ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00067.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractOne hundred and sixty‐one Australian patients with hereditary bleeding disorders comprising hemophilia A (120), hemophilia B (18), von Willebrand's disease (16), and seven symptomatic female hemophilia A or B carriers were screened for clinical and serological evidence of exposure to HTLV‐IM/LAV/ARV/HIV infection. During the previous five years (1979–1984) they had been treated almost exclusively with blood products derived from Australian voluntary donors.The prevalence of HTLV‐III antibodies in 1985 was 45%, with the highest frequency being in those with severe hemophilia A (78%) and the lowest in patients with hemophilia B (6%). Antibody positivity correlated with a reduced absolute T helper (T4) cell numbers and/or an inverted T4:T8 ratio. Lymphadenopathy was detected in 23 subjects but only 13 had an abnormal T cell ratio. Comparison of seropositivity and T4:T8 ratios in 32 patients studied in 1983 and again in 1985 suggested that T4 cell deficiency reflected HTLV‐III exposure rather than being a predisposing factor for infection with the virus. Individual patients showed considerable fluctuation in T cell subsets over a 12 month period of follow‐up, but as a population there was a slight trend with time towards diminishing T4:T8 ratio only in the antibody positive hemophilia A patients of mild to moderate severity.Three (2%) of the 161 patients screened to date have developed confirmed AIDS with fatal outcome. Following the introduction of rigid exclusion criteria for donors and heat treatment of Australian lyophilised concentrates in late 1984, no antibody negative subjects have seroconverted. To date none of 15 regular sexual partners of antibody positive patients have been consistently seropositive and four clinically well, antibody negative babies have been born to antibody posit

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00068.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractThe place of cytosine arabinoside (araC) in the treatment of T‐cell acute lymphoblastic leukemia was studied by measuring nucleoside transport sites and the conversion of araC to its triphosphate (araCTP) in lymphoblasts from the peripheral blood of two patients, who were then treated with araC. Equilibrium binding of3H‐nitrobenzylmercaptopurine riboside (3H‐NBMPR), a specific ligand of the nucleoside transporter, gave 16 510 to 29 400 sites/cell for T‐lymphoblasts on presentation or early in relapse compared with 2730 ± 1570 sites/cell for non‐T‐lymphoblasts. Accumulation of araCTP from tyM araC was four times greater in T‐cell than non‐T‐cell lymphoblasts. One patient was treated with araC (100 mg/m2daily × 7 days, continuous intravenously) at the time of her first leukemic relapse and complete remission was achieved with this single agent. When this patient relapsed and developed advanced disease the T lymphoblasts showed a 75% reduction in their ability to accumulate araCTP which paralleled a reduction in3H‐NBMPR binding. The second patient achieved complete remission with araC given in low dose (15 mg twice daily by subcutaneous injection) for 21 days at the time of a localised relapse in the mediastinum and pleura. These studies suggest that araC may have a place in the therapy of early stage T

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00069.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractFollowing rehydration with intravenous saline, 27 patients with hypercalcemia of malignancy were treated with a total of 32 courses of 3‐amino‐1‐hydroxypropylidene‐1, 1‐biphosphonate (APD) given by slow intravenous infusion. Twelve treatments consisted of daily infusions of APD for between two and six days whereas single‐dose APD was used in 20 treatments. Mean albumin‐adjusted serum calcium fell to the upper end of the reference range at seven days from the start of treatment, both in multiple‐dose and in single‐dose treatment groups. No relationship between total dose of APD and hypocalcemic response was observed. However, second treatments with APD following recurrence of hypercalcemia in five patients were significantly less effective than the original therapy, suggesting that resistance to APD may develop. Multiple‐dose and single‐dose intravenous APD treatments appear to be equally effective in the acute management of hyperc

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00070.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractA possible immunogenetic basis for diabetes in chronic pancreatitis was explored by studying 19 patients with both disorders, most of whom required treatment with insulin. In contrast to patients with insulin‐dependent (Type 1) diabetes, patients with diabetes and chronic pancreatitis had residual beta cell function but blunted C‐peptide responses to intravenous glucagon, absence of circulating islet cell antibodies, and HLA‐DR types similar to control subjects and patients with chronic pancreatitis without diabetes. Diabetes complicating chronic pancreatitis is therefore not associated with the biochemical or immunogenetic markers characteristic of Type 1 dia

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00071.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractA retrospective study was performed of all patients at the Royal Adelaide Hospital over a ten‐year period with biopsy proven Henoch‐Schonlein nephritis. The records of 27 patients were examined, with emphasis on clinical and histopathological presentation, treatment and outcome. A scheme for assessing glomerular histology is presented, and severity correlated with prognosis of the disease. At presentation unfavourable prognostic indicators were acute renal impairment, crescents in greater than 20% of glomeruli, and severe glomerular histological lesions. Four patients died as a result of the disease, and 20 of the patients had evidence of continued renal abnormality at follow‐up. Adult Henoch‐Schénlein nephritis is a potentially catastrophic disease, and requires careful assessment at pres

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00072.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00073.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractSerum IgG subclass concentrations were assayed in 45 patients with chronic respiratory tract infections and 16 patients with recurrent acute respiratory tract infections. Eleven of these 61 patients, all but one with recurrent acute infections, were IgA‐deficient but the remainder had normal or high serum immunoglobulin concentrations.Only 4% of patients with chronic infections were lgG2‐deficient. The prevalence of lgG2 deficiency amongst patients with recurrent acute infections was greater (31%), but in most cases this appeared to be due to an association with IgA deficiency. Owing to the limits of assay sensitivity it was not possible to determine whether any patient was lgG4‐deficient, but the number of sera with undetectable lgG4 was greater in patients with recurrent acute infections than in controls (37.5%vs10%, p<0.01), although such patients were mainly those with IgA and lgG2 deficiency. None of the patients had IgGl or lgG3 deficiency; in fact lgG3 concentrations were higher than those of controls in both groups of patients (ρ<0.001) and IgGl concentrations were higher than those of controls in patients with recurrent infections (ρ<0.01). Thus, unequivocal IgG subclass deficiency is uncommon in non‐lgA‐deficient patients, but those with lgG2 deficiency may have an immune defect requiring further in

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00074.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00075.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

AbstractWe report 50 immunocompromised patients with pulmonary infiltrates who underwent fibreoptic bronchoscopy, including bronchoalveolar lavage, on 56 occasions. The underlying diseases were mostly lymphoma, leukemia, other malignancies and renal failure. The commonest immunodeficiency factors were chemotherapy, steroids and neutropenia. A positive diagnosis could be made from analysis of the bronchoalveolar lavage on 59% (33/56) occasions. This was a comparable yield to transbronchial lung biopsy 57% (16/27), and superior to proximal airways wash 24% (13/55), or bronchial brushings 29% (10/34). Open lung biopsy added additional diagnostic information in three of the four cases in which it was performed. The most common final diagnoses were bacterial, viral orPneumocystis cariniipneumonia and recurrent malignancy. We conclude that bronchoalveolar lavage is a safe procedure with a high diagnostic yield in the immunocompromised host with suspected opportunistic pneumonia.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb00076.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY