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The Association of Cliniical Pathologists: 94th general meeting

found in tissues, and a very resistant and mycoplasmas from the genital tract but Aspects of Rubella Immunity in Wales infectious oocyst found in the stools of there was no difference in the rates of cats. Each can play a different r6le in conception of the treated or control JULIA A. MUNRO (Public Health Laboratory, University Hospital of Wales, Cardiff') the spread of infection. It is a unique groups. protozoan parasite in that it is not hostWe are unable to confirm the suggestion Although rubella is usually a mild illness of specific and affects virtually all species of Gnarpe and Friberg (1972) that childhood, virological confirmation of of mammal and birds. The prevalence of doxycycline is of benefit in the treatment rubella is most frequently required when a pregnancy is involvea. The relationship toxoplasma antibody varies not only of primary infertility. between rubella infection in pregnancy between town and country but also in and fetal damage is widely known, and different regions of the world. In town Reference dwellers in Lincolnshire the incidence is Gnarpe, H. and Friberg, J. (1972). Mycoplasma because of the need to prevent pregnant and human reproductive failure. I. The women contracting the disease, immuniabout 220%, whereas it is about 36%0 in occurrence of different mycoplasms in zation programmes have been introduced. the rural areas. In urban Hong Kong, couples with reproductive failure. Amer. J. Live atter,uated vaccine is offered to all it is 60% whereas in urban Paris it is 90 %. Obstet. Gynaec., 114, 727-731. In rural Sudan it is 22 % whereas in It. Concentrations of doxycycline in serum girls between their 11 th and 12th birthdays, ane seminal fluid and the effect on the also to any woman found to be serorural Tristan Da Cunha it is 800%. growth of T-mycoplasmas. Amer. J. Obstet. negative antenatally when it is given There are still many unsolved problems Gynaec., 114, 963-966. early in the post-partum period. To try to on how man and animals become infected. Man is surrounded by animals which Micrococcal Urinary Infections in assess the extent of the problem, results of rubella haemagglutination inhibition may transfer infection to him. In towns Young Women titres at various ages and of different they will be mainly cats and dogs but populations were studiec. It was found in the country man is in contact with a much wider variety of animals. Another MARGARET A. SELLIN, W. A. GILLESPIE, AND that prior to the introduction of the factor is raw meat which may contain the J. D. ANDERSON (Department of Bacteri- immunization programme, 300% of toxoplasma parasite but little is known to ology, University ofBristol and Department children aged 10 to 15 years were still what extent this can cause infection. of Pathology, County Hospital, York) susceptible to rubella and 12 % of the In France it has been shown that the Prospective surveys of acute urinary antenatal population. Rubella vaccine ingestion of raw meat can cause infection, infections in females aged 17 to 25 has had little effect upon the antenatal and the high incidence of toxoplasma showed that most, perhaps the great population results. This means that there antibodies in Parisiens could be due to majority, of the infections followed sexual is still a need for rapid serological their eating habits. intercourse. Nearly all were caused by diagnosis of suspected rubella in early In Birmingham owners of either a cat either Escherichia coli or micrococci. pregnancy. One year's results using or dog have been shown to be associated The micrococcal infections were about haemagglutination inhibition and complewith a higher incidence of toxoplasma half as common as the coliform ones. mentary fixation titres supplemented by antibody, and these animals probably Micrococcal infection often produced sucrose density gradient centrifugation play a significant part in the transfer of more pyuria than coliform infection, and and 2 mercapto-ethanol reduction for the detection of rubella 1gM antibody infection. symptoms were at least as severe. Much more research is needed into the All the infecting micrococci belonged are presented. epidemiology of toxoplasmosis. to Baird-Parker type 3 and all were novobiocin-resistant. Most were sensitive Measurement of Plasma Volume using Mycoplasma, Doxycycline, and Human to sulphonamide. Sulphonamide treat- Human Serum Albumin labelled with Technetium Infertility ment was usually satisfactory. M. BLADES, J. DE LOUVOIS, R. F. HARRISON,

AND ROSALINDE HURLEY (Quteen Charlotte's

Hospital for Women, London) MAycoplasma hominis was isolated from the genital tracts of 13.20% of 38 fertile and 14.7% of 109 infertile couples and T. mycoplasmas from 52.6% of fertile and 57-2%/ of inferile couples. Minimum inhibitory concentrations of doxycycline for T. mycoplasmas (0-160-32 jzg/ml) and M. hominis (< 0 08 ,ag/ml) were determined. A double-blind controlled trial of doxycycline was carried out on 88 fertile couples. Levels in seminal fluid (0-220-95 pig/ml), cervical mucus (0 06-3 02 pig/ml), and serum (0 43-3 98 ,tg/ml) were measured. Twenty-eight days' treatment with doxycycline (100 mg/day) eradicated

The Micrococcaceae present in the urethra and introitus of healthy young women were investigated in forestream urine specimens and peri-urethral swabs. Forestream urine from healthy young men was also investigated. Staphylococci (all of which were coagulase-negative) outnumbered micrococci in the urethra of both sexes. Most micrococci belonged to types 1, 2 or 3, but very few of the type 3 strains were novobiocin-resistant. Thus the novobiocin-resistant type 3 strains responsible for urinary infection were rarely found in the normal urethra. These findings point to an exceptional virulence of the micrococcal biotype responsible for urinary infection. So far there has been little evidence to suggest that the infecting micrococci were transmitted from males to females.

A.

M.

HOLROYD, A.

C.

LAWRENCE, C.

PARKER, AND M. DAVIES (Haematologyl Department, Northern General Hospital and Medical Physics Department, Weston Park Hospital, Sheffield) A standard technique for measurement of plasma volume using radio-iodine-labelled human serum albumin ("'I HSA) has been compared with the same method using human serum albumin labelled with technetium (99mTc HSA) Beazley et al, 1968). The plasma volume has been measured simultaneously using two isotopes and differential counting in five normal subjects and eight patients with polycythaemia, myelofibrosis with splenomegaly, chronic granulocytic leukaemia with splenomegaly, or chronic renal

757

The Association of Clinical Pathologists: 94th general meeting failure. The average discrepancy between the two methods in 12 cases was 50 ml. A low value of 27*5 ml/kg was obtained in one normal subject using 1251 HSA compared with a value of 50 ml/kg using 99mTc HSA. The 30 pCi dose of99mTc HSA used produces a smaller radiation dose to the whole body including the blood and to the thyroid and would be suitable for sequential plasma volume measurements and measurements in pregnant women.

Reference J.

patients threatened to abort for much longer than happens in Liverpool before this became inevitable. Blood levels of HPL and HCG were measured on admission to hospital for threatened abortion. Women admitted for therapeutic abortion were used as controls. A highly significant difference was found between the mean levels of both hormones for women who in fact aborted and for those whose pregnancy continued: the differences between those wnose pregnancy continued and the

thymoma. The possible significance of these features in relation to humoral epithelial/lymphocyte interaction will be

discussed.

Gaucher's Disease with Biclonal Gammopathy MORVEN MACDONALD, MARGARETMCCATHIE, M. J. W. FAED, R. PRINGLE, H. B. GOODALL, J. S. BECK, G. R. TUDHOPE, P. E. G. MITICHELL, A. J. J. WOOD, W. GUTHRIE, AND D. SHAW

(Pathology Department,NinewellsHospital, Further, Dundee) The association between controls were not significant. the changes of Gaucher's disease and monoclonal

J. C.,Leaver, E. P., and it is possible to calculate Beazley,Smith,M.,G.Matthews, M. (1968). Placental localisation abortion taking place from the level of gammopathy is well documented (Pratt serum albumin. labelled VSmrfc using 1968). The present case appears to either hormone, but unexpectedly HCG et al, J. Obstet. Gynaec. Brit. Cwlth, 75, 470. the first in which Gaucher's disease is be (analysis a more accurate figure gives associated with biclonal gammopathy.

Effects of Natural Oestrogens on Blood of results by Mr M. C. K. Tweedie). A woman aged 48 complained mainly of Clotting-a Double-Blind Cross-over Trial Using both levels a still more accurate tiredness and was found to have pingueassessment emerges. This work was partly supported by a culae, splenomegaly, raised serum acid L. POLLER, J. M. THOMSON, AND J. COOPE and low,-glucosidase activResearch Grant from the former United phosphatase, (Department of Haematology, Withington in skin fibroblasts. The cultured ity Hospital, Manchester) A double-blind Liverpool Hospitals. blood showed pancytopenia with dimorcross-over study on the effect of natural Reference phic red cells. The marrow showed oestrogen on blood clotting and platelet Genazzani, A. R., Aubert, M. L.. Casolif M.. typical Gaucher cells and atypical deFioretti, P., and Felber, J-P. (1969). Lancet, aggregation has been performed on a generate foamy forms; excess of two 2, 1385-1387. group of 30 women. It had been claimed types of plasma cells, large and small; that naturaloestrogen did not have the transitional megaloblasts and giant metaharmful effect of synthetic oestrogen on An EM Study of Human Thynus myelocytes. Serum proteins (9 g per blood coagulation. 100 ml) included two abnormal bands on The women were randomly divided W. JONES WILLLAMS, D. L. JONES, AND electrophoresis, one IgC and one IgA. Welsh THOMAS (Pathology Department, into two groups, the first group received K. Anaemia was partly corrected by oral natural oestrogen (Premarin) for three National School of Medicine, Cardiff) iron and folic acid, but hypersplenism months and then for a further three In a fine structure study of human, normal, persisted, and thrombocytopenia and months received a placebo, whereas the hyperplastic, and tumour thymus, we leucopenia necessitated splenectomy. Two second group received the placebo first. demonstrate similar cell types though weeks after operation the serum IgG was Significant acceleration of the pro- they are present in varying proportions. at the level but IgA was thrombin time and factor VII and X The mixed thymoma differed only in halved. preoperative assays occurred with natural oestrogen showing increased numbers of mitosis With fluorescent anti-IgG and anti-IgA administration but the intrinsic tests were and predominance of large lymphocytes. sera two populations of plasma cells in We the for first describe, time, not accelerated at the three-month stage. were identified-one predominantly in The changes are similar to those which postnatal human thymus, the presence of marrow, producing IgG; the other in occur after three months' synthetic nuclear pockets in lymphocyte nuclei. marrow and spleen, producing IgA. oestrogen/progestogen oral contraceptive We also found that both lymphocytes and one of the lipids epithelial cell nuclei contain nuclear in Galactocerebroside, administration. in Gaucher's cells reticulo-endothelial bodies. It is likely that both are features of disease, is known to be strongly antigenic Endocrine Assessment of Threatened actively metabolic cells. because of its ability to produce plasma Three varieties of lymphocytes are cell Abortion proliferation when injected into 'activated'. large, and present-small, mice. Could leakage of this or other lipids cells R. E. REWELL Department of Pathology, In addition, occasional plasma The United Liverpool Hospitals, Liverpool) suggest the presence of B type lymphocytes. from the foamy, degenerate Gaucher cells At the end of pregnancy human chorionic We consider that epithelial cells have have stimulated the production of the two

gonadotrophin (HCG) and human percentilelactogen(HPL) in thebloodfall sharply. Since the half-life in the circulation of HPL is much shorter than that of HCG, it is the former that would be expected to be more useful in assessing whether or not a threatened abortion will in fact take place. Several small series have confirmed this, eg, Genazani et al (1969), though their

a functional as well as a structural r6le. There appears to be a continuity between cell mucoprotein-containing' epithelial material, cytoplasm and extracellular which is taken up by macrophages, all in close contact with lymphocytes. Some mucoprotein-containing macroare converted into foam cells. phages These features are most prominent in the

clones of plasma cells in this patient?

Reference

Pratt, P. W., et al. (1968). Blood, 31,

633.

Dissociation of Carboxyhaemoglobin in the Cadaver

(Department of Pathology, General Hospital, Nottingham) Many

H. M. RICE