'What is best for momma' A case report.
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Biomedical subjects
Publications and source records attributed to A Munro.
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The genes of the major histocompatibility complex were first known for the part they played in transplant rejection. Recently, however, it has become clear that the products of that region have an important part to play in the control of the immune response, through their effects both on cooperative and on aggressive interactions between cells. It is now possible to guess at the mechanisms which may underly the association of some major histocompatibility antigens with disease.
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Since surgical emergencies in the puerperium are rare, surgeons and obstetricians amass little experience of them. There may be considerable delay in making a diagnosis, firstly, because the abdominal symptoms are thought to be related to the pregnancy, and, secondly, because the signs are rarely convincing in contrast to the symptoms. Any of the common surgical emergencies may occur in pregnancy and the puerperium and there are some others that appear to be a particullar problem of the puerperium.
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An account is given of six cases treated with pimozide. Four of there cases fall into the diagnostic category of monosymptomatic hypochondriacal psychosis, a group with a traditionally poor prognosis. Three out of the four have responded favourably to pimozide, while the fourth showed a partial improvement. A fifth case also showed a marked degree of improvement despite a possibility of early cerebral arteriopathy. The one case which showed no improvement was suspected all along of having a personality disorder rather than a psychotic illness, and this was subsequently confirmed. It is suggested that pimozide: a) may be an effective treatment for monosymptomatic hypochondriacal psychoses whatever their aetiology; and b) may differentiate rapidly between cases of monosymptomatic hypochondriacal psychoses and dysmorphophobias due to neurotically determined factors.
Polymerized flagellin and E. coli lipopolysaccharide both express adjuvanticity in vivo and in vitro for responses to hapten conjugated to sheep erythrocytes, and hapten conjugated to soluble thymus-dependent antigens. In the case of erythrocyte-bound hapten, adjuvanticity is expressed in the absence of thymus-derived cells (T cells). However, in the case of responses to soluble thymus-dependent conjugates, carrier-specific T cells would appear to be necessary for adjuvanticity to be expressed. On the basis of these observations an hypothesis for the mechanism of B-cell induction and tolerance is proposed.
Supernatants were collected from keyhole limpet haemocyanin (KLH) primed spleen cells which had been incubated in tissue culture medium with their priming antigen KLH. These non-specific factor (NSF) containing supernatants were then tested in a microculture system for their ability to facilitate an anti-SRBC response of nu/nu or AT times BM spleen cells. It was concluded that:(a) NSF was able to engage a large number of the available pool of sheep erythrocyte (SRBC) specific B cells into an antibody response (b) this response was characterized by the development of clones expressing plaque-forming cells (PFC), the number of PFC produced within a clone being dependent upon the amount of NSF available in that culture; (c) NSF probably acted directly on B cells, and not via other accessory cell types.
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Lymphocytes from fifteen multiple sclerosis patients gave responses to phytohaemagglutinin (PHA), conconavalin A (con A) and pokeweed mitogen (PWM) which were in the normal range. However, the responses of lymphocytes to stimulation by an allogeneic lymphoid cell line (LCL) were significantly lower in HLA-7-positive than in HLA-7-negative patients (a distinction not found in control groups). Depression of con A, PHA and PWM responses were observed during intensive immunosuppression. Responses to LCL were unaltered or increased during initial azathioprine and prednisone treatment. The depression of this response following antilymphocyte globulin (ALG) treatment was delayed in the HLA-7-positive patients. One week after the end of ALG treatment, most PHA, con A and PWM responses had returned to low normal values. Reduction of azathioprine and prednisone treatment at the end of 1 year resulted in a sharp rise in PHA and con A responses in some patients. Relapses in patients were frequently associated with low responses to LCL cells.
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