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Biomedical subjects

A Shore

Publications and source records attributed to A Shore.

At least 55 records · Page 3Linked to original sources
PubMed1986

Correlation of renal histology with outcome in children with lupus nephritis.

We assessed renal histological features in 20 children with diffuse proliferative lupus nephritis (DPLN) to determine whether they were useful in predicting clinical outcome. Renal biopsies were analyzed by assigning scores indicating an activity index (AI) and chronicity index (CI). Clinical assessment of renal function at biopsy and outcome were graded according to urinalysis, serum creatinine, need for dialysis and/or transplantation, and/or death from end-stage renal failure. Renal function at biopsy correlated significantly with AI and CI. Serum complement (C3 and C4) correlated significantly with CI but not with AI. The usefulness of the clinical grading system was confirmed in ten patients who underwent repeat biopsies. Of these, four converted from DPLN to mesangial or membranous lupus and showed improvement in their grade, while only one of the six with DPLN on both biopsies improved. After a mean follow-up of 4.0 years, 14 of the 20 patients showed clinical improvement, four were unchanged, and two were worse. CI predicted clinical outcome (P less than 0.01) but AI did not. Histologic scores of AI and CI obtained from renal biopsies showing DPLN may be useful in predicting therapeutic responses and designing prospective clinical trials to determine optimum management of children with DPLN.

Adolescent↗
PubMed1986

Enhanced interleukin 1 generation by monocytes in vitro is temporally linked to an early event in the onset or exacerbation of rheumatoid arthritis.

Twenty-one patients with rheumatoid arthritis (RA) and 12 age and sex matched healthy controls were examined for the ability of their monocytes (adherent cells, AC) to spontaneously secrete interleukin 1 (IL-1) and for their peripheral blood mononuclear cells (PBMC) to secrete interleukin 2 (IL-2) induced by Staphylococcal Protein A (SPA). All RA patients had PBMC which secreted normal amounts of mitogen induced IL-2 regardless of disease activity or disease history. However, AC from RA patients who had a recent (less than 6 months) onset of their disease, or exacerbation of existing RA, had enhanced spontaneous IL-1 secretion. AC from patients with equally active RA but with historically stable disease generated normal amounts of IL-1. Enhanced in vitro IL-1 generation by circulating monocytes is temporally linked to an early event in the onset of exacerbation of RA.

Acute Disease↗
PubMed1986

Interleukin 1 and interleukin 2 generation by peripheral blood cells from patients with ankylosing spondylitis.

We examined the spontaneous secretion of interleukin 1 (IL-1) from peripheral blood monocytes and staphylococcal protein A (SPA) induced secretion of interleukin 2 (IL-2) from peripheral blood mononuclear cells from 13 patients with active ankylosing spondylitis and 10 healthy controls. IL-1 and IL-2 secretion in the patient group was not measurably different from controls (p greater than 0.05). We also examined IL-1 and IL-2 generation in 7 patients before and 2 months after therapy with a nonsteroidal antiinflammatory agent, piroxicam. A variable effect of piroxicam was observed on IL-1 and IL-2 generation despite the efficacy of piroxicam in reducing the clinical activity of the disease. Our results suggest the absence of an intrinsic aberration in IL generation from peripheral blood cells from patients with ankylosing spondylitis.

Adult↗
PubMed1986

Discoid meniscus presenting as juvenile rheumatoid arthritis.

Discoid meniscus is a mechanical lesion described as having little inflammatory reaction. We describe a child with lateral discoid meniscus misdiagnosed as juvenile rheumatoid arthritis (JRA). Synovitis responded to aspirin, but function gradually deteriorated with increasing flexion deformity until arthrotomy and meniscectomy. Histology showed intense inflammatory changes compatible with JRA. Clinical and laboratory clues to early diagnosis were the localized nature of the inflammation on physical examination, radiographs and bone scan.

Arthritis, Juvenile↗
PubMed1985

Captopril in the hepatorenal syndrome.

Five patients with hepatorenal syndrome were treated with the orally active angiotensin-converting enzyme inhibitor captopril (25 or 50 mg 6 hourly) for up to 48 hours. Only one patient showed a significant increase in urinary sodium concentration (from less than 10 to 70 mmol/liter), but without associated diuresis; renal function continued to deteriorate in all patients with persistent oliguria and rising serum creatinine. The outcome was uniformly fatal. These results suggest that in the hepatorenal syndrome, captopril in standard dosage is without benefit, and provide further evidence that the changes in the renin-angiotensin system are probably secondary to reduced renal perfusion from some other cause.

Adult↗
PubMed1984

Bone marrow evaluation in small cell lung cancer.

