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Biomedical subjects

A Martin

Publications and source records attributed to A Martin.

At least 577 records · Page 32Linked to original sources
PubMed1991

Eosinophilic gastroenteritis: report of two atypical cases.

Eosinophilic Gastroenteritis (EG) is a poorly understood disorder defined by eosinophilic infiltration of the bowel wall, eosinophilia and gastrointestinal symptoms. The disease's aetiology, course and treatment are not well known. We report two atypical cases of EG: one involving the mucosal layer and another involving the serosal and muscularis layer. The first shows how EG may present with a long history of episodes of intestinal obstruction and malabsorption and how the disease could take a severe course and may be unresponsive to treatment. The second case shows EG presenting as acute abdomen and which subsequently became asymptomatic without therapy, regardless of the fact that peripheral eosinophilia remained present. This case raises the problem of how to treat an asymptomatic patient, what parameters should be considered in order to assess the progress of the disease and the indications for treatment.

Adult↗
PubMed1991

[Amineptin dependence and iatrogenic acne. Review of the literature apropos of a case].

We relate the case of a drug addict of 31 years old whose dependence to the amineptine got complicated with severe acne-like lesions, as it sometimes happens. Compared, with teenage acne, severe acne can be distinguished by its late out break, its monstrous nature and its larger surface area. Amineptine has been found (or its metabolites) in the plasma, the urine. The treatment consists in the stopping of the drug addiction, combined with the prescription of isotretinoin.

Acne Vulgaris↗
PubMed1991

[Fetal cardiopathies. Balance of 7 years of consistent screening at the maternity unit of the Pontarlier hospital].

The authors carry out a retrospective analysis of the cases of fetal heart disease reported in a maternity clinic since 1983. Sixty-nine percent of these cases were detected by ultrasound during pregnancy. There were no malformations in a fetus of the "high-risk" mother. The early care given to malformed neonates does not appear to have improved their vital and/or post-operative prognosis. Early diagnosis of serious malformations should lead to a greater number of voluntary terminations of pregnancy.

Female↗
PubMed1991

[Reactive arthritis caused by Yersinia in children. Report of 4 cases].

Among a group of children hospitalized for "joint pain", four of the cases of reactive arthritis were due to Yersinia infection. These four cases are described. Some patients had suggestive clinical symptoms but serologic studies were needed to establish the diagnosis. Tissue group studies showed that two children were HLA B27 and one was HLA B7. Reactive arthritis due to Yersinia in a form of "enteral arthritis". The prevalence of Yersinia arthritis has not been documented. Serologic tests are essential to outrule the main differential diagnosis, i.e. chronic juvenile arthritis (juvenile rheumatoid arthritis). Short-term resolution of symptoms is seen in every case. The long-term outcome is less well documented, especially with regard to the risk of recurrence and to relationships with peripheral joint disease and spondylarthropathies of early adulthood. HLA B27 positivity may be a risk factor. The pathogenesis of Yersinia-induced reactive arthritis is unclear; current studies are focusing on immunologic factors. The uncertainties concerning long-term outcome justifies renewed interest in childhood reactive arthritis.

Adolescent↗
PubMed1991

Heterozygous hypobetalipoproteinemia with fasting chylomicronemia.

We describe a disorder in which low-density lipoprotein (LDL)-cholesterol and apolipoprotein B are in low concentration (0.47 mmol/L and 0.28 g/L, respectively) and chylomicrons are still present in plasma after an 18-h fast. The d less than 1.006 fraction was isolated by flotation ultracentrifugation and the apolipoproteins were analyzed by electrophoresis, immunoblotting with anti-apolipoprotein B-100 antiserum, and isoelectric focusing. In the d less than 1.006 fraction of the fasting serum, we found an apolipoprotein B form with the same apparent molecular mass as apolipoprotein B-48 and similar in amount to apolipoprotein B-100 (respective percentages, 46% and 54%). The monosialylated form of the apolipoprotein C-III was severely decreased. After an oral fat load, the repartition of the two species of apolipoprotein B did not change greatly (respective percentages, 60% and 40%), and the concentration of serum triglyceride increased only from 1.20 to 1.65 mmol/L.

Adult↗
PubMed1990

How easy is it to contact the duty medical doctor responsible for acute admissions?

OBJECTIVE: To ascertain ease or difficulty of contacting duty junior doctors responsible for acute medical admissions by telephone. DESIGN: Telephone survey of hospitals in six health regions in England and Wales. SETTING: 70 Randomly selected hospitals, 15 of which were excluded because of non-acceptance of acute medical admissions. PARTICIPANTS: 71 Duty doctors (duty house physicians, senior house officers, or registrars responsible for acute medical admissions) in 48 hospitals; seven duty doctors in seven hospitals were excluded (four declined to participate and three required a written explanation of the survey). 67 Doctors gave full information to all questions. MAIN OUTCOME MEASURES: Time taken for hospital switchboards and duty doctors to reply to telephone call, diagnoses of patients recently admitted, and on call rotas and hours of sleep of duty doctors. RESULTS: Hospital switchboards responded within 30 seconds in 87 (74%) calls, and in 76 calls (64%) the duty doctor requested was contacted within a further two minutes. Chest pain, possibly due to myocardial infarction, was the most common reason for acute medical admissions. Nearly half (48%) of the duty doctors in larger hospitals reported having 4-5 hours sleep or less on their nights on call. Most (30) were on a one in three rota; two were on a one in two rota. CONCLUSIONS: Despite impressions to the contrary contacting the duty medical team by telephone seemed fairly easy. Although most junior doctors were on a rota of one in three or better, insufficient recognition may be given to their deprivation of sleep during nights on duty.

Communication↗
PubMed1990

Evidence for the presence of an endogenous cytosolic protein inhibitor of intestinal fucosyltransferase activities.

Soluble endogenous inhibitory activities for glycoprotein: alpha (1-2) and alpha (1-3) fucosyltransferases are demonstrated in rat small intestinal cytosol. These inhibitors are retained on DEAE-cellulose and are eluted as two fractions A and B. Fraction B is non dialyzable, heat stable and pronase-resistant and consists probably of poly-nucleotides. Fraction A is also non-dialyzable, but is thermolabile and pronase-sensitive, suggesting that it contains proteins. The inhibition of fucosyltransferase activity by fraction A is competitive for GDP-fucose and non-competitive for the glycoprotein substrate. Inhibition is not due to interfering enzymatic activities (glycosyl-nucleotide pyrophosphatases, glycosidases or proteases) and is reversible. This protein inhibitor, with a molecular weight of 60,000, is found only in the intestine and the pancreas and appears to be different from the previously reported inhibitors of brain glycolipid glycosyltransferases.

Animals↗
PubMed1990

Study of the effect of a glycosaminoglycan-peptide complex on the degradative enzyme activities in human osteoarthritic cartilage.

The in vitro collagenolytic and proteoglycanasic activity from human fibrillated osteoarthritic cartilage was determined using labelled proteoglycans and type II collagen as substrates. In vitro, a glycosaminoglycan-peptide complex (GP-C Rumalon) induced a dose-dependent inhibition of both collagenolytic and proteoglycanasic activities while sodium salicylate and indomethacin had only a weak suppressive effect on proteoglycanase. Phospholipase A2 activity was unmodified by GP-C suggesting that the effect of the drug on degradative enzymes was unrelated to prostaglandin formation.

Aged↗
PubMed1990

The effect of ketoconazole on fertility of male rats.

The effect of ketoconazole on the fertility of male rats was evaluated. Three days of oral dosing with ketoconazole at 200 mg/kg reduced fertility compared to controls. A complete loss of fertility was observed after doses of 400 mg/kg. There was no change in the testicular weight, epididymal sperm concentration or epididymal weight between the control and treatment groups. Motility was reduced in the high-dose group and forward progression was reduced in both dosing groups compared to control. These data support previous observations in the dog and primate that orally administered ketoconazole alters sperm viability. Although ketoconazole is too toxic for contraceptive application, its derivatives may be useful for this purpose.

Administration, Oral↗
PubMed1990

Immunoscintigraphy of human lung squamous cell carcinoma using an iodine-131 labelled monoclonal antibody (Po66).

Monoclonal antibody (McAb) Po66 has been obtained by immunisation of mice against a human lung squamous cell carcinoma. The in vitro reactivity of the antibody with cancer cells and its ability to localise in human lung cancer xenografts growing in nude mice have been reported earlier. Presented here is the first clinical evaluation of the antibody for scintigraphic detection of tumours. Thirty-three patients with histologically confirmed primary non-small cell lung carcinoma were investigated. Twenty-seven of them were explored at the preoperative stage and six at 6 months after surgery. Biodistribution results were obtained from seven operated patients by combining injections of 131I-radiolabelled Po66 and of 125I-labelled unrelated immunoglobulin. The localisation index was three times higher for this specific antibody. Immunoscintigraphy detected 78% of primary tumours and 100% of recurrences. In this short series of patients, immunoscintigraphy proved helpful in the assessment of tumour spread in four patients by visualising localisations in the mediastinum or the contralateral lung which the CT scan had failed to demonstrate. Immunoscintigraphy was also more efficient than plain chest X-ray for the detection of local tumour recurrences.

Adult↗
PubMed1990

Assessment of AIDS-related cognitive changes: recommendations of the NIMH Workshop on Neuropsychological Assessment Approaches.

This article presents an extended (7-9 hours) and a brief (1-2 hours) battery designed to evaluate early cognitive changes associated with seropositive, asymptomatic persons. The battery was recommended by an NIMH Workgroup which was guided by 10 principles in its development. The domains assessed by the battery are: (1) Indicators of Premorbid Intelligence; (2) Attention; (3) Speed of Processing; (4) Memory; (5) Abstraction; (6) Language; (7) Visuoperception; (8) Constructional Abilities; (9) Motor Abilities; and (10) Psychiatric Assessment. Although the battery assesses a wide range of psychological functioning, specific emphasis has been placed on divided and sustained attention as well as speed of processing and retrieval from working and long-term memory. Descriptions of both the traditional clinical tests and tasks used in cognitive psychology are provided. Although the Workgroup strongly recommends the use of the extended battery in order to ensure the most sensitivity, it recognizes that there may be situations in which this is not possible. In order to increase the likelihood that neuropsychological tests will identify neurologically affected CDC Stage II and III seropositive individuals, the Workshop recommends that each patient's protocol be rated by two trained neuropsychologists using the same clinical criteria. The Workgroup also recommends that a concerted effort be made to incorporate data from the extended and the brief batteries in some central data bank.

AIDS Dementia Complex↗
PubMed1990

Detection of autoantibodies to recombinant human thyroid peroxidase by sensitive enzyme immunoassay.

Autoantibodies to thyroid peroxidase (TPO), the thyroid 'microsomal' antigen, are widely utilized in the diagnosis of human autoimmune thyroid disease. Crude human thyroid preparations of TPO are of differing potency, contain residual thyroglobulin (Tg) and other human membrane antigens, and are available in only limited amounts. Hence, immunoassays for anti-TPO are unstandardized and of variable sensitivity and specificity. We co-transfected the Chinese hamster ovary (CHO) cell line with a full-length human TPO cDNA expression plasmid. We selected a high expressing recombinant TPO positive cell population (CHO-TPO) by Northern blot analysis, then fluorescence laser flow cytometry using both human polyclonal and murine monoclonal anti-TPO antibodies. Solubilized 100,000 g membrane preparations from both CHO-TPO and CHO cells were used as antigens in a specific ELISA with CHO antigen serving as background control. In a selected series of known anti-TPO positive (n = 46) and negative (n = 73) sera there was a high correlation between ELISAs utilizing recombinant or natural-TPO antigen (r = 0.93). There appeared to be no difference in the affinity of high titre human anti-TPO for recombinant and natural-TPO antigen with both ELISAs able to detect 0.05 U/ml of anti-TPO activity (reference preparation NIBSC 66/387). These data predict a new era in standardized thyroid autoantibody testing utilizing recombinant antigen preparations.

Animals↗
PubMed1990

Treatment of hairy cell leukemia with alternating cycles of pentostatin and recombinant leukocyte A interferon: results of a phase II study.

Fifteen patients with hairy cell leukemia (HCL) were treated with deoxycoformycin (pentostatin; dCF) (4 mg/m2 intravenous [IV] every week x 3) and recombinant interferon-alpha 2a (rIFN-alpha 2a) (3 x 10(6) units subcutaneously [SC] daily x 4 weeks) in alternating months for a total of 14 months. Eleven patients had undergone splenectomy; four had received prior systemic therapy with chlorambucil and/or steroids. All 15 are evaluable for toxicity and peripheral blood response, while 14 are assessable for bone marrow response. Toxicity was tolerable with grade 3 or 4 nausea and vomiting in three patients, neutropenic fevers in five, transient but significant depression in eight, and localized cutaneous herpes zoster in four. Circulating hairy cells were undetectable by the end of the first month in 10 of 13 patients, and by the end of the second month in the other three. Fourteen patients had bilateral bone marrow biopsies performed at baseline after 6 months of treatment, at the end of treatment (14 months), and at 6-month intervals during follow-up. Before treatment, all patients had hypercellular marrows with hairy cels replacing normal marrow elements; all showed at least a 95% clearing of their hairy cell infiltrate by 6 months of therapy. However, small collections of residual hairy cells could be detected intermittently on at least one side of bilateral samples in all patients. All patients have completed treatment with a median duration of follow-up off therapy of 27 months (range, 15 to 31 months). To date, all peripheral counts and serum soluble interleukin-2 receptor (sIL2R) levels remain stable, and no patient has had progression of the hairy cell infiltrate in the bone marrow. Although no patient achieved a pathologic complete response, alternating monthly cycles of dCF and rIFN-alpha 2a produced durable partial remissions (PRs) in all patients. Continued follow-up is required to determine the length of such remissions.

Adult↗
PubMed1990

Induction of human thyroid cell ICAM-1 (CD54) antigen expression and ICAM-1-mediated lymphocyte binding.

To further understand the mechanism of lymphocyte accumulation within the thyroid gland in autoimmune thyroid disease we have examined the expression, regulation, and functional significance of the intercellular adhesion molecule-1 (ICAM-1, CD54) in human thyroid monolayer cells and immortalized thyroid cell clones. Human thyroid monolayer cells derived from both normal and abnormal human thyroid tissue showed low basal expression of the ICAM-1 antigen by flow cytometric assessment (mean % +/- SD positive cells = 13.7 +/- 6.1) compatible with the presence of ICAM-1 positive nonthyroid cells within the monolayer cultures. However, thyroid cell ICAM-1 antigen expression was further induced by exposure to recombinant human interferon-gamma (IF-gamma). At 100 U/ml, IF-gamma induced ICAM-1 expression in 56.0 +/- 19.0% of thyroid monolayer cells. Even greater expression of ICAM-1 antigen was induced by IF-gamma in human fetal thyroid cell monolayers of high purity (up to 80% of ICAM-1 positivity) thyroid monolayers established from a patient with Graves' disease (up to 84%), and in two immortalized human thyroid cell clones, 12S and TAD-2 (up to 61%). Furthermore, dose-response curves for ICAM-1 and HLA-DR antigen induction by increasing concentrations of IF-gamma showed that ICAM-1 antigen gene induction was 10-fold more responsive to IF-gamma than the HLA-DR antigen gene. In order to explore the functional consequence of ICAM-1 antigen expression by thyroid epithelial cells we examined the binding of peripheral blood mononuclear cells to thyroid monolayer cells and immortalized thyroid cells. These studies revealed a preferential adhesion of human PBMC to IF-gamma-treated thyroid monolayers compared to untreated control monolayer cells. Furthermore, this IF-gamma-induced cell adhesion was specifically inhibited by monoclonal anti-ICAM-1. These experiments demonstrate not only the capacity of human thyroid epithelial cells to express ICAM-1 antigen in the presence of a cytokine but, in addition, identify ICAM-1 antigen as responsible for enhanced T cell binding to thyroid epithelial cells. ICAM-1 antigen may, therefore, play an important role in T cell targeting and accumulation within the thyroid gland in autoimmune thyroid disease.

Antibodies, Monoclonal↗
PubMed1990

Intrathyroidal accumulation of T cell phenotypes in autoimmune thyroid disease.

In this study we have correlated peripheral T cell subset phenotypes with intrathyroidal lymphocyte accumulation in patients with autoimmune thyroid disease (Graves' and Hashimoto's disease). Our study utilized euthyroid family members for one of our control groups (n = 48) thus significantly limiting familial, but not disease-specific, influences on these T cell phenotypes. Our principal new observations were found only in patients with Graves' disease. As previously reported, there was a decrease in CD8+ (suppressor/cytotoxic) T cells in the peripheral blood of patients with untreated hyperthyroid Graves' disease (n = 27) (mean +/- SEM, 19 +/- 1.1% in patients compared with 25 +/- 1.2% in controls, p = 0.03), a finding not observed in treated, euthyroid Graves' disease patients or their relatives. However, the relative number of CD8+ T cells, assessed by CD4:CD8 ratios, was increased in the intrathyroidal T cell populations (n = 10), when compared to normal and patient peripheral blood. There were no consistent changes in total CD4+ (helper) T cells in the peripheral blood of patients with treated and untreated Graves' disease but a reduction in CD4+2H4+ (suppressor-inducer) T cells was seen in patients undergoing surgery for Graves' disease (13 +/- 6.9% compared with 39 +/- 3.4%). Again, however, this T cell subset was increased within the target organ of the same patients (41 +/- 5.9%). These data point to either a selective accumulation, or a specific "homing", of certain T cell subsets within the thyroid gland of patients with Graves' disease where T cell differentiation may be strongly influenced by antithyroid drug treatment and the local immune environment.

Antithyroid Agents↗