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Biomedical subjects

A Pines

Publications and source records attributed to A Pines.

At least 199 records · Page 11Linked to original sources

Transformation of chronic lymphocytic leukemia to plasmacytoma.

In a woman with chronic lymphocytic leukemia (CLL), a maxillary plasmacytoma developed after 8 years. The membrane-bound immunoglobulin of the leukemic lymphocytes, the cytoplasmic immunoglobulin of the plasma cells, the serum monoclonal protein and the urine Bence-Jones protein had the same heavy and light chains--mu kappa. This suggests that the leukemic cells transformed to plasma cells. This very rare event is a complete reversal of the more common transformation that occurs in CLL and manifested by de-differentiation. Only in one case out of the 20 previously reported patients with CLL and multiple myeloma there was evidence, like in the current case, of a common clonal origin of the two B-cell neoplasms.

Adult↗

Waldenström's hyperglobulinemic purpura: an unusual immune complex disorder.

A case of Waldenström's hypergammaglobulinemic purpura in a 37-year old woman is presented. The symptomatology was very mild and confined only to the skin, despite very high quantities of circulating immune complexes which were found in her serum. The unusual manifestations of Waldenstrom's purpura compared to other immune complex disorders is discussed.

Adult↗

Guillain-Barré syndrome associated with acute cytomegalovirus mononucleosis syndrome.

A case of Guillain-Barré syndrome (GBS) in a young patient who suffered from an acute cytomegalovirus (CMV) infection is presented. The diagnosis was reached following the isolation of the virus from the urine and the demonstration of high titers of both IgM and IgG antibodies in the serum. In contrast to previous cases in which GBS was merely associated with positive serology for CMV, but with almost no clinical manifestations of CMV mononucleosis syndrome, our patient had a full blown picture of acute CMV mononucleosis, including peripheral lymphocytosis, splenomegaly, hepatic involvement and hemolysis. Severe transient hypocomplementemia was also noted.

Adult↗

Clinical trial of microcrystalline hydroxyapatite compound ('Ossopan') in the prevention of osteoporosis due to corticosteroid therapy.

A controlled clinical trial was carried out in 40 patients at risk of osteoporosis because of long-term treatment with prednisolone (5 to 20 mg/day) to determine the efficacy and tolerance of microcrystalline hydroxyapatite compound (MCHC) when used to prevent the appearance or progression of osteoporosis: 32 patients were treated with 6 to 8 g MCHC for 12 months and 8 served as an untreated control group. The two groups were well matched as regards age, sex and underlying disease; 37 patients (29 MCHC, 8 control) successfully completed the trial. The majority (68%) of the patients had back pain prior to the trial, the severity of which was graded at 3-monthly intervals. In the MCHC-treated group, there was a dramatic and significant (p less than 0.001) reduction in pain during the trial, almost to the point of its disappearance. Of 19 patients with initial back pain only 2 still reported any pain at all after 12-months' MCHC treatment. In the control group, back pain severity increased during the trial in 3 patients and was unchanged in the fourth. Neither MCHC-treated nor control group patients showed any significant change in standing or stem height during the 12-months' trial period. Both mean cortical thickness and mean metacarpal index figures showed small, insignificant decreases during 12-months' MCHC treatment but much more marked decreases in the control group which, despite the small number of patients, came close to being statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Reduction of follicle-stimulating hormone (FSH) secretion in FSH-producing pituitary adenoma by bromocriptine.

An FSH-secreting pituitary adenoma was demonstrated in a 32-yr-old man who presented with unilateral optic atrophy without any clinical or laboratory evidence of hypogonadism. Semen analysis was normal, although basal FSH levels were markedly elevated (greater than 80 mIU/ml). He had normal plasma LH levels and no other detectable endocrine abnormalities. Administration of GnRH elicited delayed and sustained FSH and brisk LH responses. Administration of TRH resulted in TSH and PRL responses and unexpected FSH and LH elevations. Two surgical operations resulted in temporary reduction of plasma FSH levels, but it increased later concomitant with CT demonstration of tumor growth. After pituitary irradiation, no reduction in FSH levels occurred. A single dose of 5 mg bromocriptine elicited a significant reduction in FSH levels from 137 to 64 mIU/ml. Long term treatment with 15 mg/day bromocriptine resulted in further reduction of FSH level, to 36.4 mIU/ml, without any change in tumor size. This finding implies that bromocriptine could be an adjunctive therapy or an alternative to other modes of treatment in patients with these rare tumors.

Adenoma↗

Rheumatoid arthritis-like syndrome: a presenting symptom of malignancy. Report of 3 cases and review of the literature.

Recent onset arthritis might be an early manifestation of an occult malignancy. Three patients are described: one with carcinoma, primary site unknown; one with oat cell carcinoma of the bronchus; and one with breast cancer. The presenting symptom of their disease was polyarthritis. Two of the patients were seropositive and in two patients the arthritis regressed following the removal of the tumor. Awareness of paraneoplastic arthritis, especially if its appearance is explosive or in relatively old age, should caution the physician of the possibility of a potentially curable, but hidden neoplasm.

Aged↗

Serum levels of polychlorinated biphenyls and some organochlorine insecticides in women with recent and former missed abortions.

Polychlorinated biphenyls and some organochlorine insecticides (DDT isomers and their metabolites, lindane (gamma-BHC), dieldrin, heptachlor epoxide) were assessed in the serum of 17 women with recent missed abortions, 7 women who experienced one or several missed abortions in their past, and 7 women with normal, second trimester pregnancy. Fifty-three percent of the cases of recent missed abortion had PCB serum levels higher than the mean plus two standard deviations of the control group. The mean PCB serum level in women with recent missed abortion and relatively high PCB serum levels was significantly different from that of the control group (103.04 versus 20.69 ppb, P less than 0.001). The mean PCB serum level of the former missed abortions group was also significantly different from that of the control group (82.00 versus 20.69 ppb, P less than 0.001). The quantity of the higher chlorinated biphenyl homologues (penta- and hexachlorobiphenyls) was increased in the high PCB level, missed abortion group and in the former missed abortion group, while the lower chlorinated biphenyl homologues were decreased in these groups in comparison with the control group. The percentage of total o,p'-DDT serum level, as related to total DDT, showed an increase in the high PCB level, recent missed abortion and in the former missed abortion groups, in comparison with the control group (36.18 and 48.98 versus 25.57, respectively). The fact that the former missed abortion group showed increased PCB serum levels similar to those found in the high PCB level, recent missed abortion group confirms the existence of an association between relatively high PCB serum levels and the occurrence of missed abortion. The possible role of PCBs in the occurrence of missed abortion is discussed.

Abortion, Missed↗

Hyposplenism in systemic lupus erythematosus.

Hyposplenism, which is suggested by a typical peripheral blood smear and by the absence of splenic activity in a 99m Tc sulphur colloid scan, has been recently found to be associated with various diseases. This condition increases the susceptibility of patients to certain bacterial infections principally by pneumococci, meningococci and Haemophilus influenzae. The association of SLE and hyposplenism has not often been reported before; thus we see fit to report another such case. The administration of polyvalent pneumococcal vaccine is recommended in this condition.

Bacterial Vaccines↗

Finger clubbing associated with laxative abuse.

We have added two cases of finger clubbing in laxative-abusing patients to the four other cases recorded in the literature. Laxative abuse should be added to the already long list of diseases in which clubbing may appear. The pathophysiologic basis of clubbing is still obscure.

Adult↗

Familial palindromic rheumatism: a possible association with HLA.

Palindromic rheumatism is very rare in children. The familial occurrence of the disease has been only briefly reported previously. A family is described here in which the mother and her 3 children suffered from typical palindromic rheumatism, which ran a benign course. All 4 members were seronegative and the HLA types of the children were identical. The HLA genotype of the mother was HLA A2, Cw4, Bw41, Bw6, DR5, MT2/Aw32, CX, Bw44, Bw4, DR1, MT1. HLA DR5 has previously been found to be associated with juvenile rheumatoid arthritis, while DR1 in Jews is significantly associated with adult-onset rheumatoid arthritis. DR5 was shared by the mother and her 3 children. The presence of the antigen DR5 in this sibship suggests that palindromic rheumatism may be a variant of juvenile rheumatoid arthritis with a relatively late onset and a more benign course. Tissue typing of patients with palindromic rheumatism may give a clue to prognosis. The patients' youth and the familial involvement, with identical HLA characteristics, are the outstanding features of this family.

Adolescent↗

Transient post-partum hypothyroidism.

Transient hypothyroidism was observed in two young women a few months following childbirth. It is suggested that throughout their pregnancy they had already suffered from auto-immune thyroiditis, the symptoms of which were suppressed at that time, as found in many other auto-immune diseases. Being transient, post-partum hypothyroidism is an exception to the rule that treatment by thyroid hormone replacement should never be stopped in hypothyroidism. Post-partum hypothyroidism has to be considered in every suspected case of post-partum depression, because of the possible similarity in the clinical presentation.

Adult↗