摘要:

Summary::Immunological abnormalities in coeliac disease and their response to dietary restriction. I. Serum immunoglobulins, antibodies and complement. R. N. Ratnaike and A. G. Wangel,Aust. N.Z. J. Med., 1977,7, pp. 349–352.Twenty‐three patients with coeliac disease were studied whilst on a normal diet and again after a mean period of 15 months on a gluten‐free diet. Serum levels of IgG, IgA and IgM, total haemolytic complement, C3, serum autoantibodies and precipitins to dietary proteins were compared to those in age and sex matched control subjects. There was considerable individual variation, but as a group, patients on a normal diet had significantly raised IgA and low IgM and an increased prevalence of antibody to reticulin, smooth muscle and dietary protein. These abnormalities disappeared during the period of dietary restriction suggesting that they are disease epiphenomena rather than primary pathogenetic fa

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04393.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary::Immunological abnormalities in coeliac disease and their response to dietary restriction. II. Immunoglobulin containing cells, immunoglobulins and dietary antibodies in the small bowel. R. N. Ratnaike, J. Wilson and A. G. Wangel,Aust. N.Z. J. Med., 1977,7, pp. 353–355.The numbers of immunoglobulin (lg) containing cells in jejunal mucosa were determined in 29 patients with untreated coeliac disease and 28 control subjects. The patients had significantly increased numbers of lgM containing cells. Seven of the patients were studied again after 12 months on a glutenfree diet and showed a significant reduction in the number of lgM containing cells. The increase noted in untreated patients is therefore likely to be a manifestation of the disease rather than a primary abnormality of aetiological significanc

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04394.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Factors influencing small bowel changes in dermatitis herpetiformis. I. C. Roberts‐Thomson, D. P. Stevens, B. Michel, W. E. Braun, P. J. Morris, A. J. Wall, D. J. Fone and H. J. Dworken,Aust. N.Z. J. Med.,1977, 7. pp. 356–362.Factors influencing small bowel morphology in dermatitis herpetiformis (DH) were investigated by comparing patients with DH and normal small bowel biopsies to patients with DH and abnormal small bowel biopsies. The mean age of 18 patients with morphological changes in small bowel (38 years) was significantly lower (P<0 001) than the mean age of nine patients with normal bowel mucosa (60 years). HLA typing confirmed the high frequency of HLA‐B8 in DH (64%) but HLA‐B8 was unrelated to the presence or severity of small bowel lesions. Four patients had diarrhoea with progressive weight loss or abdominal cramps subsequently responsive to gluten withdrawal. In this subgroup serum levels of IgG and IgM were significantly lower than in patients with normal small bowel mucosa. Small bowel involvement appeared to be independent of the duration and severity of skin disease, and the deposition of immunoglobulin and complement (C3) in the dermal papillae of skin adjacent to skin

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04395.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:A test of the ventilatory response to hypoxia and hypercapnia for clinical use. M. J. Hensley and D. J. C. Read,Aust. N.Z. J. Med., 1977,7, pp. 362–367.A new technique is described for testing the ventilatory response to hypoxia and to hypercapniaThe test consists of interposing 15–20 seconds of hypoxia in 3–4 minutes of rebreathing 7% CO2; the hypoxia is induced by taking three to five breaths from a bag containing N2, and CO2at an identical level. When required, hypoxic tests can be performed at several different PCO2levels to define the interaction of hypoxic and hypercapnic stimuliIn eight healthy subjects, 29 hypoxic tests were performed, at an average PCO2of 58 mm Hg (range 53–64). The correlation between ventilatory increments and 02‐desaturation was significant in 27 of the 29 tests (r = 0.81‐0.99). At the minimum 02‐saturation (average 85%; range 75–91%) there was a statistically significant ventilatory response to hypoxia in all 29 tests (average +60%; range +14 to +141%). At 90% O2‐saturation, the average increment of ventilation was +48%This method has important theoretical and practical advantages for clinical studies: (i) the test involves only 15–20 seconds of hypoxia; (ii) since the hypoxic drive to breathing is greatly enhanced by hypercapnia only a mild degree of hypoxaemia is necessary to obtain a clearly defined response; (iii) the augmented ventilation, produced by rebreathing, allows N2to be rapidly introduced into the lungs without the need for voluntarily imposed deep breathing; (iv) the elevated PCO2increases cerebral blood flow and minimises brain tissue hypoxia. (v) Since rebreathing 7% CO2greatly reduces mixed venous‐arterial and cerebral tissue‐arterial PCO2differences, the cerebral tissue PCO2and CO2stimulus are virtually unaffected by both ventilatory and cerebral blood flo

