ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00359.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00360.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00361.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe efficacy of interferon treatment for Australian patients with chronic active hepatitis B (CAH‐B) was assessed by a three‐centre randomised controlled trial in Sydney and Brisbane. Thirty patients (29 with histologically‐proven CAH‐B with and without cirrhosis and one with chronic persistent hepatitis) were allocated to receive either thrice weekly intramuscular injections of recombinant human leucocyte interferon ‐αA (either 2.5, 5.0 or 10.0 million units/m2) for six months followed by 12 months of observation, or to be observed for 18 months without active treatment. Three of 23 treated patients but none of seven controls underwent clinical, biochemical and histological resolution of their disease with loss of HBsAg, HBeAg and HBV‐DNA from serum. An additional six treated and two control patients underwent a sustained partial remission of their disease. This was characterised by resolution of symptoms and serum aminotransferase abnormalities in association with seroconversion from HBeAg positive to negative, loss of HBV‐DNA from serum but persistent hepatitis B surface antigenaemia. In such patients, there was significant improvement in histological appearances but some necroinflammatory activity remained and fibrosis was unchanged. Although total response rates were similar in treated and control subjects, they appeared to occur earlier after interferon treatment.Treatment with interferon was associated with predictable but minor side effects that usually did not necessitate dose reduction and rarely compromised the patient's life style. Interferon is thus a feasible treatment for CAH‐B. Complete responses occurred only in treated patients and partial responses appeared to occur earlier in treated than in untreated patients. However, differences in the partial response rate at 18 months were not significant and seroconversion from HBeAg positive to negative was not associated with complete histological resolution of disease activity. Hence, while interferon is a promising agent for treatment of CAH‐B, efforts must continue to define more optimal treatment regimes and to identify those patients most likely to res

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00362.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractPost‐mortem examinations were performed on 89 Chinese with fatal acute myocardial infarction, who represented an unselected 45.6% of a series comprising 195 consecutive hospital deaths from acute myocardial infarction in Hong Kong. In 83 patients (93.3%), the acute infarcts were correctly identified, and old infarct scars or patchy fibrosis were found in 21 patients (23.6%). Of the 85 sudden deaths, 33 patients (38.8%) had no definite mechanical complication and therefore could have died of primary arrhythmias, ten patients (11.8%) had rupture in the free ventricular wall with cardiac tamponade. Two other patients had rupture of the interventricular septum and one more patient had rupture of papillary muscle. Evidence of significant coronary atherosclerosis was identified in 94.7% of patients, with one‐vessel disease in 18.7%, two‐vessel disease in 33.3% and three‐vessel disease in 42.7% of patients respectively. Critical lesions were present in left main stem in 8%, left anterior descending artery in 45.3%, circumflex artery in 8% and right coronary artery in 17.3% respectively. Occlusive coronary thrombi were identified in 18.7% of patients. These pathological findings were compared with reports on fatal myocardial infarctions from the western co

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00363.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractAutologous bone marrow transplantation, using unpurged cryopreserved autologous marrow, was performed on ten adult patients with acute myeloid leukaemia in remission. Seven patients were in first chemotherapy‐induced remission of their disease, while three were in later remission. Patients ages ranged from 24 to 52 years, with a median of 38.5 years. Conditioning therapy consisted of oral busulphan 16 mg/kg over four days and intravenous cyclophosphamide 60 mg/kg on two days. Bone marrow cells were thawed and infused two days later. All patients showed signs of marrow engraftment, however this was delayed in comparison with patients receiving allogeneic transplants. All patients developed fever requiring antibiotic therapy and one patient died of overwhelming sepsis. Another patient died of hepatic veno‐occlusive disease two months after transplant. Serious, but non‐fatal, hepatic complications occurred in two other patients. One patient, transplanted in third remission, relapsed 16 months post‐autograft. No other relapses have been seen, with one second remission patient remaining leukaemia‐free at 24 months, and six first remission patients in continuing remission 11 to 23 (median 20) months post transplant. These encouraging results require confirmation in a randomised clinical trial comparing autologous marrow transplantation versus standard che

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00364.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00365.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractTwenty‐nine patients of 18,000 inpatient admissions over a six‐month period developed ischaemic hepatitis accompanied by peak aspartate aminotransferase (AST‐EC 2.6.1.1) activity greater than 1,000 U/L. Seventeen of these 29 patients died either during or shortly after the episode of ischaemic hepatitis, with an overall mortality of 58.6%. Mortality was not due in any of the cases to the hepatitis but rather the underlying cause. Ischaemic hepatitis was the commonest cause of an AST activity greater than 1,000 U/L in this hospital population (29 of 52 patients i.e. 56%). This condition is more common than generally appreciated and is associated with a poor prog

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00366.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractOne hundred and nine subjects with chronic bronchitis were studied prior to winter and without clinical infection, to determine baseline patterns of bacterial colonisation. Qualitative analysis of cultures of oropharyngeal swabs showed little difference from age matched normal controls (17) except for growth of small numbers of Gram negative coliforms in the chronic bronchitic group. Quantitation of bacteria colonising the oropharynx showed small numbers (mean of 105cfu/ml), with no particular bacteria dominating.Haemophilus influenzaewas present in 7.3% of throat swabs from chronic bronchitic patients, but the organism was always less than 10% of the total count. Quantitation of bacteria in sputum showed significantly higher numbers (mean 107cfu/ml).H. influenzaewas detected in 25.7% of available specimens, and when present constituted>90% of the total count.Biotyping ofH. influenzaeisolates demonstrated a separate colonisation of the upper and lower respiratory tracts.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00367.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe aim of this study was to determine the degree and duration of hypoxaemia during bronchoalveolar lavage (BAL) and to examine the effect of supplemental oxygen on this response. Transcutaneous oxygen tension (PO2) was recorded continuously in 22 patients having bronchoscopy alone (Group 1), and during BAL in patients with a variety of connective tissue disorders. Thirty eight of these patients were breathing room air (Group 2) and 28 were given supplemental oxygen (Group 3). The mean fall in PO2in Group 1 was 12 ±3 mmHg and the PO2in these subjects rose promptly to the initial value once the bronchoscopy was finished. The mean falls in Groups 2 and 3 were 24±4 and 32±5 mmHg and the mean times taken for the PO2values to return to baseline after the procedure were 47±9 and 53±10 minutes respectively. The PO2fell to less than 60 mmHg in 76% of the patients in Group 2 but in only 25% of those in Group 3. It is recommended that supplemental oxygen be given to all patients having BAL during and for one hour after the procedure and that oxygenation be monitored continuously throughout the bronchoscopy. Arterial blood gases should be always measured prior to bronchoscopy and BAL. In those cases where it is not possible to maintain the PaO2at 70 mmHg or more the procedure should be undertaken with great care and with due consideration of the risk of the hypoxaemia that may o

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1990.tb00368.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY