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Biomedical subjects

D C James

Publications and source records attributed to D C James.

At least 73 records · Page 4Linked to original sources
PubMed1983

IgA antibodies to Klebsiella pneumoniae in ankylosing spondylitis.

Serum IgA antibodies to Klebsiella pneumoniae were measured in 65 patients with ankylosing spondylitis (AS) during different phases of disease activity and compared with the antibody level in 21 psoriatic arthritis (PsA) patients, 43 rheumatoid arthritis (RA) patients and 57 healthy controls. The mean IgA antibody to Klebsiella in AS patients with an erythrocyte sedimentation rate (ESR) greater than or equal to 15 mm/h was significantly higher than the antibody level in patients with an ESR less than 15 mm/h (p less than 0.02) and tended to increase with rising ESR. There was a significant difference in anti-Klebsiella antibody levels between AS patients with an elevated ESR and antibody levels in PsA patients (p less than 0.001), RA patients (p less than 0.001) and healthy controls (p less than 0.005). There was no difference between healthy controls and patients with PsA, RA or AS patients with a low ESR. The IgA anti-Klebsiella antibody was specifically absorbed out from sera with inactivated klebsiella pneumoniae organisms. Antibody levels to Candida albicans and Escherichia coli did not differ in patients vis-à-vis control subjects. The mean serum anti-Klebsiella IgA level was found to be higher in patients who were either clinically active or had positive faeval cultures, when compared with patients with inactive disease and negative cultures, but these differences were not statistically significant, although when both parameters were examined together a significant additive effect was detected (p less than 0.001). It is concluded that patient with AS exhibit a specific elevation of serum IgA antibody to Klebsiella antigen.

Adult↗
PubMed1982

Bone-marrow transplantation for severe aplastic anaemia using histocompatible unrelated volunteer donors.

Two patients with severe aplastic anaemia received bone-marrow transplants from unrelated donors selected for HLA compatibility. Graft-versus-host disease occurred in both patients but responded to treatment. Both patients had stormy courses after grafting, but subsequently their conditions improved, and one was not receiving any treatment at follow-up after day 330 while the other had mild chronic graft-versus-host disease at day 150. These results show that unrelated, histocompatible volunteers may successfully donate marrow for the treatment of severe aplastic anaemia, though many problems remain to be solved.

Adult↗
PubMed1982

A comparative study of toxic erythema of pregnancy and herpes gestationis.

We compared the clinical features, histopathology, immunopathology and immunogenetics of 30 patients with toxic erythema of pregnancy and 24 patients with herpes gestationis. Although we found some clinical and histopathological overlap we highlighted several important differences. In toxic erythema of pregnancy prominent striae were frequently present. Herpes gestationis was suggested by the occurrence of periumbilical lesions, acute exacerbations immediately after delivery, and persistence of the eruption for more than 3 weeks post-partum. In herpes gestationis, immunofluorescence studies were consistently positive, there was a high frequency of HLA-B8 and an association with autoimmune thyrotoxicosis. Toxic erythema of pregnancy did not share these immunological features. Therefore we feel that toxic erythema of pregnancy and herpes gestationis should continue to be classified as separate disorders.

Adolescent↗
PubMed1981

Reversal of clinical features of Hurler's disease and biochemical improvement after treatment by bone-marrow transplantation.

A one-year-old boy with type I H mucopolysaccharidosis (Hurler's disease) was given a bone-marrow transplant (BMT) from his mother in an attempt to replace the deficient enzyme, alpha-L-iduronidase (iduronidase). These is definite evidence of engraftment, the enzyme activity of the recipient's leucocytes reaching heterozygote levels within 37 days of the BMT. Graft-versus-host disease (GVHD) developed but was partially controlled by steroids. From 3-4 months after graft until the present (13 months after the graft) iduronidase activity has been present in the serum and the urine and there has been evidence of considerable degradation of glycosaminoglycans excreted in the urine. The hepatosplenomegaly has disappeared, corneal clouding has cleared, and deterioration in the child's development seems to have been arrested.

Aminoacridines↗
PubMed1980

Is aortography abused in lower-limb iscaemia?

Request for aortography on 82 patients in one hospital in 1978 were assessed to determine the effect of the investigation on the patient's subsequent management. In 49% of cases the request was fully justified. In the remaining 51% of patients, none of whom had reconstructive surgery, the request was considered either inappropriate (38%) or of marginal value (13%). The reasons for this high porportion of unnecessary aortograms were related to the clinical specialty and the level of experience of the doctor making the request. A simple algorithm which may be helpful when deciding to perform an aortogram is suggested. It is concluded that aortography should be requested only by experienced medical staff and only after a decision has been taken to offer the patient operative treatment.

Aortography↗
PubMed1979

Inferior caval venography in the assessment of renal carcinoma.

Inferior caval venography by a non-catheter technique was carried out in 30 cases of renal cell carcinoma. Occlusion of the renal vein was shown in 15 of these and occlusion of the inferior vena cava in a further three. Deformity of the vena cava by adjacent growth was found in nine instances. Renal arteriography was performed in 27 of these patients and the demonstration of the renal vein by this method has been compared with that of caval venography. The incidence of collateral veins on the arteriogram and the finding of impaired renal function as an index of renal vein occlusion has been discussed.

Adenocarcinoma↗
PubMed1979

Interstitial cystitis.

Twenty histologically proven cases of interstitial cystitis were investigated in an attempt to find evidence of a possible autoimmune mechanism in its aetiology. HLA tissue typing was performed, autoantibody profiles were obtained, and a questionnaire of the patients' past history completed, especially with respect to other autoimmune conditions. An experiment was designed to test the effect of sodium cromoglycate on rat bladders. The results are discussed in relation to the management of patients with interstitial cystitis.

Aged↗
PubMed1977

Successful bone marrow transplant for Fanconi's anaemia.

A 15-year-old boy with Fanconi's anaemia, who required four units of blood each month, received a bone marrow graft from his 9-year-old brother, who has HLA identical and compatible on mixed lymphocyte reaction. Considerable immunosuppression was used and bacterial infection was prevented by vigorous decontamination in a Vickers-Trexler isolator. After the graft the patient's blood counts remained satisfactory for nine months, but it took six months before qualitative immune function was normal.

Adolescent↗
PubMed1977

HLA antigens in sarcoidosis.

The HLA antigens were identified in sixty-five patients with sarcoidosis, comprising forty-five with uveitis, twelve with erythema nodosum and eight with arthritis. In the group with arthritis, B8 was present in seven of eight (P = 0-0016) and the haplotype 1,8 in five of eight (P = 0-0053). A1 was present in 44% with uveitis (P = 0-04). There was no other significant disturbance of antigen frequencies in uveitis or in erythema nodosum, but it was noteworthy that B27 was present in only two patients with uveitis.

Arthritis↗