Tuberculosis in a children's hospital.
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Biomedical subjects
Publications and source records attributed to D Gill.
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Of 27 women in the reproductive age group receiving continuous ambulatory peritoneal dialysis for more than 3 months, 4 of 7 who menstruated developed recurrent hemoperitoneum. Tubal ligation had been done in 3 of these 4 women. There were 37 episodes of hemoperitoneum; 22 occurred at midcycle and 15 with menstruation. One patient required repeated blood transfusion, but after oral anovulant therapy no further bleeding occurred and no transfusion was required. Two patients needed laparotomy: one for heavy intraperitoneal bleeding originating from a luteal cyst, and the other for severe lower abdominal pain from follicular and luteal cysts. Ultrasound examinations suggested the presence of small ovarian cysts in the two remaining patients. Recurrent midcycle hemoperitoneum in women on continuous ambulatory peritoneal dialysis may be triggered by ovulation and associated ovarian cyst formation. Suppression of ovulation should be considered.
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The HLA-A, -B, -C, -DR, Bf and GLO phenotypes of 109 unrelated Saudi Arab males have been determined. HLA-A and -B antigen frequencies were compared with data reported for European Caucasoids and various Arab populations. Most similarities in antigen frequencies were seen between Saudi Arab and Iraqi populations. A high frequency of Bw50 was observed in Saudi Arabs. The frequencies of HLA-DR antigens in Saudi Arabs were compared to European Caucasoids. HLA-DR7 was at high frequency in Saudi Arabs. Linkage disequilibria between alleles of HLA loci was examined. Many instances of previously reported antigen associations were seen in Saudi Arabs, together with a number of associations which have not been described elsewhere. HLA-Cw6-Bw50-DR7-BfS0.7 is suggested as being a common haplotype in Saudi Arabs.
Sixty nine patients took part in a double-blind study to investigate the efficacy of bilateral, unilateral, and simulated ECT in the treatment of depressive illness. The findings suggest that both bilateral and unilateral ECT are highly effective treatments for depression and are significantly superior to simulated ECT. There was also evidence that patients receiving bilateral ECT recovered more rapidly than those receiving unilateral ECT and required significantly fewer treatments. The relevance of these findings to clinical practice is discussed.
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Clinical trials are used to test drug therapy but the principles of a trial may be applied to the assessment of any treatment (although the essential formality of a trial might confuse and irritate a general practitioner involved as a participant or reader of results). This is the first of two articles which aim to reconcile the theory of formal clinical trials and the practice of medicine.
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The synthesis of the fluorescent derivative of adenosine, by reaction with 5-(dimethylamino)naphthalene-1-sulfonyl chloride in dry pyridine at low temperature, yielding 3'-O-[5-(dimethylamino)naphthalene-1-sulfonyl]adenosine (3'-O-dansyladenosine), is here described. 3'-O-Dansyladenosine is partially soluble in water (approximately 10(-4) M) and upon excitation at 325 nm exhibits maximum fluorescence emission at 516 +/- 22 nm (corrected) in buffered aqueous solution at pH 7.6 with a quantum yield of 0.21 and a lifetime of 11.8 +/- 0.2 ns. The fluorescence of 3'-O-dansyladenosine is sensitive to the polarity of its solvent: in pyridine, a quantum yield of 0.61 at the emission maximum of 435 nm was observed. 3'-O-Dansyladenosine is a reversible competitive inhibitor of adenosine deaminase with a moderate inhibitive dissociation constant K1 = (1.54 +/- 0.13) X 10(-5) M. The enzyme-substrate analogue association constant was determined by equilibrium dialysis to be K = (0.69 +/- 0.05) X 10(5) M-1, very close to KI-1. The hydrophobic nature of its binding site in adenosine deaminase is evident from the strong blue shift of the fluorescence emission maximum to 440 nm, the 4-fold increase in fluorescence quantum yield, and the longer lifetime of 15.8 +/- 0.2 ns; the tight, rigid nature of the complex is evident from its high fluorescence polarization value, 0.23. An 85% decrease in the fluorescence emission intensity of the adenosine deaminase-3'-O-dansyladenosine complex in the presence of adenosine indicates the selective binding to the enzyme active site. Correlation between the conformation of the probe, either when free in various solvents or when bound to the enzyme, and its fluorescence quantum yield is noted. 3'-O-Dansyladenosine is suitable for fluorescent labeling of adenosine deaminase in cell systems.