Secondary acute myeloid leukaemia with 7q- complicating azathioprine treatment for rheumatoid arthritis.
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Biomedical subjects
Publications and source records attributed to C C Mok.
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The sequence around the thiol group in lens proteins has been investigated. The proteins were converted into their carboxy[(14)C]methyl derivatives and submitted to partial acid hydrolysis, or digested with proteolytic enzymes. Acid hydrolysis of bovine alpha-crystallin gives N-seryl-(S-carboxymethyl)cysteine, Ser-CMCys (Waley, 1965a), but this dipeptide is not obtained from beta-crystallin or gamma-crystallin. Trypsin and chymotrypsin also give different peptides from the three crystallins. The radioactive peptide from alpha-crystallin and chymotrypsin has the sequence Ser-CMCys-Ser-Leu; another peptide, Asp-Leu-Leu-Phe, was also identified. The radioactive peptides obtained from bovine alpha-crystallin are probably also obtained from human alpha-crystallin, and from bovine and human albuminoid (the insoluble lens protein). alpha-Crystallin has been fractionated by chromatography in urea on DEAE-cellulose. Comparison of the fractions by peptide ;mapping', and immunochemically, shows that they fall into two classes. The fraction eluted first differs from the later fractions, but the later fractions resemble each other The first fraction may represent impurities, or it may be a structurally different sub-unit of alpha-crystallin.
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With improved disease survival, arterial thromboembolism has become an important cause of morbidity in patients with systemic lupus erythematosus (SLE). A number of conventional and non-conventional risk factors are associated with accelerated atherosclerosis. Regular surveillance and control of traditional risk factors is mandatory, and so is the appropriate use of the statins, anti-malarial agents, anti-platelet agents, and anti-coagulation for primary and secondary prevention of arterial thromboembolism in SLE patients. Judicious use of corticosteroids, calcineurin inhibitors, hormonal replacement therapy, and the cyclooxygenase 2 inhibitors is equally important.
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Cryptococcal meningitis is a rare but well recognized complication of systemic lupus erythematosus (SLE). Since in all previously reported cases in the medical literature the patients developed this opportunistic infection as the result of immunosuppressive therapies, whether the intrinsic immunological abnormalities of SLE per se contribute to the susceptibility remains controversial. We report on a patient who presented concurrently with cryptococcal meningitis and cryptococcaemia at the time of her diagnosis of active SLE. This highlights the possibility that intrinsic immunological defects of SLE may be directly responsible for the predisposition to fungal infections. In addition, when SLE patients present with neurological symptoms, the possible presence of central nervous system (CNS) infection must be checked for, even if immunosuppressive treatment is not being considered.