Eleven corneal specimens from nine patients with Salzmann's nodular degeneration of the cornea, together with all available clinical information, were collected for this study. The specimens were examined by light and electron microscopy. An antecedent keratitis was diagnosed by history and microscopic findings in every case. The corneal epithelium showed degenerative changes, its thickness varied, and in nodular areas it often consisted of only a single layer of flattened epithelial cells by light microscopy. Bowman's membrane was missing over the nodules, and in this zone there was excessive secretion of a basement membrane-like material. Hyaline degeneration of collagen, cellular debris, and electron-dense hyaline deposits were seen in the collagen of the nodules. The number of fibrocytes in the nodules varied from many that were active to a few that were degenerating. External irritation because of poor epithelial protection was interpreted as a causative factor, although other tissue repair mechanisms may also have played a role.
The objectives of this article are (1) review the contribution of traditional midwives to family planning communication in several Asian countries; (2) organize knowledge gathered from various studies into general guidelines for the most effective use of traditional midwives in family planning programs; and (3) present hypotheses for future research. In certain countries where pilot projects have tested the potential performance of traditional midwives in family planning programs, results have been encouraging. In other nations, more research is needed to determine the contribution traditional midwives can make to the family planning program.
PIP: Traditional midwives are found in almost every village and in many urban neighborhoods in the developing world, delivering the majority of births in these areas. Several Asian nations have begun to recognize the potential contribution of traditional midwives to modern family planning and health programs. A total of about 17,000 traditional midwives have been trained as family planning recruiters in Indonesia, Malaysia, the Philippines, and Thailand. Because traditional midwives deliver a large number of births in Asian nations, the potential is great for them to reach large numbers of women regarding family planning -- particularly poor, illiterate women. There is much to be learned from the traditional health system and governmental health and family planning programs should join hands with these older systems.
PIP: Traditional midwives are active in most villages and many urban areas of Asia, Africa, and Latin America. They deliver babies, provide prenatal and postpartum care, teach folk methods of birth control, treat infertility, and enjoy the confidence of many women. Most official family planning programs make little or no use of these traditional midwives. Research should be conducted into the most effective ways of recruiting and rewarding midwives in family planning programs. They seem to function best when provided with adequate training, supervision, and incentives. Traditional midwives are participating in the national family planning programs in Pakistan, Indonesia, Malaysia, and the Philippines. Only in Iran do they participate in the medical aspects of family planning. Midwives in Iran do IUD insertions and their performance compares favorably with that of medical personnel.
All subspecies of black rats (Rattus rattus) used in the present study are characterized by having large and clear C-bands at the centromeric region. The appearance of the bands, however, is different in the subspecies. Chromosome pair No. 1 in Asian type black rats (2n=42), which are characterized by an acrocentric and subtelocentric polymorphism, showed C-band polymorphism. In Phillipine rats (R. rattus mindanensis) the pair was subtelocentric with C-bands, but in Malayan black rats (R. rattus diardii) it was usually acrocentric with C-bands. In Hong-Kong (R. rattus flavipectus) and Japanese black rats (R. rattus tanezumi) it was polymorphic with respect to the presence of acrocentrics with C-bands or subtelocentrics without C-bands. The other chromosomes pairs showed clear C-bands, but in Hong-Kong black rats the pairs No. 2 and 5 were polymorphic with and without C-bands. In Japanese black rats, 6 chromosome pairs (No. 3, 4, 7, 9, 11 and 13) were polymorphic in regard to presence and absence of C-bands, but the other 5 chromosome pairs (No. 2, 5, 6, 8 and 10) showed always absence of C-bands. Only pair No. 12 usually showed C-bands. C-bands in small metacentric pairs (No. 14 to 20) in Asian type black rats generally large in size, but those in the Oceanian (2n=38) and Ceylon type black rats (2n=40) were small. In the hybrids between Asian and Oceanian type rats, heteromorphic C-bands, one large and the other small, were observed. Based on the consideration of karyotype evolution in the black rats, the C-band is suggested to have a tendency toward the diminution as far as the related species are concerned.
A rare electrophoretic variant of superoxide dismutase (SOD) was found in one Filipino of 146 Filipinos, 1382 Malaysians and 816 Indonesians examined. The variant consists of two usual bands and two slower migrating bands similar to those reported earlier. Superoxide dismutase variants are common among people of certain localized regions in Europe, however, this is the first report of such a variant occurring in people of non-European origin.
Several medical schools in Southeast Asia have identified deficiencies in their undergraduate medical education that result in inappropriate training of students for the health-care problems that exist in their respective countries. Curriculum changes have been made that take students out of the laboratory and the subspecialty-oriented university hospital and place them in extramural programs in the community. Both the deficiencies identified and the solutions developed merit study by North American medical educators, especially those teaching primary care in family practice.
This report summarizes the results of a comparative study of the virulence of the "S-M," H, and C strains of P. knowlesi for Indian rhesus monkeys (Macaca mulatta) and cynomolgus monkeys [M. irus (fascicularis)] of Malayan (West Malaysia) and Philippine origins. Each of the above strains produced fulminating, uniformly fatal infections in the rhesus monkey and mild, chronic infections, characterized by relatively low level parasitemias in cynomolgus monkeys of Philippine origin. In striking contrast, the H and C strains produced infections in cynomolgus monkeys of Malayan origin which were indistinguishable in severity from infections produced in M. mulatta. The circumstances of the study precluded evaluation of the virulence of the "S-M" strain for M. irus of Malayan origin. Even so, the available data make it necessary to qualify the long-held belief that infections with P. knowlesi in M. irus invariably follow a benign course.