摘要:

Summary:Humoral immunity has been investigated in 39 first‐degree and 12 second‐degree relatives of patients with ACH. A significant increase was shown in the number of abnormal immunological findings, especially hyperglobulinaemia and the presence of tissue antibodies. It is considered that these results support the hypothesis that a genetic factor is involved in the pathogenesis of

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03214.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:Twenty young narcotic addicts who had been using drugs intravenously for at least two years were examined for the presence of liver disease. Eleven (55%) had abnormal liver function tests, and 19 (95%) had abnormal liver biopsies. Fourteen showed the changes of chronic persistent hepatitis. The remaining five showed in addition greatly expanded portal tracts with dense lymphoid aggregates and poorly formed histiocytic granulomas. Foreign material was identified in five biopsies. No patient had HB Ag in the serum, but four had detectable levels of HB Ab. It is concluded that the liver lesion is associated with the repeated intravenous injection of contaminated drug preparations, but no single causal agent, infective or chemical, has been clearly identified. Despite little biopsy evidence of progression, florid changes persist long after drug taking has stopped, so that a benign prognosis cannot be assured.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03215.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:The effects of body weight, sex, concurrent therapy and dosage increment on the correlation between diphenylhydantoin plasma level and dose were studied in 229 adults. The correlation between plasma level and dose was improved by expressing the latter on a body weight basis rather than as a total daily dose without regard to body weight. Sex did not influence the correlation but the intake of other drugs did. There was considerable variation between patients in the diphenylhydantoin dose (on a body weight basis) needed to raise plasma drug level from zero to 5–10μg/ml, but when plasma drug levels were above the latter range, a given dose increment (on a body weight basis) had a more uniform effect on drug plasma level in different patients. It is suggested that diphenylhydantoin metabolism varies rather considerably from patient to patient, but that as metabolism approaches saturation (i.e. at drug plasma levels over 7μg/ml) the drug tends to accumulate rather uniformly in the body in relation to the patient's body weight. Knowledge of these relationships can assist in the determination of appropriate diphenylhydantoin dosages for patie

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03216.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:The effects of age, sex, dosage increment and concurrent drug therapy on the correlation between plasma diphenylhydantoin concentration and its dosage have been studied in 125 epileptic children. Sex differences and concurrent intake of other drugs had no effect on the correlation but age did. Children below 11 years of age tended to require higher drug doses (on a body weight basis) than older children or adults to attain a given plasma diphenylhydantoin level. The dosage increases necessary to raise plasma diphenylhydantoin levels from 0–7,μg/ml varied greatly between children, and tended to be higher in children than in adults. When plasma diphenylhydantoin levels were above 7μg/ml a given dosage increment (expressed on a body weight basis) tended to have the same effect on plasma diphenylhydantoin level in both children and adults.The data suggest that prepubertal children can metabolize diphenylhydantoin faster than adults, perhaps because they have less steroidal hormones to compete for a metabolic pathway. However, once diphenylhydantoin metabolism approaches saturation (with plasma drug levels above 7μg/ml) the drug ac‐cumulates in all individuals largely in proportion to body weight. These data can be used to assist in determining appropriate diphenylhydantoin doses in ch

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03217.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:Administration of 5‐fluorocytosine in fourteen cases of invasive or systemic fungal infection was accompanied in ten by elimination of the infection. Results which particularly indicated the usefulness of the drug consisted of instances where fungal infections were eliminated following the failure of amphotericin B treatment, and in some patients whose antimicrobial defences had been compromised by immunosuppressive therapy. Success was frequently obtained in infections withCandidaandAspergillusspecies, as well as in penetrating ocular infections where laboratory identification of the fungus had not been made. The outcome in two cases ofCryptococcus neoformansmeningitis was unsatisfactory, and this was shown in one to be due to the emergence of a resistant strain. Toxicity of a minor and reversible nature was encountered in four patients, and consisted of diarrhoea, anaemia or hepatocellular damag

