Vaccination against severe hepatosplenic disease in schistosomiasis japonica: a hypothesis

Manifestations of serious disease in chronic schistosomiasis such as portal hypertension, collateral circulation and hepatosplenomegaly are ascribed to T cell-dependent obstructive granuloma formation with subsequent fibrosis principally in the liver. Collagen synthesis and tissue fibrosis may also result from indirect effects of T cell dependent macrophage activation but also from direct effects of eggs productions. Mature eggs are known to be a rich source of "immunopathologic" antigens. It is proposed that antibodies, through their effects on both mature and immature eggs, may markedly decrease opportunities for expression of immunopathologic responses. The hypothesis is that antibodies of certain specificities and certain istotypes can inhibit embryonation of immature and/or effect early or accelerated destruction of mature eggs. The disease modulating consequences of these stem from inhibition of sustained production and release of immunopathologic antigens. The anti-immunopathologic effects being termed "anti-embryonation immunity" (directed against immature eggs) and "anti-miracidial immunity" (accelerated desctruction of mature eggs). On theoretical grounds, sensitization of hosts for anti-embryonation immunity would be a particularly effective means of vaccinating against severe hepatosplenic disease. Such a vaccination strategy could also lead to reduced transmission of infection. It should also inhibit production of egg products with effects in the liver such as hepatotoxicity and promotion of collagen synthesis. The hypothesis emphasizes the consequences of the immune responses on the source of immunopathologic antigens (i.e the egg) in modulation of granuloma formation and disease abatement. The alternative, and in our view, less attractive strategy of vaccination for anti-immunopathology, is to promote immuregulatory responses (e.g. suppressor T cells) which operate to inhibit immunopathologic effector cells and antibodies.(Summary)

On plasma phosphatase levels in pregnancy in the Philippines

During pregnancy, the alkaline plasma phosphatase should increase. In the Philippines, in spite of a definite tendency to increasing values with the progress of pregnancy, the observed levels are still below normal due to the abnormally low initial values. Low plasma phosphatase levels may have an effect on the ossification processes of the fetus. As consequence of the low phosphatase levels of the mothers, newborn infants have a very low plasma phosphatase level. The low levels are most probably due to unbalanced diet of the mother, if we like to avoid the term "malnutrition". We found likewise low levels in pregnant women and in some adult of both sexes. Low plasma phosphatase levels seem to be the rule in Filipinos of any age. (Summary and Conclusion)

Studies on hydatidiform mole

1. Excessive uterine enlargement or its sudden occurrence in a mole has the tendency to become malignant2. Every case of mole should be examined by early microscopy for malignancy. Benign cases should be followed up in young women for three months, and in women approaching menopause, for three years, for clinical evidence of chorioepithelioma. (Conclusion)

The use of the male Philippine Rana vittigera Wiegmann in the diagnosis of pregnancy

1) Using 780 frogs, we studied the suitability of the male Philippine Rana vittigera as a test animal for the diagnosis of pregnancy2) Of 44 non-pregnant cases, not a single false positive reaction was observed3) Eighty-six known pregnancies in the last trimester were examined. Of these, however, using a 2cc. urine specimen for injections, 3 negative reactions occurred which became positive after the urine from the same cases were concentrated and injected in amounts equivalent to 10 cc. of the native urine4) The earliest age of amenorrhea that gave a positive reaction was 10 days after the first day of the missed menstrual period. (Summary)

Widening the indications for cesarean section

1. A review of cesarean sections done at the Philippine General Hospital during two separate periods is made, to indicate the increasing incidence and scope of cesarean section2. The effects of the broadening scope of cesarean section on the hemorrhages are shown, particularly on maternal and infant mortality3. The ill-effects of the broadening scope of cesarean section is shown on the incidence of rupture, and incidence of sterilization on 117 primary sections out of 773 sections done at the Philippine General Hospital from 1945 to the close of 19514. Our conclusion is that the immediate good effects outweigh the remote ill-effects of the obstetric cripple, since these are preventable by good skill and judgment on the lst section, massive antibiotics and blood transfusion to aid in the healing and prophylactic measures on all previous sectioned cases5. While the good results justify the broadening of the indications for the operation, there is a tendency to abuse the operation in preference to vaginal delivery; but this tendency can be controlled through good obstetric judgment and an honest conscience. (Summary and conclusions)