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LETTERSthe IgG galactose deficiency seen in rheumatoid arthritis and in a relatively small number of patients with systemic lupus erythematosus (SLE) and Crohn's disease as evidence that changes in carbohydrate are merely a consequence of chronic inflammation.We have set out at some length (2) the arguments for the view that structural changes involving galactose in the Fcy oligosaccharides are restricted to certain diseases. In particular, we have determined the percentage of IgG oligosaccharide chains lacking galactose in over 300 patient sera representing 25 different disease states, and concluded that the galactose glycosylation defect is confined to juvenile and adult rheumatoid arthritis, SLE associated with Sjogren's syndrome, active Crohn's disease, and untreated pulmonary tuberculosis (3). Normal galactose values were obtained not only in SLE uncomplicated by symptoms of Sjogren's disease, but also in primary Sjogren's syndrome, ankylosing spondylitis, psoriatic arthropathy, myositis, scleroderma, leprosy, Klebsiella infection, and other disorders. These findings have recently been confirmed using a novel lectinbinding assay (4). Thus, the data from our laboratories show that this intriguing defect is not a characteristic feature of the chronic inflammatory state in general, but has important associations with certain diseases.The authors' earlier comments concerning decreased lymphocytic galactosyltransferase were prophetic (5).

Summary A case of ichthyosis vulgaris associated with tuberculoid leprosy is reported. Ichthyotic scales were markedly accentuated within the anaesthetic patches of leprosy. The probable mechanism of the accentuation of ichthyosis by leprosy is discussed.

SummaryResults of therapeutic trial of diazepam in tetanus are presented. The trial included 200 cases of tetanus-167 non-neonates and thirty-three neonates. The patients were divided into two groups and were matched as regards age, sex and severity of the disease. The cases of group I received standard treatment while the cases of group II received diazepam in addition. Over-all mortality in group I was 54% and in group II, 26 %. The results were statistically significant in non-neonates and in severe degree of tetanus. The drug was well tolerated and side effects were not observed.

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