摘要:

Abstract:Gene rearrangements of immunoglobulin and T cell antigen receptor gene loci were studied in 67 patients referred to a general hematology clinic. The results of gene analysis supported the clinical diagnosis in most cases where involved tissue was studied. However, in a number of cases, gene rearrangement studies gave unexpected results of possible diagnostic significance. Thus two patients who presented diagnostic difficulties were finally diagnosed as having non‐Hodgkin's lymphoma; gene analysis suggested that the initial diagnosis of Hodgkin's disease may have been correct. In two patients who had chronic lymphocytosis and were suspected of having chronic lymphocytic leukemia, no evidence of monoclonal disease of B or T cells could be found and the basis for the lymphocytosis was presumed to be non‐malignant. Gene analysis was able to detect monoclonal B cell disease in the otherwise normal blood of two of six patients with lymphoma, one of two patients with macroglobulinemia, and none of six patients with myeloma.The study of gene rearrangements may be a practical aid to diagnosis in some situations of uncertai

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05039.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.tb05040.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:In order to compare the frequency of elevated lymphocyte proportions and elevated Leu3/Leu2 (helper/inducer to suppressor/cytotoxic) ratios in sarcoidosis with those in clinically similar interstitial lung diseases (ILDs), bronchoalveolar lavage (BAL) lymphocyte proportions and Leu3/Leu2 ratios were determined for 20 patients with sarcoidosis and 30 patients with other (non‐sarcoidosis) ILDs [cryptogenic fibrosing alveolitis (seven), lung connective tissue disease (seven), extrinsic allergic alveolitis (four), lymphoproliferative disease (two), and asbestosis (ten)], as well as in eight control subjects. BAL lymphocyte proportions were elevated above control values in 19 (95%) patients with pulmonary sarcoidosis (mean value 36 ± 3%) but also in 12 (39%) patients with non‐sarcoidosis ILDs (mean value 17 ± 4%). Leu3/Leu2 ratios were over 2.5 in 15 (75%) of the sarcoidosis patients (mean ratio 4.4 ± 1). In all control subjects, however, and in all but one of the non‐sarcoidosis groups, Leu3/Leu2 ratios were below 2.5 (p<0.001 for each compared to sarcoidosis patients). Helper/suppressor ratios over 2.5 are found in the majority of our sarcoidosis patients and, unlike raised lymphocyte proportions alone, are not commonly seen in other ILDs, suggesting that evaluation of BAL helper/suppressor cell ratios may be of value in the investigation of patients

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05041.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.tb05042.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:Sixteen patients with hematological malignancy received cyclophosphamide (120 mg/kg), fractionated total body irradiation (12 Gy), oral cyclosporin, and an HLA‐identical sibling marrow transplant depleted of T cells by incubation with the monoclonal antibody anti‐HuLy‐m1 (CD2) and rabbit complement with (five patients) or without (11 patients) anti‐HuLy‐m8 (CD8). These 16 patients were compared historically to 84 patients with hematological malignancy receiving cyclophosphamide (120 mg/kg), fractionated total body irradiation (12 or 14 Gy), oral cyclosporin, and unmanipulated HLA‐identical sibling marrow, for parameters of engraftment and graft‐versus‐host disease (GVHD). Graft failure occurred in one of the 16 T‐cell depleted recipients and in one of the 84 non‐depleted recipients. Engraftment was slightly but significantly slower in the T‐cell depleted group and bacterial infections significantly more, frequent and severe than in the unmanipulated group. There was a suggestion that the severity of acute GVHD was reduced in those receiving T depleted marrow. Randomized trials will be necessary to determine if marrow T‐cell depletion results in superior long‐te