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03218.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:An evaluation of the hypoglycaemic effect of tolbutamide was performed over 69 months in 50 newly diagnosed ketosis resistant diabetics who were predominantly obese, female, and Negro in origin. All were participants in the University Group Diabetes Programme, and were randomly assigned to four treatment groups (placebo, tolbutamide, constant insulin, and variable insulin), which were indistinguishable by baseline characteristics.The hypoglycaemic effect of intravenously administered tolbutamide showed no evidence of change with time and was not significantly different in tolbutamide treated patients. The hypoglycaemic effect of orally administered tolbutamide in the fasting state was also maintained throughout. After a glucose load a specific impairment of the hypoglycaemic effect of tolbutamide was noted during the course of the study. However, a progressive rise in blood sugar levels occurred in all treatment groups after the first twelve months of therapy both in the fasting state and after a glucose load, and this was greater than any changes in treatment response. The changes in blood sugar levels were not related to changes in body weight.The results show that the delayed reappearance of hyperglycaemia associated with tolbutamide therapy is not primarily and drug related phenomenon.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03219.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:The occurrence of neutropenia and abnormalities of granulopoiesis in Parkinsonian patients treated with mixtures of levodopa and dextrodopa, and not in patients treated with pure levodopa, suggests that dextrodopa depresses granulopoiesis, possibly by competitive antagonism of phenylalanine. However, treatment of patients with chronic granulocytic leukaemia with 8 g of dextrodopa daily for up to five weeks failed to control their disease. Despite these results it is considered that the use of amino acid antagonists remains a potentially valuable approach to therapy of chronic granulocytic leukaemia.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03220.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:In a consecutive series of 20, patients with tricyclic antidepressant self‐poisoning, urinary catecholamine excretion was measured, and the catecholamine level compared with that in ten patients having taken an overdose of other drugs. In both patient groups the electrocardiograph was monitored continuously for a minimum of 48 hours to detect cardiac arrhythmias. Urinary nor‐adrenaline excretion was elevated during the first 24 hours after tricyclic anti‐depressant self‐poisoning, to a level 2–3 times that found in the other overdose group, but was normal by the third day. Cardiac tachyarrhythmias developed in four of the patients with antidepressant overdosage. The findings support the concept that sympathetic nervous system overactivity underlies the cardiac tachyarrhythmias which commonly accompany self‐poisoning with this cla

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03221.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:Direct and indirect arterial pressures were compared in 30 patients by one observer in a “blind” manner. Arterial pressures were raised and/or lowered in six patients. Two cuff sizes were used (22.5× 12.5 cm and 27.5 × 11.00 cm) and skin fold thickness and arm circumference were noted. Differences as great as 25 mm Hg were noted between directly measured and indirectly measured diastolic pressure, and disappearance of Korotkov sounds was found to be more accurate than muffling as a criterion of diastolic pressure. Systolic pressure was measured much more accurately than the diastolic and was recommended as the pressure to be used as a guide to diagnosis and treatment of hypertension. No significant difference in accuracy was noted between the two cuffs. Mean difference between direct and indirect readings were systolic—3.13mm Hg diastolic muffling 17.92 mm Hg and diastolic disappearance 6.70 mm Hg. Direct pressure recording was found to be simple and painless to the patient and its more frequent use is advocated especially where there is any suspicion as to accuracy of indirect p

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03222.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY

摘要:

Summary:The faecal excretion of bile acids, which are the major product of cholesterol catabolism, was measured in four groups of subjects: 1. normolipidaemic (8); 2. familial hypercholesterolaemic (8); 3. overweight, hypertriglyceridaemic (6); 4. overweight, normolipidaemic (6).Bile acid excretion was significantly less (p<0.05) in hypercholesterolaemic (2.99 mg/kg/day) than in normolipidaemic subjects (3.88 mg/kg/day). Excretion was highest in hypertriglyceridaemic subjects (6.07 mg/ kg/ day). Although total bile acid excretion was also high in overweight, normolipidaemic subjects, it was found to be normal when corrected for body weight (3.87 mg/kg/day.).Familial hypercholesterolaemia may therefore reflect diminished catabolism of cholesterol to bile acids. By contrast, cholesterol turnover and catabolism is increased in hypertriglyceridaemia, and this is independent of any associated overweight.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1974.tb03223.x

出版商:Blackwell Publishing Ltd    

年代:1974

数据来源: WILEY