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Congenital leukemia is a rare disorder that usually presents with extramedullary infiltrates and myeloid phenotype in 80% cases. The authors present 4 cases of congenital leukemia diagnosed over 11 year period, three of which were of acute lymphoid leukemia and one was of biphenotypic leukemia.

Japanese encephalitis (JE) virus infection induces infiltration of neutrophils in neural as well as extraneural tissues in patients. As interleukin-8 (IL-8) has inflammatory properties, the present study was undertaken to investigate the IL-8 concentrations in cerebrospinal fluid (CSF) and serum from patients with JE and correlate them with neutrophil counts. IL-8 was measured in the CSF or serum of 30 patients with confirmed JE. The majority (92%) of the acute CSF samples showed raised levels of IL-8 with raised numbers of polymorphonuclear leucocytes. Similarly, significantly higher serum IL-8 concentrations were detected in the acute phase of illness than in convalescent JE patients or normal healthy controls. Twenty-one of 25 patients with high concentrations of IL-8 showed significantly increased neutrophil counts in acute phase sera. A gradual decline in neutrophil counts was observed in the convalescent phase of patients who recovered. There was a significant correlation between IL-8 level and the severity of illness, as all severely ill and fatal cases showed higher levels of IL-8 in acute CSF or serum than the levels found in those who recovered. IL-8 concentrations remained high for a longer period in patients with prolonged severe illness than in those who made a complete recovery.

Japanese encephalitis virus (JEV) induces human peripheral blood monocytes to secrete a chemotactic cytokine [human macrophage-derived factor (hMDF)] which causes chemotaxis of neutrophils. The only known assay for hMDF cannot quantify its level in samples, so an enzyme immunoassay has been standardized for detection of hMDF and hMDF-specific antibodies in test samples. The reported enzyme linked immunosorbent assay (ELISA) was found to be sensitive (89%), specific (91%), accurate (92 2%) and reproducible and was able to detect a minimum concentration of 23 ng hMDF/ml in test samples. The chemotactic factor could be detected in JEV inoculated mouse sera and JEV infected culture fluids. Significant finding of the test was the detection of hMDF in sera of human cases of JE.

The purpose of this study was to determine predictors of posttraumatic convulsions in children. Study subjects included children under 12 years of age, who were admitted to the Safdarjang Hospital, New Delhi, during the year 1997 (January to December) after suffering head trauma. The occurrence of first convulsion after head injury was taken as the outcome variable in the study. Medical records were reviewed for data about clinical, radiological and epidemiological features of such children. The study revealed that children younger than 2 years of age (odds ratio, OR 2.96; 95% confidence interval, CI 1.42-6.21), those suffering severe head injuries, i.e. with low Glasgow Coma Score (OR 3.07; 95% CI 1.40-6.77), and those with longer period of unconsciousness after head trauma, especially longer than 12 h (OR 1.71; 95% CI 0.69-4.19) have higher likelihood of suffering convulsions after head injury. However, none of the radiological findings were found to be significantly associated with posttraumatic convulsions.

Serum samples collected since 1989 with various patterns of reactivity for human immunodeficiency virus (HIV)-1, on the basis of screening ELISA and confirmatory Western blot (WB) test, were subjected to the detection of HIV-2 infection based on screening dot immunoassay and confirmatory WB for HIV-2. Significant prevalence of HIV-2 infection was (37.03%) among sera reactive for HIV-1 by ELISA but indeterminate by Western blot, compared with sera reactive for HIV-1 by ELISA and WB (3.29%) or negative by WB (2.63%). Out of 16 HIV-2 positive sera, 5 (31.25%) showed evidence of concomitant HIV-1 infection. This study demonstrates evidence of HIV-2 infection as early as 1989, earlier than reported so far from India.

In this study, viruria following Japanese encephalitis virus (JEV) infection in mice has been shown to appear earlier in pregnant than in normal mice with proteinuria and haematuria. This was related to the production of splenic macrophage derived neutrophil chemotactic factor (MDF) following JEV infection. Intravenous inoculation of MDF in mice resulted in leakage of cells, proteins and erythrocytes in the urine as a result of altered capillary permeability. The isolation of virus from kidney did not correlate with the shedding of virus in the urine. The histological examination of sections of kidneys showed no morphological damage; however, ultrastructural degenerative changes in the mesangial cells were observed following JEV infection. These data suggest that JEV-induced macrophage derived factor regulates the leakage of proteins, erythrocytes and cells into the urine.

An indirect immunofluorescent technique for rapid diagnosis of patients of Japanese encephalitis (JE) was developed by demonstrating the viral antigen in CSF cells. The CSF samples of 31 consecutive patients admitted with acute viral encephalitis during 1987 were studied. In 15 patients the diagnosis of JE virus infection was made on the same day. Classical techniques for virus detection and antibody serology were also conducted in these patients. The indirect immunofluorescence for JE virus antigen detection in CSF cells proved to be a rapid and simple procedure for making a quick diagnosis of infection.

Following intraperitoneal inoculation, Japanese encephalitis virus replicated in peritoneal macrophages, appeared on day 3 in the splenic macrophages of the perifollicular region and later in cells of the periarteriolar lymphoid sheath (PALS) as shown by indirect immunofluorescence. Productive JEV infection was observed both in macrophages and T-cells. Morphological study of spleen during JEV infection revealed proliferative changes, with increased number of macrophages from day 3 p.i. in the perifollicular region followed by accumulation of polymorphonuclear leucocytes which reached a maximum on day 9 p.i. The T dependent areas were considerably enlarged by day 9 and gradually reduced in size by week 3. At later periods germinal centres appeared in the T independent area and were prominent by day 15. The cells containing virus antigen disappeared with the appearance of germinal centres, thus indicating the role of the latter also in virus clearance.

Long term B-cell memory to Japanese encephalitis virus (JEV) in latently infected mice was investigated by adoptive cell transfer. Both IgM and IgG memory were elicited by antigen challenge or cyclophosphamide induced reactivation of virus. A weak antigen-specific IgM response for a brief period and a strong IgG response were detected in Swiss albino mice exposed to secondary infection. A correlation between the secondary IgM antibody and protection against JEV challenge was observed in adoptive transfer experiments. This was abrogated by pretreatment of the serum with 2-mercaptoethanol. Similarly secondary immune splenic T-cells up to day 5 post-reactivation provided protection. These results suggest that a long term antigen-specific IgM and IgG memory was induced by JEV challenge in latently infected mice. Further, the role of IgM antibody and T-cells in the response of mice to secondary JEV infection has been shown.