In the 12-year period between 1974 and 1985, 19 children aged between 8 and 12 years with systemic lupus erythematosus (SLE) were seen in the Department of Paediatrics, University Hospital, Kuala Lumpur. A preponderance of females (M:F = 1:2.8) and ethnic Chinese was evident. Renal biopsies revealed a wide Iange of renal morphology, including minimal change glomerulonephritis, focal proliferative glomerulonephritis, diffuse proliferative glomerulonephritis with varying degrees of severity and membranous glomerulonephritis. The majority (15) of patients had clinical SLE at the time of renal biopsy, of whom 4 were also grossly nephrotic. In the remaining 4 patients a diagnosis of SLE was made after further investigation for nephrotic syndrome (2) and acute nephritis (2). The pattern of renal pathology in childhood lupus nephritis appears not to differ significantly from adults.
Key words: Systemic lupus erythematosus, glomerulonephritis
A total of 101 entomological specimens recovered from human cadavers were processed and studied. Analysis of the data indicated that about 95% of these specimens were maggots of flies. Maggots of the blowfly Chrysomya (Family: Calliphoridae) especially Ch. rufifacis and Ch. megacephala were predominantly found in 77 cases (76.2%) while larvae of several other flies of the genera Sarcophaga, Calliphora, Lucilia and hermetia were also recovered. It was notable that Musca domestica or other related flies were not found in all these specimens. The age of these larvae was useful in the determination of the minimum time lapsed after death. However, more biological studies on animal carcases should be conducted for more accurate determinations. Methods of collection, preservation and despatching of specimens were also discussed.
Tatumella ptyseos, the type species for the genus Tatumella, is a newly established member of the Family Enterobacteriaceae. It is a Gram-negative, oxidase negative, fermentative rod that grows on Mac Conkey agar. This first isolate was obtained from the blood culture of a neonate having neonatal jaundice with presumed sepsis. The organism was in vitro sensitive to Gentamicin, Chloramphenicol, Cotrimoxazole and Ampicillin. The patient was treated with Ampicillin and Gentamicin and recovered uneventfully.
An 18-year-old Malay lady was treated with high dose steroids for three and a half years for idiopathic thrombocytopaenic purpura. At 21 years, after a series of relapses, a splenectomy was carried out. In addition, two nodules at the hilum of the spleen were also removed. Histological examination of these nodules revealed features of Kaposi's sarcoma. Kaposi's sarcoma resulting from immunosuppression by corticosteroids is rare. Our patient is the first such case reported in Malaysia.
We investigated microwave-stimulated fixation of tissues for transmission electron microscopy using a domestic microwave oven operating at a frequency of 2.45 GHz with an output power of 500W. Microwave-stimulated fixation, in 4% glutaraldehyde, of fresh rat kidney, liver, heart and brain tissues was compared to conventional fixation. Human renal biopsies were similarly studied. Electron microscopy showed excellent ultrastructural preservation comparable to that obtained by conventional fixation. The optimal temperature range for microwave-stimulated fixation was found to lie between 50 degrees C and 55 degrees C. Our results indicate that microwave-stimulated fixation is a rapid and reproducible technique and can be effectively applied to routine diagnostic pathology.
In the 10-year period from October 1977 to July 1987, 149 cases of primary IgA nephropathy were histologically confirmed through renal biopsies in the Department of Pathology, University Hospital, Kuala Lumpur. The ages of these patients ranged from 5 to 72 years, with the majority in the 20-30 year age group. There was no sex preponderance. The ethnic distribution showed a significant predominance of Chinese with 107 (71.8%) Chinese, 24 (16.1%) Malays, 15 (10.1%) Indians and 3 others. A wide range of renal glomerular pathology was seen, the commonest being diffuse mesangioproliferative glomerulonephritis (59.1%). Focal proliferative glomerulonephritis (14.1%) followed by minimal change glomerulonephritis (10.7%) were next in order of frequency. Immunofluorescence studies consistently demonstrated heavy and predominant IgA deposition in the mesangium. Weak deposition of C3, IgG and IgM were also observed in various combinations.
A simple and sensitive double-antibody radioimmunoassay for human growth hormone (HGH) was developed, optimised and validated. The anti-hGH sera raised in 2 rabbits were highly specific with low cross-reactions of 0.19% and 0.3% with human placental lactogen and 0.21% and 0.13% with human prolactin. The mean sensitivity of the assay determined from 28 assays was found to be 0.4 +/- 0.2 mIU/L. Mean recovery of added exogenous hGH was 98.8 +/- 6.8%. Linearity studies of samples diluted at 1:2, 1:4 and 1:8 gave values of 101.3 +/- 5.3%, 109.6 +/- 13.4% and 97.3 +/- 13% respectively of those expected. The reproducibility of the assay was good; within assay coefficient of variation for serum samples with GH concentrations of 2.7, 13.6 and 28.2 mU/l ranged from 5.1 to 8.3% while the inter-assay precision varied from 4.9 to 10.3%. The in-house assay showed good correlation (r = 0.96, p less than 0.001) with a commercial HGH RIA kit (Dainabot, Japan). A reference normal adult fasting GH level of less than 7 mIU/l was established from 95 samples assayed by this method.
The routine study of bone marrow trephine biopsies involves fixation, decalcification, paraffin-embedment, sectioning and staining. However, this process creates artifacts, produces shrinkage of tissue, consumes time and can result in sections of unsatisfactory cytological quality. It also renders the tissue unsuitable for enzyme-histochemical and immunohistochemical analyses. Frozen section of bone marrow without decalcification was evaluated as an alternative method for the study of bone marrow. This method was found to give sections with comparable cytological quality to that of paraffin-embedment, yielded sections for interpretation within 24 hours, and allowed enzyme-histochemical and immunohistochemical analyses to be applied successfully.