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Biomedical subjects

D Taube

Publications and source records attributed to D Taube.

86 records · Page 5Linked to original sources
PubMed1984

Impaired lymphocyte and suppressor cell function in minimal change nephropathy, membranous nephropathy and focal glomerulosclerosis.

The response of lymphocytes to Concanavalin A (Con A) was measured in patients with the nephrotic syndrome due to minimal change nephropathy (11 patients), focal glomerulosclerosis (15 patients) and membranous nephropathy (21 patients); autologous serum was not used in these studies. There was a significant reduction in lymphocyte transformation in each group of patients compared to normal controls (p less than 0.01 for each group), but there was no significant difference between the individual groups of patients. Impaired lymphocyte transformation to Con A appears therefore to be a general feature of the nephrotic syndrome and is not exclusive to minimal change nephropathy. Measurements of suppressor cell function in 4 patients with minimal change nephropathy, 9 patients with focal glomerulosclerosis and 12 patients with membranous nephropathy were performed at the same time as the above studies. In each group suppressor cell function was decreased, indicating that the impaired lymphocyte response to Con A is not due to increased suppressor cell activity. These findings do not support the hypothesis that an abnormality of lymphocyte function peculiar to minimal change nephropathy is pathogenetic in that disease and not in other causes of the nephrotic syndrome; it seems more likely that the abnormalities described are secondary to the nephrotic state.

Adolescent↗
PubMed1984

Vasculitis affecting the kidney: presentation, histopathology and long-term outcome.

Fifty-three patients who by clinical and/or histological criteria were judged to have vasculitis affecting the kidney were reviewed. Patients with systemic lupus or Schönlein-Henoch purpura were excluded. Segmental necrotising glomerulitis was taken as a manifestation of vasculitis ('microscopic polyarteritis'). Those patients in whom vasculitis was confined to glomerular capillaries were compared with those who in addition had vascular lesions outside the glomeruli. The two groups were found to have identical clinical features. Clinical presentation was predominantly extrarenal, and exclusively renal in only two. Three patients were classified histologically as Wegener's granulomatosis, four had malignant tumours and two relapsing polychondritis. Hepatitis B surface antigen was absent in all of 37 patients tested. Renal disease presented with microscopic haematuria and minor proteinuria in the majority (32) but 16 patients presented with rapid deterioration of renal function, including seven with anuria. Histologically 42 patients showed segmental necrotising glomerulitis ('microscopic polyarteritis'), six diffuse proliferative glomerulonephritis,and in five only minor or ischaemic glomerular changes were present. Crescents were found in 41/42 of those with segmental necrotising glomerulitis, nd involved more than 50 per cent of glomeruli in 15 patients. Immunohistochemical studies were generally negative except the fibrin. Electron microscopy showed no evidence of immune deposits in necrotising glomerulitis, but these were present in 2/6 patients with diffuse proliferative glomerulonephritis. Overall prognosis was poor, 35 patients having died, 20 early in the course of the disease and 15 later. Oligoanuria and extensive crescent formation were adverse signs. Survivals were 54, 38 and 34 per cent at one, five and 10 years respectively. Of those who survived the initial illness, 12 were stable with apparently inactive disease, whilst 16 continued to show clinical signs of activity and required treatment. A variety of treatments was employed including oral and intravenous corticosteroids, immunosuppressive agents, anticoagulants; only one patient was treated by plasmapheresis. It is difficult to draw any firm conclusions as to the efficacy of treatment and survival rates remain unsatisfactory.

Acute Disease↗
PubMed1983

High versus "low" dose corticosteroids in recipients of cadaveric kidneys: prospective controlled trial.

Corticosteroids have the major role in the immunosuppressive treatment of patients who have received renal transplants. Despite their extensive use there is still debate about the appropriate dose that will prevent rejection of the renal allograft with the least morbidity. From March 1979 to November 1981 a randomised controlled trial of high (33 patients) v low oral dose (34 patients) of prednisolone along with azathioprine was conducted in recipients of first cadaveric transplants who had received a blood transfusion within six months of transplantation. The main difference in outcome between the two groups was a high incidence of some infections in the high dose group. Patient mortality, graft survival, transplant function, and number of rejection episodes were indistinguishable in the two groups, but rejection episodes tended to occur later in the high dose group. These findings suggest that the use of lower doses of corticosteroids soon after cadaveric renal transplantation does not jeopardise graft survival and results in lower patient morbidity.

Adolescent↗
PubMed1983

Development of sleep-waking temporal sequencing in infants at risk for the Sudden Infant Death Syndrome.

The periodic organization of waking, quiet sleep, and active sleep was studied in control infants and siblings of victims of the Sudden Infant Death Syndrome. Spectral estimates of all-night binary state time series recorded at 1 week and 1, 2, 3, 4, and 6 months of age revealed disturbed patterns of sleep states, especially in active sleep, from as early as the first week of life. These disruptions continued until at least 6 months of age. These data support the contention that the temporal patterning of sleep state can be used as an important neurologic marker for development.

