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Ten patients with macular amyloidosis were studied with particular reference to the role of friction. All 10 patients had a history of prolonged rubbing over a period of 2-5 years with various objects, such as bath sponges, brushes, towels, plant sticks and leaves. The presence of amyloid was confirmed by histochemical stains in six cases and by electron microscopy in four cases. The study confirms the role of friction in the causation of macular amyloidosis and hence, the term 'frictional amyloidosis' aptly describes the condition. The study also emphasizes the need for electron microscopy in the diagnosis of frictional amyloidosis.

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BACKGROUND: Direct immunofluorescence (DIF) is considered to be a major advance in the diagnosis of connective tissue diseases, particularly lupus erythematosus (LE); however, the reliability of the technique depends on several factors, such as age and site of the lesion, type of immunofluorescence, type of immunoglobulin, etc. False positives and false negatives can occur. OBJECTIVE AND METHODS: To determine the diagnostic value of DIF we studied 18 clinically established cases of cutaneous lupus erythematosus (CLE). Lesional biopsies were subjected to routine histopathologic examination and direct immunofluorescence. The results were compared. RESULTS: Direct immunofluorescence was positive in 72.7% and histopathology in 66% cases. Combination of the two techniques (with one or both methods giving characteristic findings) was positive in 83% cases. The most common antibody was IgG, seen in 77.8% cases. A homogeneous pattern of immunofluorescence, with IgG, was seen in 55.5% of the cases. Although histopathology gave positive or suggestive results in all cases, DIF was negative in two cases of early cutaneous LE. CONCLUSION: Although DIF is an extremely useful diagnostic tool, it should always be used in conjunction with histopathology and the combination of the two methods yields the best results.

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Renal functional status in Mycobacterium leprae infected mice can be best studied by examining the enzymatic status of brush border membrane vesicles from proximal convoluted tubule. The role of vaccination in modulation of the renal status brought by the disease has been studied using this technique. The characteristic marker enzymes of renal brush border membrane--namely alkaline phosphatase, leucine aminopeptidase and gamma-glutamyl transpeptidase decreased significantly (p less than 0.01) in due course in M. leprae infection over a period of 9 months. The combined vaccine (BCG + M. leprae) may have a protective effect on renal abnormalities only in the initial stages of infection as indicated by a significant rise in enzymatic levels. However, no significant (p greater than 0.05) protective effect of vaccine was found in a more advanced disease state after 9 months in infected mice.

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A case of chronic pyelonephritis masquerading as a renal neoplasm in a young adolescent male is presented. The diagnostic dilemma posed by the disease, and its management, are discussed.

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The reactive oxygen species generation capacity of Kupffer cells and blood monocytes was studied through chemiluminescence (CL) in guinea pigs, infected intracecally with Entameba histolytica, on days 0, 3, 7, 14 and 21 post infection. There was an elevated response up to the 14th post-infection day. The CL response of these cells was diminished on the 21st post infection day though it was significantly higher than up the controls. The CL response increased exponentially with the severity of cecal lesions. A direct correlation was observed between the CL response of phagocytic cells and cecal lesions of animals. The role of oxygen species in causation of tissue injury during intestinal amebiasis is postulated.

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We describe the clinical course of a patient with florid, predominantly neurological, Wilson's disease who developed serious toxic effects of d-penicillamine therapy but responded well to long term oral zinc sulphate. A congenital portosystemic shunt has decompressed the portal bed adequately to prevent the development of varices. We also documented the return to normal of a grossly abnormal pancreolauryl test after withdrawal of zinc.

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Fourteen patients, 9 males and 5 females with chronic severe intractable psoriasis resistant to conventional therapies were treated with methotrexate. Five had psoriatic erythroderma while 9 had extensive disease. Methotrexate therapy given orally in weekly single doses of 20-30 mg was effective in all cases. The side effects observed included nausea and vomiting headache, pain abdomen, diffuse alopecia and loss of appetite.

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Histopathological studies in guinea-pigs infected intracaecally with Entamoeba histolytica were carried out longitudinally on days 3, 7, 11, 15, 20 and 35 after infection. Three characteristic modes of development of caecal lesions were observed. These in order of their prevalence were the classical inflammatory cellular infiltration, lymphoid hypertrophy and necrotizing colitis. Occasional amoeboma formation was observed in progesterone-treated animals. This is the first time that histological lesions which mimic the human intestinal amoebiasis have been described in the experimental animal.

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