Kahn Test Research Articles

The Osseous Manifestations of Eosinophilic Granuloma: Report of Nine Cases

The existence of a lesion in bone which histologically appears granulomatous, non-specific, and is infiltrated with histiocytes and eosinophilic leukocytes was first reported, simultaneously, in 1940, by Otani and Ehrlich (13) and by Lichtenstein and Jaffe (10). Undoubtedly the lesion had been seen previously, but its exact nature and course were not described. Since 1940, a number of authors have reported single examples or small groups of cases, leading to considerable discussion of the relationship of this lesion to the older entities of Hand-Schüller-Christian's disease, or lipogranulomatosis, and Letterer-Siwe's disease, also called reticulosis or non-lipoid histiocytosis (Jaffe and Lichtenstein, 8; Green and Farber, 5; Mallory, 11). Disagreement concerning the exact terminology is, therefore, to be expected. “Solitary granuloma of bone” was proposed by Otani and Ehrlich (13). Green and Farber (5) suggested “‘destructive granuloma of bone,’ ‘single’ or ‘multiple’ as the case may be, adding parenthetically ‘Hand - Schüller - Christian syndrome.’” Eosinophilic granuloma, as used by Jaffe and Lichtenstein (8), seems preferable and will be used in this paper. It is our purpose to present the roentgen findings in 9 cases, confirmed by biopsy, which were seen in an Army General Hospital, together with the pertinent clinical and laboratory findings. In each case the biopsy sections were reviewed and the histopathologic diagnosis confirmed by the Army Medical Museum. Case I (Fig. 1): White male, 21 years of age. Onset September 1943 with constant headaches and pain in the orbits. There were no convulsions, vomiting, or visual changes. In October, a fluctuant, tender, but non-pulsating mass developed in the left forehead. A roentgenologic bone survey revealed a solitary lesion in the left frontal bone; no similar lesions were present in other bones. Laboratory Findings: The Kahn test was negative. Nothing unusual was found on urinalysis, which was negative for Bence-Jones protein. The white blood count was 5,700 (66 per cent polymorphonuclears, 5 per cent eosinophils); blood serum calcium 10 mg. per 100 c.c.; phosphorus 3.5 mg. per 100 c.c.; total protein 6.1 gm. per 100 c.c., basal metabolic rate + 7; blood cholesterol 194 mg. per 100 c.c. Although at biopsy in November the tumor appeared grossly malignant, involving both tables of the skull, the histologic picture was the classical one of eosinophilic granuloma. Case II (Fig. 2): White male, 24 years of age. Onset October 1943 with trembling and numbness of right hand. The patient had two episodes of unconsciousness but no headaches. A small mass was palpable in the left parietal region. Physical examination showed the right arm to be weaker than the left. Except for the left parietal lesion, a roentgenographic bone survey was negative. Laboratory Findings: The Kahn test was negative.

ACUTE GLOMERULAR NEPHRITIS IN AN INFANT WITH CONGENITAL SYPHILIS

We present the following case with a report of the autopsy and a review of the opinions of various writers as to the diagnosis of nephritis in the newborn and in young infants. <h3>REPORT OF A CASE</h3> M. S. J., a Negro girl 2 months of age, was admitted to Grady Hospital, Atlanta, Ga., May 26, 1942. Her chief complaint was swelling of the hands, the feet, the stomach and the face for the preceding five days and frequent vomiting. Her weight on admission was 10 pounds 10½ ounces (4,833.6 Gm.); her temperature was 99.6 F. (rectal). The patient, who was a second child, had been delivered at home; she weighed 7 pounds (3,175.14 Gm.) at birth. She was breast fed. The mother, according to her own statement, had shown a positive reaction to the Kahn test during her recent pregnancy but had received no treatment. <i>Physical Examination.</i>—On examination

Relapsing Fever and B. proteus X Kingsbury

WHILE in Ethiopia with a mobile bacteriological laboratory, it was noted that there was an association between the findings of blood spirochffites and an agglutination of B. proteus X Kingsbury. Of 650 cases in which Borrelia were found and which were tested for agglutinations, 211 gave agglutination of Kingsbury in dilutions of 1/100 and more. An examination of specimens submitted for Kahn test failed to reveal a corresponding high level in 'normal' individuals, and the testing of malaria cases disposed of the possibility of an 'anamnestic' type of reaction.

