D.R. Gamble

ISLET-CELL ANTIBODIES IN DIABETES MELLITUS

Islet-cell antibodies (I.C.A.) were found in 38% (319/829) of insulin-dependent diabetic patients, in 5% (6/112) of insulin-independent diabetics, and in 1.7% (3/177) of non-diabetic subjects. In the insulin-dependent group I.C.A. were found in 85% of patients immediately after the onset of symptoms and they became less common as the duration of disease increased I.C.A. were equally common in both sexes and the decline in their prevalence was independent of age. The antibodies were directed against cytoplasmic components of islet cells but not against insulin itself. The appearance of I.C.A. probably follows cell damage occurring before the onset of symptoms. By contrast, thyroid and gastric autoantibodies were more common in older patients and females. There was no correlation between the presence of these antibodies and I.C.A. in patients with either diabetes of recent onset or longstanding disease.

ISLET-CELL ANTIBODIES IN JUVENILE DIABETES MELLITUS OF RECENT ONSET

Antibodies reacting with human pancreatic islet cells were found by immunofluorescence in the sera of 51 of 105 children with diabetes mellitus of recent onset. These antibodies were of IgG class, and several of them fixed complement and reacted with pancreatic islets of other species. Thyroid microsomal and/or gastric-parietal-cell antibodies were found in only 10 of the patients with islet-cell antibodies, and none of them had adrenal antibodies. These findings contrast with previous reports which have stressed the rarity of islet-cell antibodies in adult diabetics and their occurrence only in patients with other evidence of autoimmune disease.

A VIROLOGICAL AND EPIDEMIOLOGICAL STUDY OF PATIENTS WITH ACUTE HEARING LOSS

Virological and epidemiological data were examined in thirty-nine patients with acute hearing loss. The hearing loss was unilateral in thirty-one patients and bilateral in eight. There was a history of upper-respiratory-tract infection before onset of deafness in ten of the patients. Cases were more common in the autumn, with nineteen of the cases occurring in the 3 months from September to November. About half of the patients were 20-40 years old and half 46-73 years old; only one patient was aged less than 20 years. Antibodies to several common viruses were titrated, and there was evidence of recent infection by mumps virus in one case and by Mycoplasma pneumoniae in another. Although no evidence of recent virus infection was found in the remaining patients, it is suggested that the condition may be viral in origin and that further studies should be undertaken.

CLOTHING DESIGN FOR OPERATING-ROOM PERSONNEL

Abstract Aerial dispersal of skin bacteria was reduced by about 80% in male subjects wearing an experimental operating-suit made of close-weave Ventile fabric. In a limited trial the suit was found acceptable by theatre staff. Drawers made of Ventile fabric reduced dispersal by 80% in the unclothed subject, but were less effective when worn under other clothing. This happened both for total bacterial counts and, in one subject, for counts of Staphylococcus aureus. 1/107 (1%) of young women and 5/100 (5%) of postmenopausal women were Staph. aureus dispersers. The wearing of stockings increased the dissemination by young women of skin bacteria from the legs.

Viruses in drinking-water. Reconsideration of evidence for postulated health hazard and proposals for virological standards of purity.

Stringent virological standards for drinking-water have been proposed by the World Health Organisation and by others, but there is no evidence of the spread of virus infection by drinking-water that has been adequately treated to conventional bacteriological standards. There is evidence for waterborne transmission of hepatitis and viral gastroenteritis but the case for the introduction of virological standards is critically examined. It is concluded that there is no evidence that drinking-water in the U.K. contributes to the spread of virus infection, and that the introduction of virological standards for drinking-water could not at present be justified. Moreover, in the absence of any information relating the degree of viral contamination to disease, there is no logical basis on which to set the level of a practical virological standard.

The Role of Viruses in Acute Auditory Failure

A study of 67 patients with sudden sensorineural hearing loss is reported. They had no previous ear disease, generalised disease history of trauma or recent antibiotic therapy. There were 31 men and 36 women; 56 had unilateral symptoms. 41 had vertigo and 15 gave a history of a recent respiratory infection. The age incidence was bimodal, having peaks in age groups 25-29 years and 45-49 years. Eight patients had antibody titres high enough to suggest a recent infection: four with a respiratory pathogen which was probably unconnected with the hearing loss; two with mumps virus; and one each with measles and varicellazoster virus. The available evidence suggests that these three are the viruses most likely to cause sudden hearing loss.