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Biomedical subjects

A Carter

Publications and source records attributed to A Carter.

At least 127 records · Page 7Linked to original sources
PubMed1984

Plasma cholesterol concentration and extra lipid band in monoclonal gammopathies.

Plasma lipids and lipoproteins were studied in 21 patients with benign monoclonal gammopathy, 21 patients with multiple myeloma and seven patients with Waldenström's macroglobulinaemia. Results were compared with those of a control group, age and sex matched. Low plasma cholesterol levels in all three patient groups were associated with low HDL-cholesterol concentrations. Apo A-I, but not apo B, was significantly reduced. Sixty per cent of the patients exhibited an extra lipid band on plasma lipoprotein electrophoresis, which could be an immunoglobulin-lipid complex. In these patients plasma and LDL-cholesterol levels were significantly lower than in those patients in whom this band was absent. No correlation was found between the severity of the disease and plasma lipid pattern.

Aged↗
PubMed1984

Pancoast's syndrome in multiple myeloma.

A 74-year-old patient developed IgG multiple myeloma. 7 months later a right Pancoast's syndrome was observed. Computerized tomography established the extrapleural origin of the tumor. Fine needle aspiration revealed pathological plasma cells. Partial reduction of plasmacytoma was noted following radiotherapy, but the patient succumbed to pneumonia. Autopsy confirmed that a plasmacytoma caused the Pancoast's syndrome. The importance of early diagnosis and accurate therapy of this rare manifestation of multiple myeloma is discussed.

Aged↗
PubMed1984

Acute leukemia following chemotherapy and radiation therapy--a report of 15 cases.

14 patients developed acute nonlymphocytic leukemia and 1 patient developed Burkitt's leukemia following longterm chemotherapy and/or radiotherapy for other disorders. The main primary disorders included multiple myeloma, Hodgkin's disease, non-Hodgkin's lymphoma and breast carcinoma. Acute leukemia developed earlier in patients treated by chemotherapy with or without radiotherapy than in patients treated by radiotherapy alone (63 months, range 24-132 months; 201 months, range 48 months to 30 years, respectively). 13 patients presented without organomegaly and 8 were pancytopenic. Abnormalities of myeloid and erythroid cell lines were observed in the majority of the patients. A high rate of acute erythroleukemia (5 out of 14) was found. Increased reticulin fibers were found in 3 patients. The leukemia was invariably refractory to treatment with a median survival of 4 months. The possible role of preexisting abnormal marrow structure in the development of therapy-related leukemia is discussed.

Acute Disease↗
PubMed1983

Detection of IgD 'hidden' lambda light chain.

Immunoelectrophoresis and immunodiffusion of some IgD myeloma proteins fail to demonstrate precipitin bands between the light chain and anti-light chain serum. Reduction and alkylation of purified IgD preparation was found to render the molecule reactive to anti-lambda serum. Iodinated IgD myeloma protein was successfully precipitated by both anti-delta and anti-lambda antibodies. Both antisera precipitated heavy and light chains of a MW of 70,000 and 24,000 daltons respectively. In addition, a band of 39,000 daltons was also evident. Reduction and alkylation of the iodinated molecule, followed by precipitation with anti-delta serum demonstrated only the 70,000 and 39,000 daltons bands. The present report indicates that by sensitive techniques, such as iodination and immunoprecipitation, non-reactive hidden light chains can be detected in IgD lambda molecules.

Electrophoresis, Polyacrylamide Gel↗
PubMed1983

Lymphocyte subpopulations in benign monoclonal gammopathy.

Peripheral blood samples from normal individuals and from patients with benign monoclonal gammopathy or multiple myeloma were separated and assayed by immunofluorescence and rosette formation for T, B, TG and TM subpopulations. When compared with normal individuals and multiple myeloma patients, the benign monoclonal gammopathy patients could be divided into 2 groups. The 1st group demonstrated a T/B ratio similar to normal individuals, whereas in the 2nd group the ratio resembled that of the myeloma patients, with a decrease in the fraction of T lymphocytes, accompanied by an increased number of B lymphocytes. An analysis of the monoclonal Ig fraction levels indicated that the 2 groups differ in this respect as well. In the 1st group, the level of the monoclonal immunoglobulin was stable, with small fluctuations. The 2nd group demonstrated a general increasing M-component, especially in the 4-6 months preceding the study. The 2 benign monoclonal gammopathy groups exhibited a trend to a lower TM/TG ratio compared to normals; this change is more prominent in the 2nd group. Analysis of the T lymphocyte subpopulations indicated an overall decrease in the fraction of TM multiple myeloma. The above-mentioned parameters might thus aid in discriminating among BMG patients with regard to their tendency towards a malignant transformation.

B-Lymphocytes↗
PubMed1982

Incidence, prognostic significance and therapeutic modalities of central nervous system involvement in multiple myeloma.

In 114 patients with systemic malignant gammopathies followed during a 10-year period in the hematology clinic of the Rambam Medical Center, 23 episodes of CNS involvement were recorded. 19 cases with spinal cord compression and 4 cases of intracranial plasmacytomas. Early diagnosis followed by prompt laminectomy and subsequent radiotherapy resulted in complete recovery in 50% and partial improvement in 30% of the patients with spinal cord involvement. In good responders. overall survival was not affected by the neurological complication. In the 4 patients with intracranial involvement, external plasmacytomas of the skull preceded the neurological symptoms. 3 of them were diagnosed late, which led to delay and failure of accurate treatment. Only 1 patient was immediately operated and continued to be well for the past 2 years.

Aged↗
PubMed1981

Clinical usefulness of urinary 3-methylhistidine excretion in indicating muscle protein breakdown.

Urinary excretion of the post-translationally modified amino-acid 3-methylhistidine, derived from the contractile proteins actin and myosin, was measured in patients with conditions associated with nitrogen loss. The ratio of 3-methylhistidine:creatinine excretion, a measure of the fractional catabolic rate of myofibrillar protein was increased in severe injury, thyrotoxicosis, neoplastic disease, prednisolone administration, and sometimes Duchenne muscular dystrophy. In myxoedema, osteomalacia, and hypothermia the ratio was decreased; and starvation, elective operations, and rheumatoid arthritis had little effect. Provided that the diet is meat free, measurement of urinary 3-methylhistidine may provide useful information on the cause of protein loss.

Adolescent↗
PubMed1981

Spontaneous immunoglobulin changes in human plasma-cell dyscrasia.

A series of spontaneous changes affecting the nature of the immunoglobulin secretion of plasma cels is described in a patient initially diagnosed as IgG lambda benign monoclonal gammopathy. After several years a slight increase in the amount of serum monoclonal immunoglobulin occurred; shortly thereafter an aggressive form of multiple myeloma was diagnosed. Unexpectedly a rapid spontaneous decrease of the monoclonal immunoglobulin, accompanied by the appearance in the serum of increasing quantities of a complex containing intact lambda light chains, then occurred. Concomitantly a fragment of the corresponding free light chain was was detected in the urine. A parallel is drawn between the facts observed in this patient and in an animal model recently proposed to explain the different types of structural immunoglobulin abnormalities in multiple myeloma.

Female↗
PubMed1980

Endoscopic retrograde cholangio-pancreatography: related nosocomial infections.

The flexible endoscopes of a gastroenterology department were microbiologically examined after one patient developed a possible nosocomial infection. The endoscopes were found to be contaminated by pseudomonas species. An appropriate cleaning regime was developed and the initial difficulties in sterilising the instruments are described. The medical records of all ERCPed patients for the one and half years prior to and the half year after the monitoring exercise were examined. It was found that approximately 50 percent of patients examined in the half year prior to the introduction of endoscopic monitoring had infections with Pseudomonas species.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1980

Early detection of doxorubicin cardiotoxicity by M-mode echocardiography.

The influence of increasing doses of doxorubicin on the heart was examined in 30 patients with solid tumors, M-mode echocardiography being used to evaluate left ventricular contractility. The function of the left ventricle remained normal in 26 subjects, whereas four patients had evidence of cardiotoxicity after cumulative doses of 220, 380, 420, and 450 mg/m2. Transient overt heart failure was noted in one subject only. Doxorubicin cardiotoxicity can be detected by M-mode echocardiography, a simple and non-invasive technique, prior to the appearance of overt congestive heart failure. Patients demonstrating left ventricular dysfunction are probably not candidates for receiving further therapy with anthracycline antibiotics. Limitation of M-mode echocardiography include a 28% incidence of inadequate studies in this group of patients, and a relative inaccuracy of the technique in evaluating patients with prior myocardial infarction.

Adolescent↗
PubMed1980

The effect of 3-methylhistidine in food on its urinary excretion in man.

1. To establish whether 3-methylhistidine in food is quantitatively excreted in the urine, five normal adults on a vegetarian diet were given known amounts of 3-methylhistidine in meat or fish. The mean cumulative 5-day increment in 3-methylhistidine excretion in non-hydrolysed urine accounted for an average of 90% of the 3-methylhistidine given during the first 3 days of this period. 2. To define the variation in urinary 3-methylhistidine on a constant mixed intake, the daily 3-methylhistidine excretion was measured for 6 days in four patients on a metabolic "balance" diet. The mean daily variation was less than 10%. 3. The results show that under the conditions of this study the increase in urinary 3-methylhistidine above basal levels can be quantitatively accounted for by the 3-methylhistidine content of additional food; in subjects on a constant diet it should be possible to detect relatively small changes in 3-methylhistidine excretion.

Adult↗
PubMed1980

The physiopathological significance of benign monoclonal gammopathy: a study of 64 cases.

Sixty-four patients with monoclonal protein in serum but initially without evidence of multiple myeloma, macroglobulinaemia, amyloidosis or lymphoma, were studied. Fifty patients (78%) were observed for a period of exceeding 3 years. Based on the follow-up data the patients were classified into the following four groups: Group 1 = patients with transient monoclonal gammopathy: 4 . 7%; Group 2 = patients without significant increase in monoclonal serum protein: 75%; Group 3 = patients with more than 50% increase in monoclonal serum protein: 14 . 1%; Group 4 = patients in whom multiple myeloma developed: 6 . 2%. The mean interval from discovery of the serum monoclonal protein to evolution to multiple myeloma was 61 months. Retrospective analysis of age, sex, blood count, bone marrow picture, antigenic type and size of serum monoclonal proteins, presence of small amounts of homogeneous light chain in the urine, serum albumin level, levels of residual immunoglobulins, did not help to distinguish initially the patients in whom the monoclonal gammopathy evolved to multiple myeloma from patients in whom the disease remained benign and stable. The evolution to multiple myeloma had occurred abruptly after long periods of stable condition; and until this progression the follow-up data were similar to the patients with benign disease. The possible physiopathology of occurrence and evolution of benign monoclonal gammopathy is discussed.

Adult↗
PubMed1980

Multiple acquired haemostatic defects. Case report and review of the literature.

A 14-year-old girl presented with severe haemorrhagic diathesis. Her past history suggested a congenital bleeding disorder. Investigations disclosed severe deficiency of all four vitamin K-dependent factors and a functional defect of platelets. These were caused by simultaneous administration of vitamin K antagonists and anti-inflammatory drugs. A complete clinical and laboratory recovery took place following withdrawal of drugs. The severity of the haemorrhagic diathesis prompted us to describe the case in order to draw the attention of medical personnel to the dangerous potentiation effects of different drugs administered with vitamin K antagonists.

Adolescent↗
PubMed1980

Three day pleural inflammation: a new model to detect drug effects on macrophage accumulation.

Mononuclear cell accumulation is of major importance in maintaining chronic inflammatory conditions. In an effort to model this phenomenon, 0.3 ml of a 1% carrageenan solution was injected into the pleural cavity of rats; at various times thereafter peripheral blood and pleural exudate samples were collected. Seventy-two hours after carrageenan injection, 82.3 +/- 3.7 x 10(6) cells (N = 6; mean +/- S.E.) were present in the pleural cavity; over 80% of these cells were macrophages as determined by morphologic and histochemical criteria. Animals treated with dexamethasone had a significantly reduced number of pleural macrophages. Animals treated with the nonsteroidal anti-inflammatory agents, naproxen and indomethacin, had an elevated intrapleural macrophage content. The number of intrapleural cells was not affected by the antirheumatic agents levamisole, d- and dl-penicillamine or gold sodium thiomalate. Animals treated with tilorone, dapsone, hydroxychloroquine, phenylmethane-sulfonyl fluoride and 1,10 phenanthroline had a reduced pleural cell count.

Animals↗