A Shaker for Use in the Kahn Test

A Shaker for Use in the Kahn Test

Effect of Electrolytes upon Kahn Precipitates from Human and Animal Sera

The problems created by the existence of falsely positive serologic reactions have been a source of difficulty since the advent of the Wassermann test. Kahn reported the first satisfactory differential test; this was based upon specific temperature differences. We became interested in determining whether or not reactions in human and animal sera could be distinguished by the effect of electrolytes. Animal sera were used in these studies because they give general biologic reactions which are apparently of the same type as those found in human falsely positive serologic reactions., while studying the effect of Nacl solutions upon the Kahn Precipitates from animal sera, it was observed that the precipitate resulting from the reaction of Kahn antigen and horse serum was soluble in 4% NaCl solution. At the same salt concentration, precipitates from syphilitic human sera remain insoluble. The effect of other concentrations of NaCl (ranging from 0% to 30%) upon horse, human, guinea pig, hog, cow, sheep, and chicken sera were investigated. All sera were diluted to give approximately two plus reactions in the standard Kahn test by a method previously described. Verification tests were made upon each serum to check the specificity of the reaction. All sera gave the expected reactions (i.e., either syphilitic, general biologic, or negative type) with this test. Controls were also made using the same quantities of serum and salt solution. However, an artificial antigen containing the same quantities of alcohol and saline as in the original antigen was used. Control reactions were completely negative except in the chicken sera. It was found that each species of animal serum investigated gave characteristic aggregation and dispersion patterns of the Kahn precipitate.

Studies of the Kahn Test*

Journal Article Studies of the Kahn Test*: II. Evaluation of Results Obtained with Plasma Get access M. B. Kurtz, M. B. Kurtz From the Bureau of Laboratories, Michigan Department of Health, Lansing, Michigan Search for other works by this author on: Oxford Academic Google Scholar Erma Hill Erma Hill From the Bureau of Laboratories, Michigan Department of Health, Lansing, Michigan Search for other works by this author on: Oxford Academic Google Scholar American Journal of Clinical Pathology, Volume 12, Issue 6_ts, January 1942, Pages 33–36, https://doi.org/10.1093/ajcp/12.6_ts.33 Published: 01 January 1942 Article history Received: 10 February 1941 Published: 01 January 1942

CHICAGO LARYNGOLOGICAL AND OTOLOGICAL SOCIETY

<h3>Symposium on Syphilis</h3><h3>Interpretation of Serologic Reactions Based on a Nationwide Survey.Dr. Francis E. Senear.</h3> The interest in the serology of syphilis has perhaps not kept pace with the interest in the more general phases of the subject, so far as the medical profession at large is concerned and particularly with respect to the public. However, the field has become just as complex as that of the therapy of syphilis. Since 1923 three meetings have been held under the direction of the League of Nations for the purpose of making a study of the various tests used in the diagnosis of syphilis. At the third meeting, held in Uruguay in 1938, it was concluded that the Kahn test was the best. The American Society of Clinical Pathology, however, recognizing that a number of tests developed in the United States had not been adequately represented, asked Surgeon General Parran to arrange

The Kahn Test: A Simplified Technique

The Kahn Test: A Simplified Technique

Studies of the Kahn Test. I. A Special Tube for the Preparation of Antigen Suspension

Studies of the Kahn Test. I. A Special Tube for the Preparation of Antigen Suspension M. B. Kurtz, and E. M. Hill CopyRight https://doi.org/10.2105/AJPH.30.2.180 Published Online: August 29, 2011

THE LAUGHLEN TEST

The desirability of a serologic test for syphilis more rapid and more easily performed than any at present available at the Massachusetts General Hospital, to be used in the outpatient clinic and for the testing of emergency donors, gave the incentive for a comparative study of the Laughlen test with the tests now in use, i. e., the Hinton, the Wassermann and the Kahn. The Hinton test is used as a routine at the Massachusetts General Hospital on all specimens of serum sent to the laboratory. The less sensitive standard Wassermann test rather than the Kolmer modification is performed on the serums giving a positive Hinton reaction, in order to grade the more strongly positive ones. The Kahn test is done in emergencies. The technics of these tests are too well known to require description. In the present study the rapid Hinton method was used in 780 cases. This test

DOUBLE VOCAL CORD

Congenital reduplication of one or both vocal cords appears to be an extremely rare anomaly. We have been able to find reports of only 5 cases, all in the foreign literature. We report here a case, with autopsy, of unilateral occurrence of this anomaly, in a patient who died of pulmonary tuberculosis. REPORT OF A CASE Mrs. N. F., a Negress aged 49, was admitted to Riverside Hospital on July 30, 1937. Examination revealed extensive bilateral tuberculosis, with submiliary involvement on the right side and extensive pyopneumothorax on the left. She stated that she had been hoarse all her life; otherwise there was nothing pertinent in her history. Examination of her sputum gave positive results, and her Kahn test was negative. A routine examination of the larynx was attempted during her confinement in the hospital, but she was uncooperative, making it impossible to visualize her larynx. In view of her

History of Syphilis in 180 Patients in Which the Kline Tests, the Kolmer Test and the Kahn Test are in Disagreement

History of Syphilis in 180 Patients in Which the Kline Tests, the Kolmer Test and the Kahn Test are in Disagreement

Carcinoma of the Cervix with Patellar Metastases: Case Report

A case of a squamous-cell carcinoma of the cervix with metastases to the patella is of sufficient rarity to warrant reporting. N. V., a white woman, aged thirty-six, was first seen at the Cincinnati General Hospital on Jan. 10, 1936, complaining of vaginal bleeding which had begun the preceding month. History: No family history of cancer was obtained. The patient9s general health had always been fair and except for the usual childhood diseases her history was essentially negative. She had been operated on at another hospital in 1932, at which time a bilateral salpingectomy, appendectomy, cervical repair, and perineorrhaphy were done. The menarche had taken place at fifteen years, and periods had occurred every twenty-four days, of three to seven days9 duration. There was no history of dysmenorrhea, menorrhagia, or metrorrhagia. The patient was married, and had had six children, all living, the oldest fourteen years of age, the youngest five years. There had been no miscarriages. There was no complaint of hematuria, polyuria, or nocturia. Occasional attacks of frequency had occurred for several years, which were said to last for several weeks, disappearing spontaneously. The Kahn test was negative on two occasions. Physical Examination: The patient was thin and rather poorly nourished in appearance, anemic looking, and apparently in some pain. There was no undue dyspnea. The examination was essentially negative except for the pelvic findings. The glands of Bartholin and Skene were negative. Just inside the vagina, extending in an anterior direction, was an overgrowth of tissue to the left. The cervix was almost entirely destroyed by cancer. Considerable bleeding was present. The uterus was small and, while it was in anterior position, was firmly fixed. Rectal examination showed no extension of the growth. There was good sphincter control. Diagnosis: A diagnosis of far advanced squamous-cell carcinoma with vaginal extension was made and was confirmed by the microscopic findings on biopsy.

On Serological Tests for Syphilis with Very Small Amounts of Patient's Serum

In this bulletin the author, who is chief serologist in the Ministry of Health, gives technical details for performing the Wassermann test as previously described by the same author, the Kahn test, the Meinicke test and the recently reported Rosenthal method, by using minute amounts of serum. Microtechnics are desirable in the case of infants, from whom it is often difficult to obtain amounts of blood sufficient for regular tests. The bulletin should be of interest to laboratory workers.

Antigen Mixing Tube for the Kahn Test.

Antigen Mixing Tube for the Kahn Test.

THE PRESUMPTIVE KAHN TEST

Journal Article THE PRESUMPTIVE KAHN TEST Get access E. J. FITZGERALD, M.D., N.U.I. E. J. FITZGERALD, M.D., N.U.I. Assistant Medical Officer, Winwick Mental Hospital Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 46, Issue 6, 1 June 1934, Pages 277–279, https://doi.org/10.1111/j.1365-2133.1934.tb09780.x Published: 01 June 1934

KAHN REACTION WITH SPINAL FLUIDS CONTAINING VARYING AMOUNTS OF SYPHILITIC BLOOD

This article deals with the question of the accuracy of serologic tests of spinal fluids that are tinged with blood. Any one who has performed many lumbar punctures has had his share of bloody taps. All of us, no doubt, have frequently questioned the reliability of the report from the laboratory on serologic reactions in such cases. In our own clinic the occasional lack of agreement of serologic reactions with some of the clinical findings as well as the occasional lack of uniformity of the reactions to the Kahn test of the cerebrospinal fluid from week to week has led us to investigate this matter more thoroughly. Kafka 1 was one of the first to emphasize the importance of contamination of the spinal fluid with blood. He advised that the amount of blood in the specimen be estimated and added to a known normal cerebrospinal fluid, and the result noted.

The Comparative Value of the Serologic and Roentgenologic Diagnoses of Congenital Syphilis

The time to diagnose congenital syphilis is immediately after birth, hence the importance of the development of accurate methods which will establish beyond a question of doubt the presence of syphilitic infection in the newborn. The clinical aspects of syphilis have changed considerably in the last 25 years. It is rare that one encounters in hospital practice fully developed, clinical syphilis. The general rule is that there is very little clinical indication of syphilis. Furthermore, clinicians rarely make exhaustive searches for the presence of syphilis. The great majority rely upon the examination of the blood or spinal fluid, or both. In congenital syphilis, unless one is aware that the mother has syphilis, and unless definite evidence of syphilis is present in the newborn, such as skin lesions, etc., the detection of syphilis has, up to recent times, depended entirely upon examination of the blood. Lately, the roentgenologic diagnosis of syphilitic involvement of the osseous system has been developed to a high degree of accuracy. The diagnosis of congenital syphilis by serologic methods applied to the cord blood has had varying degrees of success, and there is a general opinion among many obstetricians that the examination of the cord blood is not very accurate. It is important to emphasize now that, in reviewing the literature, one must pay careful attention to the methods employed for the serologic diagnosis of syphilis. In Mount Sinai Hospital, a complement fixation test, the Kahn test, and Kline's micro-precipitation test have been used routinely. A description of the technic and the results obtained on cases other than obstetric has been reported from this laboratory (1). The same tests were applied to maternal blood and blood obtained from the cord at delivery. In a few cases, blood was taken from the fontanel. In all instances of positive serology, re-checks were made on blood obtained from the fontanel. Cord blood is very apt to be antecomplementary, according to Kolmer (2), yet in about one thousand examinations we have had no antecomplementary reactions, and we attribute this to the technic used in obtaining the blood. As soon as the child has been delivered, the cord is wiped dry with a sterile sponge, cut through with sterile scissors which have not been used for any other purpose during the course of the delivery, and the blood allowed to drip freely into a test tube. The tube is immediately corked and sent to the laboratory. We feel that, if the tests are carried out properly—and it must be remembered that these tests for syphilis are highly technical and must be done with great care—the results have a very high degree of accuracy. Furthermore, it is our opinion that, if similar tests serve to diagnose acquired syphilis without clinical manifestations, they should be equally applicable to the blood of mothers and newborn infants.

A Case of Carcinoma of the Thymus

A case of thymic tumor is reported in which the clinical diagnosis was cellulitis of the neck, with sinus thrombosis; the roentgen diagnosis was abscess or tumor of the upper mediastinum, and the pathologic diagnosis, made postmortem, was carcinoma of the thymus, with metastases to the lungs, liver, and mesenteric lymph glands. Anamnesis.—The patient, colored, male, aged 28, was admitted to the John D. Archbold Memorial Hospital on Aug. 25, 1930, and died on Aug. 28, 1930. The past history was unimportant. The present illness began five weeks previous to admission with sore throat, toothache, fever, and general malaise. Several days later swelling of the neck was noted which soon became progressively more marked. Edema of the eyelids appeared and later marked difficulty in breathing and swallowing was noted. For three or four days previous to admission nothing could be swallowed except small amounts of fluid. Physical Examination.—Temperature 101 degrees F., pulse 120, respiration 30. The patient was a well-nourished, well-developed colored male. Respiration was labored, the neck markedly swollen, the face and eyelids edematous, and there was a bilateral exophthalmos. The swelling of the neck was uniformly hard and smooth; nothing suggesting enlarged glands in this or any other area was found. No dilatation or prominence of the superficial vessels was discernible. A bloody mucus discharge exuded from the mouth and nose. There were coarse râles and exaggerated breath sounds throughout both lungs. There was a wide area of dullness over the upper mediastinum. No edema of the arms or thorax was noted. Laboratory Findings.—White blood cells, 9,150; polymorphonuclear leukocytes, 80 per cent; eosinophiles, 2 per cent; transitional cells, 4 per cent; lymphocytes, 14 per cent. Red blood cells, 3,350,000. Hemoglobin, 60 per cent. The blood sugar and non-protein nitrogen were within normal limits. The urine, which contained a few granular casts, had a specific gravity of 1.035. The Kahn test was negative. Roentgen Report.—Examination of the chest was made August 26, 1930. A single film only was made because of the semicomatose condition of the patient. There was a large dense mass, 11 cm. in width, in the upper mediastinal area, extending laterally on both sides beyond the mediastinum. The upper border extended above the sternoclavicular articulations and the lower border fused with the heart shadow. The lateral borders were well defined and regular. There was definitely a diminished aëration of the upper lobe of the right lung but no other evidence of pathology. Considering the history and course of the illness it was thought that the condition was mediastinal abscess rather than tumor. The patient died on his fourth day in the hospital.

The specificity of the kahn test unaffected in human trypanosomiasis

The specificity of the kahn test unaffected in human trypanosomiasis