Primary Malignant Melanoma of Vagina: The Options of Management

Primary malignant melanoma of the vagina is rare but aggressive. Various treatment options include surgery and adjuvant therapy has been advocated but the outcome remained unpredictable. Standard treatment protocol is yet to be established. We report a case of 54-year-old, Para 4+1, with malignant melanoma of the vagina. She underwent wide local excision but the surgical margin was not clear of malignant cells, hence adjuvant radiotherapy was given. Combination chemotherapy was initiated subsequently as her disease disseminated. She succumbed later due to septicaemic shock. The treatment options for vaginal melanoma were reviewed.

Intraperitoneal Chemotherapy Following Refractory Intravenous Route in Advanced Ovarian Cancer

Platinum based adjuvant chemotherapy is generally recommended for ovarian cancer to improve the survival rate. Intravenous route is commonly used, easily administered and less associated complications. However, intraperitoneal route is gaining its popularity as a single procedure or adjunctive to the intravenous route. Numerous questions on its eligibility and safety are still perplexed. A case review on a patient with non optimal debulking surgery of advanced ovarian cancer was studied. Intravenous platinum based chemotherapy combined with paclitaxel failed to bring her to clinical remission. Second line chemotherapy, gemcitabin rendered her to poor response with unresolved debilitating ascites needing recurrent drainage. Surprisingly, a trial of intraperitoneal chemotherapy with cisplatin revealed a great response with a complete clinical remission.

Introduction of a rapid dipstick assay for the detection of Leptospira-specific immunoglobulin m antibodies in the laboratory diagnosis of leptospirosis in a hospital in Makassar, Indonesia.

An easy, rapid and robust dipstick assay for detection of leptospira-specific immunoglobulin M (IgM) antibodies was evaluated on 403 patients admitted for hospitalization because of fever. The clinical symptoms and signs of 35 patients were consistent with leptospirosis. The final diagnosis for the remaining patients was as follows: 136 with typhoid fever, 82 with hepatitis, 74 with malaria, 48 with infections of the respiratory tract, and 20 with fever of unknown origin. The clinical diagnosis of leptospirosis was confirmed for 24 (68.6%) patients by the combined results of the microscopic agglutination test (MAT), the reference test for leptospirosis, and of IgM ELISA, a standard laboratory test for the serodiagnosis of leptospirosis. In addition, serum specimens from 8 (2.2%) patients with a final clinical diagnosis other than leptospirosis were found to be positive in MAT and/or IgM ELISA. Compared with the results of MAT and IgM ELISA a sensitivity of 91.6% and specificity of 93.6% was calculated for the dipstick assay. Most of the serum samples from the laboratory confirmed patients gave a moderate to strong staining intensity of the antigen band of the dipstick and were easy to read. The results demonstrate that the dipstick assay is convenient to use and allows the rapid and accurate confirmation of patients with clinical suspicion of leptospirosis in areas where the disease is endemic.

Antitumor mechanisms of Eubacterium lentum and its components.

In the present study, some antitumor mechanisms of Eubacterium lentum (TYH-11) and bacterial components having antitumor effects were investigated. E.lentum induced maximum NK cell activity in C3H/He mice on day 1 after injection (90.6% against 33.9% of control at E:T ratio 50:1) and the activity was kept at a level of 48.6% on day 7. Tumoricidal peritoneal macrophages were induced 9 days after E.lentum injection into BALB/c mice (56.2% against 10.1% control at E:T ratio 10:1). Tumoricidal macrophage activity persisted at the same level for at least 11 days. Cytotoxic T lymphocyte (CTL) activity was induced only in tumor bearing mice treated with E.lentum, 4 weeks after tumor inoculation. Antitumor activity was observed in the cell wall (CW) and membrane fractions (CM) of E.lentum. CW induced NK cell activity; the activity was transient while the kinetics of NK activity by CM showed 2 peaks, on day 1 and day 7. Tumoricidal macrophages were induced by CW and the activity level was the same as that induced by whole body, while that induced by CM was at a lower level. Neither CW nor CM induced CTL in tumor bearing mice.

Evaluation of the Mycobacterium leprae particle agglutination (MLPA) test as a tool in the epidemiology of leprosy in high prevalence village in South Sulawesi, Indonesia.

This study reports on the usefulness of an IgM phenolic glycolipid-1 (PGL-1) Mycobacterium leprae particle agglutination (MLPA) test for serodiagnosis of leprosy in a prospective longitudinal community survey in a high prevalence village in South Sulawesi, Indonesia, IgM PGL-1 MLPA has simple and limited value as a screening method for detection of transmission of leprosy in the community. Many normal persons in the community in a high prevalence area had increased IgM anti PGL-1 antibodies, presumably as a consequence of early subclinical infection. In conclusion, this study demonstrated that the MLPA test can only reliably detect anti-PGL-1 antibodies in the community and may be useful for follow-up study of subclinical infection of leprosy among individuals living the an endemic area.