ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02990.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02991.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02992.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Frusemide has recently been shown to antagonise exercise‐induced bronchospasm, an action attributed to blockade of chloride channels in the bronchial epithelium. In order to test the hypothesis that frusemide non‐specifically antagonises bronchospasm, we tested the bronchial reactivity to inhaled histamine in ten subjects aged 22 to 35 years, after nebulising 30 mg of frusemide, and after nebulising the frusemide vehicle (water at pH 9.1). The geometric mean (histamine PD20) after inhalation of the solution was 0.6 μmol and after frusemide was 0.45/μmol. The mean difference in PD PD20between control and frusemide was – 0.50 μmol (frusemide test more reactive) but this change was not statistically significant. We conclude that nebulised frusemide does not antagonise histamine‐induced bronchospasm, and that the ability of frusemide to block exercise‐induced bronchospasm may be specific to t

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02993.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:In a randomised, double‐blind cross‐over study, objective measures were used to compare the effect of a single oral dose of a standard preparation of levodopa‐benserazide (Madopar M) with a sustained‐release preparation (Madopar HBS) in 9 Parkinsonian patients with ‘end of dose deterioration’. The response of patients to an optimised regimen of each preparation was also assessed using a patient diary.In all patients the onset of effect of Madopar HBS following a single dose was delayed compared with Madopar M. The duration of effect of a single dose of Madopar HBS was substantially (38‐120%) longer than Madopar M in five patients and the same or shorter in four patients. According to the patients diaries, six patients noted an increase in ‘on’ hours while on Madopar HBS. The duration and severity of dyskinesia was similar for the two preparations.Madopar HBS is likely to be useful in some Parkinsonian patients with ‘end of dose deterioration’. As the effect of each dose is delayed it is probably best given in combination

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02994.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Hodgkin's disease limited to the infradiaphragmatic region was seen in 30 of 306 (9.8%) of all Stage I and II patients referred to the Peter MacCallum Cancer Institute between 1968 and 1980. The male:female ratio was 2.3:1 with median age of 43.5 years at presentation.Of the seven patients with clinical stage (CS) IA‐IIA disease who had staging laparotomy and splenectomy only one CSIIA patient had splenic involvement. The patients were staged as pathological stage (PS) IA 2, PSIIA 5, CSIA 4, CSIIA 10, CSIIB 9.Primary treatment was by radiation in 24 patients, combination chemotherapy in five and surgical excision in one. Twenty‐five patients achieved complete response. Relapse free survival (RFS) at five and ten years was 59% and the five and ten‐year survival was 75% and 67% respectively.On univariate analysis the significant prognostic factors for RFS and survival were stage, constitutional symptoms and presence of bulky disease.Using Cox regression analysis the only significant variable for RFS and survival was bulky disease (p= 0.01, 0.02).A treatment policy for patients with infradiaphragmatic Hodgkin's disease is recomm

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02995.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Antibody to hepatitis C has been variously detected in 1‐20% of haemodialysis patients in recent studies from overseas. To determine the frequency of antibodies to the C100‐3 protein of the hepatitis C virus (anti‐HCV) a cross‐sectional study was performed in 60 patients on maintenance haemodialysis in Western Sydney. Six patients (10%) were anti‐HCV seropositive. Four of the six anti‐HCV positive patients were also hepatitis B core antibody positive, compared with nine of 54 anti‐HCV negative patients (p<0.05). All anti‐HCV positive patients had received multiple blood transfusions. Serum alanine aminotransferase (ALT) was not useful as a screening test. Recent evidence suggests that anti‐HCV seropositivity underesti

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02996.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Catheter‐induced His bundle ablation for refractory supraventricular arrhythmias is most commonly performed with direct‐current shock energy of 200‐300 joules. The high energy pulse delivered by direct‐current shock produces a lesion in the atrioventricular node by fulguration, with the residual energy being dissipated as a pressure wave.The effect of direct‐current shock His bundle ablation on global and regional ventricular function was assessed in 14 consecutive patients by radionuclide ventriculography performed before and after ablation and again three months later. All studies were performed with ventricular pacing at 110 bpm.Global left ventricular ejection fraction was found to be significantly reduced at the three month study (0.43 ± 0.03 vs 0.50 ± 0.03, pre ablation,p= 0.02). A significant reduction in wall‐motion score was also seen in six of the seven patients who had normal wall motion in pacing rhythm prior to ablation. Deterioration was mainly seen at the left and right ventricular apices.The observed reduction in ventricular function that follows direct‐current shock His bundle ablation may result from myocardial damage from electro‐coagulation or from barotrauma and supports continued investigation into alternative, less traumatic energy sources

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02997.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Since the late 1970s patients with diabetic nephropathy have formed an increasing proportion of new entrants to the Hospital renal dialysis and transplantation programme, reaching 28% for the three year period to December 1988. Between 1 January 1975 and 31 December 1988, 87 diabetic patients were accepted for treatment. Fifty‐one per cent were European, predominantly type I diabetics. Maori (9% of the total reference population) accounted for a disproportionately high 47% due to an over‐representation by type II diabetic patients (34 of 41 Maori). These findings cannot be explained by the higher prevalence in Maori of type II diabetes but appear to be due to a more prevalent and/or aggressive diabetic renal lesion in this group. On commencing treatment, nearly all patients had retinopathy and the majority had evidence of peripheral vascular disease, hypertension and neuropathy. CAPD was the initial mode of renal replacement therapy in 70% of patients. Overall patient survival was 77% at one year and 42% at three years, and survival on CAPD was 76% and 37% at one and three years, respectively. Patient survival on transplantation was 63% at one year and 58% at three years. Graft survival was 51% at one year and 46% at three years. Although the short term outlook for diabetic patients on renal replacement therapy is encouraging, longer term survival compared to non‐diabetic patients is poor. Vascular disease is the major cause of death and an important factor in patient morb

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02998.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Abstract:Anti‐idiotypic antibodies are antibodies that are directed against the variable region of the corresponding antibody molecule and have been postulated to have a regulatory role in the immune response. Circulating anti‐idiotypic antibodies have been reported in several antibody‐mediated autoimmune diseases.We have established the following detection system for anti‐idiotypic antibodies in human anti‐glomerular basement membrane (GBM) disease. Spleen cells harvested from BALB/c mice immunised with human GBM were incubated with GBM‐coated sheep red blood cells in the presence of guinea pig complement. Each spleen cell that produced anti‐GBM antibodies resulted in a surrounding plaque where antibodies lysed the GBM‐coated RBC. The number of plaques could be inhibited by the addition of heterologous anti‐idiotypic antibodies to the plaquing mixture. Anti‐idiotypic antibodies were then sought in both acute and convalescent phase sera from patients with anti‐GBM disease and in laboratory staff who repeatedly handled GBM and sera containing anti‐GBM antibodies. Anti‐GBM antibodies were removed from all material before testing and affinity‐purified preparations contained concentrations of IgG corresponding to the range that resulted in inhibition when affinity‐purified rabbit anti‐idiotypic antibody was examined.No anti‐idiotypic antibodies could be demonstrated in any of the sera or IgG preparations examined. We conclude that if circulating anti‐idiotypic antibodies are present in patients with anti‐GBM disease, they must be infrequent, or at concentrations below the limits of detection of this assay (<1 mcg/mL). The observations of anti‐idiotypic antibodies in other antibody

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1991.tb02999.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY