摘要:

Eighty-five subjects were tested for the presence of circulating candidal antigen (CAg) and anti-candidal antibody (CAb) using both an enzyme immunoassay (ELISA) and counterimmuno-electrophoresis (CIE). The 72 studled controls included laboratory volunteers; hospitalized patients without evidence of infection; febrile hospitalized patients without evidence of candidiasis; and patients with superficial candidiasis and candiduria. The control subjects were compared with 13 patients with proven disseminated candidal infection (disease prevalence = 15%). The ELISA CAb test was of greater individual sensitivity (92%) in separating patients with systemic candidiasis from all controls combined than the ELISA CAg, CIE CAg, or CIE CAb test (61%, 15%, 69%, respectively). The CIE CAg test, though specific (100%), was insensitive. Sensitivity, specificity, and predictive values were generally enhanced by employing combinations of tests. Sera from patients with disseminated candidiasis were much more likely to yield a positive result by two or more serologic tests than were control sera (p = < 0.0004). The sensitivity of combinations ranged from 15% to 92%. The specificity of combinations ranged from 21% to 100%. The predictive value positive of combinations test ranged from 40% to 100%, Predictive value negative of combinations ranged from 69% to 98%.Patients with a variety of superficial and deep candidal infections apparently have detectable circulating CAb and/or CAg. The ELISA CAb test was superior to the other tests in identifying patients with disseminated candidiasis. Combinations of serologic tests may be superior to individual tests in the diagnosis or exclusion of serious disease due toCandida albicans.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Monoclonal antibodies are becoming increasingly useful in the clinical diagnosis and/or treatment of a number of unrelated diseases. Discussion will be directed to those monoclonal antibodies recognizing antigens within the skin which appear to have either proven or potential application in the diagnostic evaluation of the skin blopsy.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A 60-year-old woman with a diagnosis of poorly differentiated lymphocytic lymphoma presented with nephrotic syndrome. Her clinical picture and serological studies were consistent with the diagnosis of mixed connective tissue disease (MCTD). Renal biopsy demonstrated the changes of membranous nephropathy by light, immunofluorescence and electron microscopy. Treatment with corticosterolds and cyclophosphamide had no effect on the proteinuria, and she demonstrated progression of renal failure. This patient demonstrates that the lymphadenopathy associated with MCTD may be of a separate malignant origin. The treatment of MCTD may not alter the course of renal disease, and renal failure may ensue in patients with MCTD.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Metastatic malignant pheochromocytoma can be a disease of long duration and though poorly responsive to both radiation therapy and chemotherapy, pharmacologic management of its myriad manifestations can be very effective. Hypertension is the most recognized feature of this disease, but gastrointestinal manifestations can, on rare occasions, be just as serious and life threatening. We present two patients with metastatic pheochromocytoma who developed pseudo-obstruction, and discuss the pathopharmacology and treatment of this syndrome.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Ascites is an unusual feature of multiple myeloma. We report a case of ascites occurring early in the course of a patient with myeloma in whom there was no evidence of intra-abdominal plasmocytoma, and the skeleton was relatively spared. The serum contained predominantly polymeric IgA, a feature not investigated in previous cases. We reviewed the relevant literature and will discuss the suggestion that human myelomas presenting with the triad of ascites, relative or absolute sparing of the skeleton, and an IgA paraprotein bear an analogy to mouse myelomas induced by intraperitoneal instillation of irritants. The relevance of polymeric IgA is discussed with respect to tissue origin of the paraprotein. Seventeen cases were identified consistent with a definition of “myelomatous ascites” (malignant myeloma in which plasma cells and/or monoclonal immunoglobulin can be demonstrated in ascitic fluid). IgA immunoglobulin class was present at three times the incidence seen in myelomas in general (five of seven cases were specified). In twelve patients there was no identifiable intra-abdominal plasmacytoma although liver infiltration was common. Amyloldosls was reported in only one case, and no cases of uncomplicated plasma cell leukemia were noted. Ascites was a presenting feature in five cases. In each of these five there was absolute or relative sparing of the skeleton, four had no evidence of plasmacytoma, and the paraprotein was IgA in three, IgG in one, and unreported in one. In no case was there a known history of chronic intra-abdominal irritation.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Two patients presented with signs and symptoms of apparent zomepirac-Induced anaphylactic shock. All recovered with appropriated therapy. The theories of the mechanisms by which non-steroidal anti-inflammatory drugs cause this serious adverse reaction are discussed.

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1985

数据来源: OVID