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04396.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary::Cancer and teratogenesis: Infrequent occurrence after medical use of immunosuppressive drugs. G. R. Symington, I. R. Mackay and R. P. Lambert,Aust. N.Z. J. Med.,1977, 7, pp. 368–372This study examines long term “medical” immunosuppression with azathioprine or cyclophosphamide for immunopathic disease in relation to cancer and foetal malformation. The experience represents an aggregate of 241 years of treatment and 508 patient‐years of follow‐up in 133 nontransplant patients. For azathioprine the mean duration of treatment was 1 9 years and the mean duration of observation was 3–8 years, and for cyclophosphamide, the mean durations of treatment and observation were 0–7 and 4–6 years. A sample of 70 patients was shown by in vivo tests to have significantly suppressed cell‐mediated immunity. In the period of review there were observed two cancers, both squamous cell carcinomas of skin, two benign neoplasms and six keratoses; after the period of review, three further cancers were recorded, one being in a subject with a known previous cancer. Nine pregnancies with azathioprine yielded no foe

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04397.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Acute nephritis in fifty children: Clinical and immunological studies.K. P. Dawson and W. W. Richardson,Aust. N.Z. J. Med, 1977,7, pp. 373–379.The main clinical and laboratory findings in a group of 50 children with acute nephritis are described and discussed. All the group had evidence of a streptococcal aetiology. The wide spectrum of presenting complaints, the age distribution and the high incidence among Maori children are noted. The severity of the disease, as indicated by features such as hypertensive crisis, was greater than expected. Fifty per cent of our patients experienced one or more of our defined complications. Encephalopathy was seen in 12% of all patients and severe hypertension in 34%.The striking feature of the laboratory findings was the wide variation in complement changes. No constant patterns emerged which would have implicated either the “classical” or “alternate” pathway for the activation of complement in these patients. An unexpected finding was the relatively high incidence of a transient C3 nephritic factor in post‐streptococcal cases.We found also that fibrin degradation products were present in high concentrations in the urine of patients with post‐streptococ‐cal nephritis, again an une

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04398.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Do Australian Aborigines suffer from renal tract calculi?E. M. Bateson,Aust. N.Z. J. Med., 1977,7, pp. 380–381.Analysis of intravenous pyelograms performed in the Darwin Hospital over the five‐year period, 1970–1974, showed that 9% of the examinations carried out on non‐Aboriginal patients demonstrated calculi in the renal tract. Although considerably fewer pyelograms had been performed on Aboriginal patients, only one showed a calculus. The result has been shown to be highly significant and is discussed in relation to racial and other differences between the Aboriginal and non‐Aboriginal people of the Northern

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04399.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary::Adverse reactions to drugs: A 12‐month hospital survey. Kerry A. McMahon, D. B. Frewin, E. Gail Easterbrook, Elizabeth A. Hender, T. I. Lee and R. K. Penhall,Aust. N.Z. J. Med., 1977, 7, pp. 382–385.A formalised system of adverse drug reaction (ADR) reporting was instituted at the Royal Adelaide Hospital in August 1975. The present report reviews the results obtained from this system after a 12‐month period of operation. A significant number of reports associated with the use of antibiotics and radiographic contrast media were received. The importance of “feed‐back” of ADR information to prescribers is

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04400.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary:Salivary antipyrine kinetics in hepatic and renal disease and in patients on anticonvulsant therapy. A. W. Harman, R. K. Penhall, B. G. Priestly, D. B. Frewin, P. J. Phillips and A. R. Clarkson,Aust. N.Z. J. Med., 1977,7, pp. 385–390.The effects in man of liver disease, renal failure and hepatic microsomal enzyme induction on the elimination kinetics of antipyrine in saliva have been examined. Antipyrine (10 mg/kg) was given orally and assayed in saliva by gas‐liquid chromatography. The mean antipyrine half‐life from saliva in nine epileptic subjects receiving long term anticonvulsant drug therapy (6 hr±0.9 SEM) was significantly shorter than in twenty normal healthy volunteers (10.7±0.6). Therapy included phenytoin and phenobarbitone, two drugs known to induce hepatic microsomal enzymes. Five subjects with chronic renal failure exhibited no significant difference in salivary antipyrine half‐life (11.7±1.9) compared to the control group, whereas six subjects with chronic liver disease and impaired hepatic function had significantly increased half‐life values (42.4±10). The results suggest that differences in the activity of hepatic microsomal enzymes are reflected by changes in salivary antipyrine elimination kinetics. Chronic renal failure appeared to have no effect on the function of

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04401.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY

摘要:

Summary::Left main coronary artery obstruction: Early surgical experience with forty‐two patients. A. W. Gale, V. P. Chang, M. X. Shanahan and H. M. Windsor,Aust. N.Z. J. Med.1977,7, pp. 390–393.Direct coronary artery surgery was performed on 42 patients with high grade obstruction of the left main coronary artery (LMCA), with a perioperative infarction rate of 7% and a hospital mortality of 9 6%. There was no significant difference in presentation of patients with LMCA lesions and no prediction of this lesion could be made by pre‐angiographic assessment. Significant obstructive lesions in other coronary vessels were noted in most patients, triple vessel disease occurring in 27 patients (64.3%), double vessel in 14 patients (33.3%) and the LMCA lesion was an isolated lesion in only one patient (2–4%). Right coronary lesions occurred in 35 patients (83%), left anterior descending artery lesions in 38 patients (90%) and left circumflex system lesions in 34 patients (81%). The surgical procedures are di

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1977.tb04402.x

出版商:Blackwell Publishing Ltd    

年代:1977

数据来源: WILEY