TB PCR in the early diagnosis of tuberculous meningitis: evaluation of the Roche semi-automated COBAS Amplicor MTB test with reference to the manual Amplicor MTB PCR test. .

SETTING: Cecilia Makiwane Hospital, Mdantsane, Eastern Cape, Republic of South Africa. OBJECTIVE: To assess the role of the semi-automated Roche COBAS AMPLICOR(TM)Mycobacterium tuberculosis PCR test in the diagnosis of tuberculous meningitis (TBM). DESIGN: Eighty-three specimens of cerebrospinal fluid (CSF) were collected prospectively from 69 patients with suspected TBM. The COBAS AMPLICOR TB PCR test was compared with the manual AMPLICOR(TM)TB PCR test, clinical and cerebrospinal fluid (CSF) findings, direct ZN smear and radiometric TB culture. RESULTS: CSF from 7/40 (17.5%) patients treated for TBM were positive by TB COBAS AMPLICOR(TM). The sensitivity of the test was not significantly different (p=0.375) from the manual TB AMPLICOR(TM)PCR test. The comparative sensitivities of the TB COBAS AMPLICOR(TM)PCR and the manual AMPLICOR PCR for detecting cases of definite and probable TBM from CSF collected within 9 days of commencing antituberculosis treatment were 40% and 60% respectively. All 29 patients not treated for TBM were negative by COBAS AMPLICOR(TM), giving a specificity of 100%. CONCLUSION: The COBAS AMPLICOR(TM)TB PCR test is a rapid and highly specific diagnostic test for TBM. However, there was a non-significant trend favouring slightly greater sensitivity using the manual AMPLICOR(TM)TB PCR test.

Effect of immunization against synthetic peptide sequences of the alpha N-subunit of bovine inhibin on ovulation rate, gonadotrophin concentrations and fertility in heifers.

The effects of immunizing cattle against either of two peptides from the amino terminal peptide (alpha N) of the alpha 43-subunit of bovine inhibin on ovulation rate, gonadotrophin concentration and fertility were investigated. Two peptide sequences from the alpha N-subunit of bovine inhibin (P1N, bI alpha-(8-20) and P2N, bI alpha-(153-167)) were synthesized and conjugated to human serum albumin (HSA). Hereford-cross heifers (n = 5 per group) were given an initial injection of 3 mg of one of the peptide conjugates, followed by three booster injections (1.5 mg) at intervals of 11 weeks. Control heifers (n = 5) were injected with HSA only. Blood samples were taken once a week to measure antibody titre and every hour at about the time of the first oestrus and during the mid-luteal phase after the second booster injection, to measure FSH and LH concentrations. Ovulation rate was measured by ultrasonography. Gonadotrophin concentrations were analysed for four periods relative to the peak (time = 0 h) of the preovulatory LH surge as follows: pre-surge: -16 to -5 h; surge: -4 to 4 h; post-surge: 5 to 16 h and a period of 12 h during the mid-luteal (days 10-12) phase. Antibodies that bound to the individual peptides were generated and the ovulation rate increased (P < 0.05) in immunized heifers. Control heifers had one ovulation at all ovulatory cycles monitored. In group P1N, one heifer had two ovulations at each of the six cycles monitored, while another heifer had two ovulations at one cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of immunization against synthetic peptide sequences of bovine inhibin alpha-subunit on ovulation rate and twin-calving rate in heifers.

Three peptide sequences from the bovine inhibin alpha-subunit (P1: 18-30; P2: 63-72 and P3: 107-122) were synthesized and conjugated to human serum albumin (HSA). Hereford cross-heifers (n = 5 per group) were injected with 3 mg of one of the peptide conjugates, followed by three booster injections at intervals of 11 weeks. Control heifers (n = 5) were injected with HSA only. Antibodies recognizing both the individual peptides and 32 kDa bovine inhibin were generated and ovulation rate was increased in peptide immunized heifers. In group P1, 1 of 5 heifers responded with an increased ovulation rate whereas in groups P2 and P3, 5 of 5 and 4 of 5 heifers, respectively, had an increased ovulation rate. In group P2, in the first oestrous cycle following booster injections 2 and 3, 4 of 5 and 3 of 5 heifers, respectively, responded with twin ovulations, whereas a fourth heifer had three ovulations following booster injection 3. After breeding following booster injection 3, 3 of 5 heifers in group P2 and 1 of 5 in group P3 gave birth to twin calves. This study demonstrates the potential of immunizing against synthetic peptide sequences of the alpha-subunit of bovine inhibin to increase ovulation and twinning rates in cattle.

Identification and partial purification of serum growth hormone binding protein in domestic animal species.

The chemical nature and variations in serum concentrations of growth hormone binding protein (GHBP) from humans, rabbits, and rodents have been reported. To date little is known about the GHBP of domestic animals. Therefore, we initiated these studies to determine whether a serum GHBP was present in domestic animals and to purify the binding protein (BP) from serum of selected species. Using a dextran-coated charcoal separation assay, specific growth hormone (GH) binding was demonstrated in ovine, bovine, chicken, human, goose, porcine, and equine serum (listed in sequence from lowest to highest binding). Variation in BP activity was relatively high, both within and between species. Yearling ewes had higher serum GHBP than either prepubertal (4 mo) or older (5 yr) ewes. The GHBP was partially purified from chicken, ovine, and porcine serum using GH affinity chromatography. These BP had high affinity (Ka = 2 x 10(8) to 2 x 10(9) L/mol, depending on species) and low capacity (2 x 10(-10) to 5 x 10(-11) mol/unit of protein) for human GH but showed lower binding affinity for homologous GH (Ka = 2 x 10(7) L/mol). The porcine GHBP had the highest and ovine GHBP the lowest affinity for human GH. Other heterologous somatotropic hormones, ovine placental lactogen, and ovine GH displayed higher binding affinity to chicken and pig BP than the respective homologous hormones. Further chromatographic purification of the porcine GHBP resulted in an additional 1,000-fold purification. The estimated molecular weight of porcine GHBP is 50,000 to 60,000 Da. These results demonstrate that the serum from all domestic species tested contains a specific GH-binding moiety and that under the conditions described here human GH is a more efficient ligand than the homologous hormone.

Reiter's syndrome in a black patient. A case report.

Reiter's syndrome is very rare in blacks in southern Africa. The occurrence, with florid symptoms and signs, in a black patient with the HLA B27 antigen is reported.

Sarcoidosis in Ciskei. A report on 15 cases.

Since 1977 15 patients with sarcoidosis have been seen at the Cecilia Makiwane Hospital, Ciskei. Three patients were 13 years of age or less and 5 were under 20 years; 6 patients had phalangeal osteolytic lesions, 5 with concomitant skin involvement. Only 3 patients had respiratory symptoms.

Staphylococcus aureus tricuspid valve endocarditis in young women after gynaecological events. A report of 3 cases.

Three cases of Staphylococcus aureus tricuspid valve endocarditis are reported; each was preceded by a gynaecological event. In 2 cases there was no overt pelvic sepsis and there had been no operative or instrumental intervention, but in the 3rd pelvic inflammatory disease was present, probably not as a result of interference. There are few reports in the recent literature of gynaecological events precipitating this condition; in contrast, intravenous narcotic abuse is well documented. In the literature there is insufficient stress laid on the fact that non-septic gynaecological events may cause the endocarditis. The difficulties in diagnosing tricuspid endocarditis, especially in a milieu where intravenous narcotic abuse is virtually unknown, are noted. When endocarditis is present in women known not to abuse narcotics, the absence of signs of pelvic inflammation may also cause difficulties in diagnosis.

Systemic lupus erythematosus in 3 black South African men. Case reports.

Only 1 case of systemic lupus erythematosus (SLE) has been documented in a South African Black man. We report 3 further patients, 1 each from Cape Town, Durban and East London, diagnosed between 1978 and 1982. All 3 patients fulfilled the revised American Rheumatism Association criteria for the classification of SLE.

Sinus histiocytosis with massive lymphadenopathy. A case report.

A case of sinus histiocytosis is reported. This apparently rare disease was first described in 1969. The patient presented with a large, painless, bilateral cervical adenopathy which regressed completely over a 16-month period. Histological examination of a lymph node specimen showed sinuses distended with foamy histiocytes. Intervening lymphoid tissue showed a tremendous increase in plasma cells which distorted the normal architecture of the lymph node. The importance of accurate pathological diagnosis is again noted.