The records of 87 patients with small cell lung cancer were reviewed. Patients were clinically staged with bone marrow aspirate and biopsy as well as radionuclide scans of bone, liver, and brain. Extrathoracic spread was noted in 54% (47/87) and limited disease in 46% (40/87). The bone marrow evaluation was positive in 13/62 patients (21%) and seven of these thirteen patients had normal bone scans (54%). Of these seven patients, five had no other evidence of distant metastases and their survival was 7-10 months, considerably shorter than patients found to have limited disease. Bone marrow examination appears to complement radionuclide scanning in the initial staging of patients with small cell carcinoma of the lung and provides important prognostic information.

Bone Marrow Examination↗
PubMed1984

Thymosin induces helper function in OKT3-positive, E-rosette-negative human cord blood T cells.

E-rosette-negative lymphocytes (TE-), which express monoclonal T-cell markers (OKT3+) were found in higher frequencies in human cord blood (CB) (30% by phenotype and 11.7% by sequential rosette isolation) than in adult peripheral blood lymphocytes (13% by phenotype and 3.7% by isolation). TE- cells had very low levels of 5'-nucleotidase, a lymphocyte maturational marker low in thymocytes. Like other CB T cells, TE- cells possessed marked suppressor capability. Irradiated TE- cells from two cord blood samples demonstrated helper activity for Ig production by adult B cells. In six cord blood samples, however, irradiated TE- cells lacked helper activity. When incubated with thymosin, these TE- cells E+ and differentiated into inducer-helper T cells. These observations confirm previous assumptions that CB T cells are not fully differentiated. Furthermore, T cells from different CB samples may be at various stages of ontogeny. We have also shown that thymosin fraction 5 is able to confer a new immunoregulatory function.

5'-Nucleotidase↗
PubMed1984

Interleukin abnormalities in recently active rheumatoid arthritis.

Peripheral blood lymphocytes (PBL) from 14 patients with rheumatoid arthritis (RA) produced increased amounts of interleukin (IL) (p less than 0.05) as measured in a mouse thymocyte assay and showed enhanced proliferation in response to an IL containing supernatant (p less than 0.05) when compared with 9 age matched controls. Both enhanced IL production (p greater than 0.01) and responsiveness (p less than 0.002) were seen exclusively in a subgroup of 7 patients with a recent onset or exacerbation of their disease. PBL from RA patients with equally active disease which had been unchanged for more than 6 months produced and responded to IL normally. There was a direct correlation between IL production and responsiveness (r = 0.69, p less than 0.005). These 2 distinct IL abnormalities appear to reflect disease initiating or exacerbating factors in RA.

Arthritis, Rheumatoid↗
PubMed1983

Evidence for activated peripheral blood T-cells in rheumatoid arthritis.

We have previously demonstrated defective antigen specific T-suppressor (Ts) cell function in the peripheral blood lymphocytes (PBL) from patients with rheumatoid arthritis (RA). Our study was designed to delineate whether diminished Ts activity is due to impaired interleukin (IL) dependent clonal expansion of Ts cells or to prior in vivo activation. Patients with recent onset of RA, or a disease flare, exhibited enhanced IL generation (IL-1 and /or IL-2). Increased proportions of active E-rosettes, elevated spontaneous production of IgM, and total immunoglobulin in mitogen free cultures were consistent with the concept of prior lymphocyte activation in vivo. Our results do not support defective clonal expansion of Ts cells as the basis of deficient IL generation, but do support the concept of in vivo activation of PBM cells in some patients with RA.

Adult↗
PubMed1982

Juvenile psoriatic arthritis--an analysis of 60 cases.

Sixty children who were considered to have juvenile psoriatic arthritis were analyzed retrospectively; the mean length of follow-up was 10.8 years. There was a female predominance of 3:2. The mean age at onset for both the psoriasis and the arthritis was between 8 and 9 years. A family history of psoriasis was present in almost half, and was a valuable clue in diagnosing the 26 of 60 who presented with arthritis first. The majority had a monarticular presentation, usually of the knee. Additional joints usually became involved sporadically in an asymmetric pattern, in both upper and lower limbs, so that 87% ultimately had polyarticular disease. This course is unlike the usual one of childhood arthritis. Although 40% were asymptomatic at follow-up, six patients required bilateral hip replacement, four within the first five years following the onset of arthritis. Sixteen patients received slow-acting drugs, usually gold; eight of these had had a polyarticular onset and seven a positive test for ANA.

Age Factors↗
PubMed1982

Immunoregulatory T cell subpopulations in patients with scleroderma using monoclonal antibodies.

Twenty-eight patients with scleroderma were compared with 22 healthy age-matched subjects. Monoclonal antibodies were used to detect the whole T cell population (OKT3), T helper cells (OKT4), and T suppressor/cytotoxic cells (OKT8) by indirect immunofluorescence on isolated peripheral blood mononuclear cells. A subset of scleroderma patients (i.e. 30% or eight of 28 patients) exhibited an elevated ratio of OKT4/OKT8 cells which could be accounted for, mainly by a reduction in OKT8 cells compared with controls. The scleroderma patients with an elevated OKT4/OKT8 ratio tended to be younger, have a shorter disease duration and more extensive skin involvement than patients with a normal OKT4/OKT8 ratio. There was no correlation with the presence of autoantibodies, drug therapy, or HLA-DR type. In order to further determine whether this imbalance in immunoregulatory cell subpopulations was specific for scleroderma, we further studied 16 patients with psoriatic arthritis but without manifest autoimmunity and delineated a similar subset of patients with an elevated OKT4/OKT8 cell ratio (i.e. 38% or six of 16 patients). The results demonstrate similar immunoregulatory T cell imbalances in patients with scleroderma and psoriatic arthritis. These findings suggest that numerical imbalances in lymphocyte subpopulations may not be specific for autoimmune disorders.

Adolescent↗
PubMed1982

Aberrations in lymphocyte subpopulations and function during psychological stress.

Eight trainees in psychiatry taking their final oral fellowship examinations were compared with 16 controls to determine the effect of stress on their immune system. Two measures of stress were utilized to distinguish the highly stressed subjects from those minimally stressed. T cell subpopulations, B cell numbers, mitogen reactivity, natural killer cell activity, plaque forming cell responsiveness, antigen specific T suppressor cell activity, and hormone levels were studied 2 weeks before and 2 weeks after the exam. The results demonstrated transiently elevated numbers of T and B lymphocytes but impaired plaque forming cell and mitogen responsiveness in the highly stressed group prior to their exam which normalized later. The results support the concept that stress may significantly alter the immune response in man.

Adult↗
PubMed1981

Combination chemotherapy with and without the methanol-extracted residue of bacillus Calmette-Guerin (MER) in extensive non-small-cell lung cancer: a prospective randomized study for the Piedmont Oncology Association.

One-hundred-three patients with extensive non-small-cell lung cancer were entered into a prospective, randomized trial to determine the value of MER as an adjuvant to chemotherapy. Patients were stratified according to histology and performance status. All patients received CCNU, methotrexate, and Adriamycin with 48 patients also receiving MER. All patients had a performance status of 2 or less (less than 50% bedridden), 49% had prior radiation therapy, only one patient had prior chemotherapy, and all had extensive disease. Of the patients, 42% had epidermoid cancer, 21% had large cell cancer, 32% had adenocarcinoma, and 4% had mixed adenosquamous or undifferentiated carcinoma. The response rates and response durations of the two treatment regimens were similar. Of the patients, 18% had an objective response; in 4% it was complete. An additional 29% had a stable response. Median duration of response ranged from 21 to 23 weeks. Median survival rates for non-MER and MER treatment groups were 21.5 and 18.6 weeks, respectively. The four complete responders have a survival of 24, 85, 86+, and 129 weeks. MER did not improve response for hematopoietic tolerance, was associated with significant morbidity, and was poorly tolerated. The value of immunotherapy in lung cancer remains to be established.

Adenocarcinoma↗
PubMed1981

A randomized comparative trial of chemotherapy and irradiation therapy for stage II breast cancer.

One hundred fifty-eight evaluable patients with Stage II carcinoma of the breast with positive lymph nodes were treated either with adjuvant chemotherapy or irradiation therapy followed by chemotherapy. Patients were randomized to test the effectiveness of L-phenylalanine mustard (L-PAM) with and without postoperative irradiation therapy (R.T.) against cyclophosphamide, 5-fluorouracil, and methotrexate (CMF) with and without postoperative irradiation therapy in decreasing the frequency of recurrence. No significant difference was observed between L-PAM as compared with R.T. plus L-PAM (P = 0.85). The difference between CMF and R.T. plus CMF was significant in support of CMF alone (P = 0.04). The frequency of recurrence between R.T. plus L-PAM and R.T. plus CMF showed no difference. A comparison of the chemotherapy only regimens showed an advantage of CMF over L-PAM (P = 0.05). Both the delay in starting chemotherapy and the significant decrease in percent optimal drug dosage during the first six cycles of therapy are factors that may influence the high frequency of relapse observed in the R.T. plus chemotherapy groups. Of the four treatments, CMF has the lowest frequency of recurrence.

Adult↗