Chronic fatigue syndrome. Self help groups give valuable support.
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Biomedical subjects
Publications and source records attributed to A Grant.
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The interleukin 2 (IL-2) receptor (IL-2R) is a multisubunit receptor that includes three major IL-2 binding subunits, the IL-2R alpha, beta, and gamma chains. We have detected and analyzed cooperative interactions between the IL-2R alpha and beta chains (IL-2R alpha and IL-2R beta, respectively) in COS cells transfected with cDNAs encoding the IL-2R alpha, the IL-2R beta, or both cDNAs. We demonstrated that IL-2 F42A, an analog that fails to bind to the isolated IL-2R alpha subunit and would be predicted by the hierarchical affinity-conversion model to have impaired binding to cells expressing both chains, instead readily binds to the IL-2R alpha/beta heterodimer in COS cells. Furthermore, this binding is abolished by the antibody HIEI that separates the two IL-2R subunits. The monoclonal antibodies anti-Tac and Mik-beta 1 directed at the IL-2-binding sites on IL-2R alpha and IL-2R beta, respectively, block ligand binding to the heterodimer. This binding pattern is inconsistent with the strict hierarchical affinity-conversion model that mandates an initial binding of IL-2 to IL-2R alpha followed by binding of the IL-2/IL-2R alpha complex to IL-2R beta. Instead, our results support an alternative model of preformed complexes of IL-2R beta with other IL-2R subunits. In this alternative model, IL-2R alpha and -beta exist in part as preformed complexes in which the affinity of IL-2R beta for IL-2 is altered by the proximity of IL-2R alpha, through mechanisms that do not require the prior binding of IL-2 to IL-2R alpha.
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It was hypothesised from previous observational studies in the Faroes and Denmark that dietary marine n-3 fatty acids would prolong the duration of pregnancy and thereby increase the birth weight, by influencing the production of prostaglandins involved in the process of parturition. Five hundred and thirty-three healthy Danish women were randomly assigned in the 30th week of pregnancy to fish oil (2.7 g n-3 fatty acids (4 1-g capsules Pikasol oil) per day), olive oil (4 1-g capsules per day) or no oil supplementation. The three groups differed in mean gestational age at birth (ANOVA, p = 0.006), with the fish oil group ranking highest and the olive oil group lowest. Babies born to women allocated fish oil had on average 4.0 (95% confidence interval 1.5;6.4) days higher gestational age and 107 (95% confidence interval 1;214) g higher weight at birth than babies born to women allocated olive oil; the difference in gestational age depended on the level of fish intake at enrollment, with a low fish intake enhancing the difference. Fish oil supplementation in the third trimester seems to prolong gestation while allowing continued growth of the foetus; this effect seems to explain the difference between the Faroes and Denmark in pregnancy duration.
The use of a contoured supracondylar carbon fibre plate in 22 patients with a fracture of the lower femur is reported. The patients were all elderly (mean age 80.6 years) and three patients in the study died of unrelated medical causes. Of the 19 surviving patients, in 17 the fracture united (89 per cent). The supracondylar plate was technically simple to use and the authors feel that it represents a significant advantage over existing implants for this difficult fracture.
A patient suffering from persistent hoarseness was eventually shown to have laryngeal leishmaniasis. The incubation period for the disease must have been at least 16 years, following infection in Southern Europe. Mucosal leishmaniasis is rare in the Eastern hemisphere, and laryngeal leishmaniasis has not previously been reported in the UK. Previous Mediterranean cases have run a similar chronic course and have caused diagnostic difficulty, in particular being mistaken for malignancy. Treatment with aminosidine was ineffective, but the patient responded to liposomal amphotericin.
We have studied the expression of p53 in 206 patients with gastric adenocarcinomas. A standard immunohistochemical technique employing the CM-1 anti-p53 polyclonal antibody was applied to the routinely fixed and paraffin-embedded material from these tumours; overexpression of p53 was defined as positive nuclear staining: 46% (94/206) of gastric carcinomas expressed high levels of p53. There was no significant correlation between p53 positivity and the tumour grade, growth pattern, the Lauren type or lymph node metastases. Correlation with disease stage was only marginally significant (P = 0.05). Life table analysis revealed a highly significant association between p53 expression and survival (P = 0.0062), the odds ratio of death being 1.89 (95% confidence interval 1.33-2.69). The overall 5-year survival of patients with p53-positive tumours was 3% compared with 16% for those with p53-negative tumours (median survival time being 5.6 and 11.4 months respectively). These data suggest that overexpression of the p53 oncoprotein is an independent marker of shortened survival in gastric cancer patients.
We assessed the effectiveness of intra-articular solutions of morphine, bupivacaine with adrenaline and a combination of both, compared with placebo in facilitating mobilisation and reducing postoperative pain and analgesic requirements for 24 h after operation. Forty patients undergoing arthroscopic knee surgery were studied in a double-blind, randomised, controlled trial. All treatments proved more effective than placebo in facilitating earlier mobilisation and in decreasing postoperative pain as measured by visual analogue scale. Morphine alone provided the best analgesia and significantly decreased analgesic consumption for 24 h after surgery. We conclude that 1 mg of intra-articular morphine provides effective pain relief following arthroscopic knee surgery and that the addition of bupivacaine is of no benefit.
Strongyloidiasis in immunocompromised patients is typically associated with a fulminant clinical course and little eosinophilia. We describe an immunocompromised patient with strongyloidiasis in whom the infection was only minimally symptomatic in association with a dramatic increase in eosinophil count.
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