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05043.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:Many Australian Aboriginal bushfoods contain slowly digested carbohydrate which elicit low postprandial blood glucose and insulin responses compared to Western foods, such as wheat bread. This study has shown that incorporation of flour made from a slowly digested seed,Acacia coriacea, into wheat bread (18 g/82 g wheat flour) significantly reduces the initial rise in plasma glucose levels (p<0.05) and the area under the plasma glucose curve (p<0.005) in six healthy subjects. Insulin values were also lowered at 60 minutes (p<0.025) and 90 minutes (p<0.05). Our findings suggest thatAcaciaflour, when used to dilute wheat flour in the manufacture of breads, produces a very palatable food which could be useful in the diets of diabetic individuals.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05044.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:An Australian Aboriginal family, extending four generations, with a high incidence of renal disease was investigated. Twenty‐eight of 114 members screened had hematuria. Of those tested, five had hypertension, four maturity onset diabetes, one a raised serum creatinine concentration, five elevated serum IgA levels and two cortical scarring on intravenous pyelogram. Of the eight members who underwent renal biopsy, five had IgA nephropathy and one had light and electron microscopy evidence of glomerulonephritis, but no IgA was seen on immunofluorescence. One had mild nonspecific changes by light microscopy but no immunofluorescence or electron microscopy was available and the remaining patient had mild changes consistent with hypertension and diabetes. HLA typing, carried out for 27 family members, showed an increased incidence of HLA‐B22, B27, B39, and DR1 when compared to Yuendumu Aborigines (B27 and DR1), or Australian Caucasians (B22), or both (B39). This may be due to an association with IgA nephropathy, or a family clustering of antigens. Overall, this study suggests a genetic mechanism in the pathogenesis of IgA nephropathy in some patients and, as there was evidence of renal disease in 25% of those tested, may indicate an underlying high incidence of renal disease in the Aboriginal commun

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05045.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:Neuralgic amyotrophy refers to an idiopathic syndrome where weakness and wasting occur in one limb, usually in the muscles innervated by the upper brachial plexus. Seven patients are presented who developed cranial nerve involvement (facial, spinal accessory) in the midst of a typical attack of neuralgic amyotrophy or who developed either recurrent brachial or brachial and lumbosacral plexopathies. An underlying demyelinating neuropathy was identified in one patient and two patients were heroin addicts. These reports confirm that neuralgic amyotrophy may occasionally form part of a more extensive disorder of the peripheral nervous system, thereby providing indirect support for the role of a systemic immunological factor in pathoetiology.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05046.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:To study the disposition of the anti‐inflammatory drug sulindac, its active sulphide metabolite, and the inactive sulphone metabolite, sulindac (200 mg twice daily) was given to eight elderly subjects for at least 14 consecutive days. The drug was then ceased for 72 hours, and suitable samples were collected to study its elimination. The mean steady‐state concentration for sulindac was 5.0 μg/ml, for sulindac sulphide was 6.5 μg/ml, and for sulindac sulphone was 13.2 μg/ml. These are approximately twice the reported steady‐state levels for the respective redox forms in healthy young adults. The mean half‐lives of sulindac, sulindac sulphide, and sulindac sulphone were 18.3 hours, 22.3 hours, and 54.6 hours, respectively. One patient who had mildly abnormal liver function tests developed more severe abnormalities whilst receiving sulindac. These returned towards normal after cessation of treatment. This patient had the highest steadystate plasma concentration of sulindac sulphone. It is concluded that care should be taken with the use of sulindac in the elderly, and control of patients' symptoms should be attempted with lower doses of the drug before the standard dose of 200 mg twice daily is ad

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05047.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Abstract:Data from a 1983 Auckland coronary heart disease register applying current World Health Organization criteria have been used to validate routine hospital discharge data. The register contained 905 patients under 65 years admitted to hospital and 858 of these patients were matched with hospital discharge records. Of the registered definite myocardial infarction cases 86% received the International Classification of Diseases code 410 (acute myocardial infarction); 9% of these cases received a code 411‐414 (other forms of coronary heart disease or angina) and 5% received other codes. Only 405 of the 604 cases (67%) coded 410 in the hospital discharge data were true definite myocardial infarctions according to the World Health Organization criteria. The routine hospital International Classification of Diseases data do not provide diagnostic groups sufficiently close to World Health Organization categories for them to be used alone to monitor trends in coronary heart disease morbidity rate

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1987.tb05048.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY