the years 1969-71. We then made comparisons of leading sites with data from the Singapore Cancer Registry. Relative risk values for 21 sites indicated significant differences among ethnic groups for cancers of the nasopharynx, larynx, lung, bone, skin, cervix, ovary, prostate, and penis and for lymphomas.
PIP: It is generally believed that extended families encourage high fertility, but a review of the theoretical discussions and empirical research examining the relationship between family type and fertility fails to show any support for the customary belief. Nuclear families consist of husband, wife, and their immediate children. The extended family is broadly defined as any group of related persons living together which includes but is larger than the nuclear family. The main theoretical discussions of extended family and fertility are by Davis (1957); Davis and Blake (1956); Lorimer (1954); and Goode (1963; 1964). In the patrilocal extended family, the wife wants to have offspring as early as possible to strengthen the family line and her own status in the household. In a truly joint household the authority of the elders continues after marriage; the reproductive behavior of a couple is subject to their influence. Less intimate or less intense interspousal communication precludes the possibility of discussion on fertility-related problems and family planning. Younger age at marriage and lack of privacy contributes to higher fertility. According to Goode extended family behavior is characterized by more rules for behavior, while nuclear families emphasize the conjugal bond. Since most affinal and consanguineal kin are excluded from day-to-day decisions in the nuclear family there are weaker reciprocal controls.
MeSH terms: Birth Rate; Demography; Family Characteristics*; Fertility; India; Korea; Malaysia; Marriage*; Pakistan; Parity*; Population; Population Characteristics; Population Dynamics; Sexual Behavior*; Taiwan; Marital Status*
One hundred and fourteen Rickettsia tsutsugamushi isolates, recovered from febrile patients in central Peninsular Malaysia, were antigenically analyzed by direct immunofluorescence using eight prototype strains. Twenty-nine antigenic types were detected. The TA763, TA716, Karp and TA686 strains were the most common and occurred singly or in combination with each other or other strains in 86% of the isolates.
The indirect immunofluorescence test using sonicated microfilariae of Brugia malayi has been evaluated on 173 sera from patients and persons exposed to Wuchereria bancrofti and B. malayi in endemic areas of Peninsular Malaysia. In the microfilaria-negative group, without signs and symptoms of filariasis 55/62 sera (89%) had titers of 1:16 and less. In the microfilaremic groups and in the amicrofilaremic cases with clinical filariasis, all the sera tested were positive, with the antibody titers ranging generally from 1:16 - 1:256. Cross-reaction tests were done on 16 samples of onchocerciasis sera from West Africa using sonicated antigen as well as antigen-coated CNB1-activated sepharose. Antibody titers were detected in all the sera. The usefulness of the sonicated microfilarial antigen in serodiagnosis of filariasis is discussed.