Development of coagglutination reagents for serological grouping of streptococci.

Coagglutination reagents for the rapid serological grouping of groups A, B, C, F and G Streptococcus have been developed. Antisera to groups A, B, C, F and G Streptococcus were raised in rabbits. After absorption with cross-reacting antigens, the specific antibodies were coated on Staphylococcus protein-A and used as group-specific coagglutination reagents. The sensitivity of the reagents for groups A, C and G Streptococcus was 100 per cent and the specificity was 100, 100, and 98.77 per cent, respectively. The sensitivity and specificity of these reagents were consistent up to 12 months, although specificity declined with longer storage. The in-house coagglutination reagents for groups A, C and G streptococcus were also tested in comparison with the commercially available Streptococcus Phadebact test and yielded almost identical results. Sensitivity of the in-house of group B Streptococcus reagent was low, while the group F reagent gave a high incidence of false positive reaction.

Alpha-L-fucosidase as a serum marker of hepatocellular carcinoma in Thailand.

To evaluate the role of serum alpha-L-fucosidase (AFU) in the diagnosis of hepatocellular carcinoma (HCC), we simultaneously studied both AFU activity and alpha-fetoprotein (AFP) level in 60 patients with HCC, 60 patients with cirrhosis and chronic hepatitis each, 30 patients with other liver tumors and 60 healthy subjects. Serum AFU activity in patients with HCC (1,418.62 +/- 575.76 nmol/ml/hr) was significantly higher than that found in cirrhosis (831.25 +/- 261.13 nmol/ml/hr), chronic hepatitis (717.71 +/- 205.86 nmol/ ml/hr) or other tumors (706.68 +/- 197.67 nmol/ml/hr) and in controls (504.18 +/- 121.88 nmol/ml/hr, p < 0.05). With 870 nmol/ml/hr (mean value of controls plus 3 standard deviations) considered as the cut-off point, AFU was more sensitive (81.7 vs 39.1%) but less specific (70.7 vs 99.3%) than AFP at a level of > 400 ng/ml as a tumor marker of HCC. With both markers combined, the sensitivity was improved to as much as 82.6%. AFU activity in HCC patients was correlated to tumor size (r = 0.3529, p = 0.006) but not associated with tumor staging classified by Okuda's criteria (p = 0.1). The AFU activity in the viral hepatitis group (hepatitis B or C) was also significantly higher than in the non-viral group (p = 0.0005). We conclude AFU to be a useful marker, in conjunction with AFP and ultrasonography, for detecting HCC, particularly in patients with underlying viral hepatitis and cirrhosis.

Monospecific antivenin therapy in Russell's viper bite.

Venom antigenemia was detected in 24 out of 30 Russell's viper bites. Those who suffered clinical bleeding (N = 14) had higher venom antigenemia than those who did not. The mean value of the amount of monospecific antivenin correcting blood incoagulability was 165 +/- 59.3 ml. Consequently, the recommended treatment is 60 ml of antivenin being administered intravenously at 6-hour intervals until blood coagulability is restored. There were no serious complications after antivenin administration. Renal complication (3 cases) was the major problem following this snake bite. One patient with clinical diagnosis of central nervous system bleeding died on admission.