摘要:

Abstract:Androgen receptor binding of radiolabelled methyltrienolone (3H‐R1881) was determined in cultured genital skin fibroblasts from 17 normal male controls and from 65 males with genital abnormalities. Analysis of the results was performed with patients grouped according to the predominant clinical features. Of 16 patients with complete male pseudohermaphroditism, 12 had androgen receptor (AR) deficiency, one had “receptor‐positive” Testicular Feminization, and in three, alternative diagnoses were established (17ahydroxylase deficiency; 20,22‐desmolase deficiency; mixed gonadal dysgenesis). In contrast, only four of 16 patients investigated for ambiguous genitalia (phallus intermediate between male and female, perineal urethra) showed AR deficiency. Borderline or slightly low AR levels were found in each of four boys in whom the sole abnormality was micropenis. In 26 boys with penile hypospadias, however, only one had low AR. Very low levels of AR (levels comparable to those seen in complete Testicular Feminization) were found in two of three men with infertility associated with abnormally high serum testostero

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04476.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04477.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:Continuous ambulatory peritonea! dialysis (CAPD) is being increasingly used to treat chronic renal failure in New Zealand. Peritonitis due in particular to gram positive organisms remains the major complication. Three of 92 CAPD patients trained in the Wellington Renal Unit had tuberculous peritonitis, a previously rarely reported complication. Gram positive or Gram negative bacterial infections preceeded or followed isolation of Mycobacterium tuberculosis. Differential peritoneal fluid leucocyte counts were not predictive of tuberculous infection and total leucocyte counts remained elevated in tuberculous patients treated for other concurrent bacterial peritonitides. Systemic toxicity was not encountered in these patients, symptoms being confined almost entirely to the peritoneum. CAPD was continued during treatment with anti‐tuberculous therapy, in all three patients. However, peritoneal pain on dialysis fluid in‐flow necessitated temporary hemodialysis management in two. Anti‐tuberculous chemoprophylaxis may be prudent in the at‐risk Polynesian patient with chronic renal failure who is being considered for CAPD man

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04478.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:The effectiveness of intravenous methylprednisolone pulses in 20 mg/kg/day for three consecutive days was compared with a more conventional oral prednisone regime in inducing remission in adult patients presenting with first episodes of minimal change nephrotic syndrome. Methylprednisolone was significantly less effective and failed to induce remission in six of nine patients within two weeks of treatment, while the oral prednisone regime was uniformly effective in all eight patients within five weeks. Of the six non‐responders to methylprednisolone five subsequently remitted with oral prednisone, and one with cyclophosphamide. Except for one patient in the oral prednisone group who had acute gastritis with bleeding, no serious side‐effect was seen with either treatment regi

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04479.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:Five patients with mitochondrial myopathy are discussed. Two presented with progressive external ophthalmoplegia (CPEO), one with CPEO and retinitis pigmentosa, and two with Kearns‐Sayre syndrome. Ragged red fibres and intra‐mitochondrial para‐crystalline inclusions were found in each case. The clinical heterogeneity of the mitochondrial myopathy syndrome in the presence of identical pathological changes in skeletal muscle is empha

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04480.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:During the ten year period 1970 through 1979, pneumococci from 1205 episodes of pneumococcal disease affecting children and adults in Australia were studied. These included 188 cases of bacteremic pneumonia (85% in adults), 103 cases of primary bacteremia (50% adults), 201 cases of meningitis (69% children), 13 cases of osteomyelitis and/or arthritis, and 13 cases of peritonitis. Otitis media (403 cases), conjunctivitis and sinusitis were predominant amongst 672 localised infections. Of 36 serotypes of pneumococci met with, the leading types were 19, 14, 6, 3 and 9: type 14 predominated in children with primary bacteremia, bacteremic pneumonia or meningitis, type 9 in adults with bacteremic pneumonia, and types 3 and 7 in adults with meningitis. In otitis media types 19 and 3 predominated, in conjunctivitis types 19 and 6, and in sinusitis types 6 and 19. For bacteremic and meningeal infections the current (United States) vaccine provides 83% cover, deletion of the rare (in Australia) types 2, 12 and 25 and the substitution of types 11,15 and 33 would increase cover by 5% to 88%.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04481.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:The use of fine needle aspiration (FNA) cytology in the management of patients with lymphadenopathy was investigated. The cases of non‐Hodgkin's lymphoma were classified using the Kiel classification, which is based strictly on cytological criteria. Of the 59 cases of biopsy confirmed lymphoma, FNA of nodes showed lymphoma in 53 (90%), no definite diagnosis in five (8%), and false negative diagnosis in one (2%). During the follow‐up of patients FNA was positive in seven of the eight cases with a suspected recurrence which was later confirmed by lymph node biopsy. Results suggest that FNA is useful on the initial presentation of a patient with lymphadenopathy. If the diagnosis is unequivocal it helps in planning staging procedures and in selecting involved nodes for biopsy. In some cases with intra‐abdominal disease it may obviate laparotomy. However, because false negative diagnoses do occur and because cytological classification of lymphoma is not always accurate FNA should not replace lymph node biopsy at initial presentation, but it can be used as the only investigation to confirm suspected recur

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04482.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:Thirty one patients with advanced MOPP‐resistant Hodgkin's disease were treated with adriamycin, bleomycin, vinca alkaloid and prednisolone (ABVP). Sixteen patients received vinblastine, seven received vincristine and in eight VM26 was substituted for the vinca. Of 28 patients evaluable for response 17 (61%) achieved an objective response with five (18%) complete responders. Response was significantly inferior in patients receiving VM26. Patients with a prolonged interval since previous chemotherapy had a greater chance of complete response (p<0.02) as did those with previous complete response to MOPP therapy (p<0.05). Response to treatment did not affect overall survival (p= 0.8) although relapse free survival was significantly longer for those achieving complete response (p<0.01). The regimen produced minimal gastrointestinal toxicity, but significant myelosuppression. ABVP is a well tolerated salvage therapy in advanced MOPP‐resistant Hodgkin's disease. (Aust NZ J Med 1983; 13: 369

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04483.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:Acute nonspecific carditis with advanced heart block is rare. We observed nine cases with complete heart block and one with Mobitz type II block over an eight and a half year period. Temporary cardiac pacing was instituted in all while permanent pacing was required in six patients. No death was recorded.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04484.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Abstract:A 70‐year‐old woman presented to hospital with an acute life‐threatening cervical cellulitis and laryngopharyngitis followed by pneumonia. Despite a month's treatment with intravenous antibiotics including cephamandole she developed a bacteremic empyema due to a beta‐lactamase producingH. influenzae.Subsequent treatment with chloramphenicol and surgical drainage was curative. The same pathogen was later isolated from her grandson's throat. Chloramphenicol is recommended as the drug of choice in suc

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1983.tb04485.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY