Genital, extragenital and skeletal granuloma inguinale

473

SELECTED

>UXSTRACTd

differential diagnosis of carcinoma can be facilitated by the :itlnrinistr:ttifln tri’ estrngen~ in doses of 2.5 mg./day for one week. This hormonal stimulation results in cornificat!on of superficial layers, with subsequent disappearance of pathologica cells from the smear. Thm, if no carcinoma is present, a normal smear is obtained, whereas, with true cancer, this im. provement is not noted, Thus many doubtful eases can be cleared np in a peaicni of WX-~*~L days. T/ . B.

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Chevd, M. M., and Hwe, M. J.: Chemical Diwnoeis of Pregnancy by the Determination of Histidine in the Urine, Bull. Assoc. d. gym%. et d’obst. de lang. franl;. 1: 7, 1949. The authors redescribe the ZO-minute chemical test by which pregnancy can be detected through the determination of histidine in the urine specimen. The first morning urine speei. men is used. The specific gravity is brought between 1.010 and 1.005; a 10 per cent solution of barium chloride is added, drop by drop, after which a 5 per cent potassium permauganate is added until the precipitate has a rosy tint, then filter. To 5.0 e.c. of the clear solution add several drops of a 2.5 per cent solution of bromide containing 33 per cent acetic acid -about 10 or 12 drops as a rule-and wait ten minutes. Heat the test tube then up to 50” C. after which is added, drop by drop, a 3 per cent ammonium carbonate in diluted ammonia (2 to 1) solution. If hi&dine is present the solution turns from a rosy to a red wine color. In a series of 23 patients, pregnant from 2 to 6 months, the test was found positive in all cases. There were 4 additional false positive cases. The writers report the histidine content in the urine can be elevated just before menstruation and exaggerated in fibroid cases. It rapidly disappears in toxemias and this finding alone may have real diagnostic value. C. 13.

Venered Lipp,

FOLSOMF:

Diseases

Robert G., and Bibby, Douglas IS.: Genital, IngUintie, West. J. Surg. 59: 173, 1950.

Extr8genital

and Skeletal

Granuloma

Granuloma inguinale may manifest itself by extragenital lesions and even visceral lesions. Skeletal involvement has been reported in 12 cases. The authors report here a case of osteomyelitis in which the Donovan bodies of granuloma inguinale were demonstrated. The patient was a Negro woman who complained of a profuse, foul, greenish yellow vaginal discharge. Small papular lesions over the labia had been noticed some months previously along with an enlarged lymph node in the right inguinal region. The serology was negative for syphilis. On examination the labia were covered with small tender ulcerating friable lesions with sharp and demarcated elevated borders. The right tibia midway on the anterior surface showed an elevated tender nodule 3 cm. in diameter which had ulcerated and was exuding a serosanguineous discharge. From this lesion on the tibia as well as lesions from the vulva the Donovan bodies were demonstrated. Treatment with streptomycin was initiated and response to treatment was very satisfactory. WIIJ,IAXL

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