Female↗
PubMed1983

Late onset systemic lupus erythematosus and lupus-like disease in patients with apparent idiopathic glomerulonephritis.

We report 17 patients who presented with either apparent idiopathic glomerulonephritis (16 patients) or post-streptococcal glomerulonephritis (one patient). Doubts arose about the nature of these patients' disease, either because their initial renal histology was suggestive of systemic lupus erythematosus (SLE) in the absence of its clinical or serological features, or because they developed with time the clinical or serological features of SLE. Three patients had a positive antinuclear antibody (ANA) test at the onset of their illness, but normal levels of serum binding of double-stranded DNA (dsDNAB). In another four patients the dsDNAB was slightly raised but with a negative ANA. On renal biopsy the predominant appearance was membranous glomerulonephritis (GN) in 10, subendothelial mesangiocapillary GN (MCGN) in three, and focal segmental glomerulosclerosis in two; one patient each had a focal proliferative GN and a diffuse endocapillary GN. On 1 micron renal sections stained with toluidine blue, 10 patients had immune deposits at multiple sites within the glomeruli. Over a period of one to 14 years, six patients developed extrarenal features suggestive of SLE, nine a positive ANA, and 12 increased serum levels of dsDNAB. Five patients became hypocomplementaemic. Cryoglobulins were isolated from the sera of 10 out of 12 patients; seven contained DNA. Separated cryoglobulin IgG from eight patients showed antibody activity directed against both ss and dsDNA in four, and against dsDNA only in three. On the basis of the clinical, histological and serological observation during follow-up five patients were reclassified as definite SLE, four as probable SLE and two as possible SLE. Rarely, SLE may present with nephritis as the sole disease manifestation, antedating other clinical features and even immunological markers of the disease by years. In addition, some patients with a glomerulonephritis may show clinical and immunological, or histological features of SLE, but do not fit accepted definitions of the disease.

Adolescent↗
PubMed1982

Impaired lymphocyte transformation in minimal change nephropathy in remission.

A group of 37 patients with minimal change nephropathy (MCN) in remission for a mean period of 4.9 years (range 0.25-10) and on no current treatment were found to have a lymphocyte response to the mitogen Concanavalin A which was significantly lower than normal (P less than 0.001). This reduction in lymphocyte transformation was mainly due to the 24 patients who had received in addition to steroids a course of cyclophosphamide from 1 to 12 years (mean 6.7 years) previously (P less than 0.005 when compared t normal). Although the lymphocyte response of the remaining group of 13 patients who had not been treated with cyclophosphamide was not significantly lower than normal, there were three whose lymphocyte response to Concanavalin A was below the normal range. Our findings indicate that remission of MCN may be accompanied by a persistence of the abnormal lymphocyte function which is present during the nephrotic phase, and that cyclophosphamide may cause or add to this defect by a long-term effect on lymphocytes.

Adolescent↗
PubMed1981

Long-term impairment of suppressor-cell function by cyclophosphamide in minimal-change nephropathy and its association with therapeutic response.

Lymphocyte suppressor-cell function was studied by induction with concanavalin A in 31 patients with minimal-change nephropathy (MCN) in remission. 21 patients had been treated with cyclophosphamide 0.5--12.0 years previously (mean 6.5 years) and had been in remission for 0.5--9.0 years (mean 5.1 years). The remaining 10 patients had never received cyclophosphamide and had been in remission for 1--10 years (mean 5.3 years). The cyclophosphamide-treated group had significantly less suppressor-cell function than either the controls or the non-cyclophosphamide-treated group, the latter being not significantly different from normal. When patients who had received cyclophosphamide were divided into those who had relapsed after taking this drug (10 patients) and those who had not (11 patients), suppressor-cell function was significantly impaired in the non-relapsing group. This association of impaired suppressor-cell function with failure to relapse may indicate that suppressor cells have a pathogenetic role in MCN and that the therapeutic effect of cyclophosphamide in this disease is to diminish their function. Alternatively, the impaired suppressor-cell function in the non-relapsing group may be simply a marker of effective treatment with cyclophosphamide. The finding of long-term suppression of lymphocyte function after cyclophosphamide coupled with this drug's risks of causing malignancy and gonadal dysfunction reinforces the need for caution in its use in MCN.

Adolescent↗
PubMed1981

Depression of normal lymphocyte transformation by sera of patients with minimal change nephropathy and other forms of nephrotic syndrome.

Sera from patients with the nephrotic syndrome due to minimal change nephropathy (11 patients), membranous nephropathy (14 patients) and focal glomerulosclerosis (15 patients) inhibited the response of normal lymphocytes to the mitogen Concanavalin A. Although there was a tendency for the sera of patients with minimal change nephropathy to be more inhibitory than sera from the other two forms of nephrotic syndrome, this effect of nephrotic sera on normal lymphocytes is not confined to minimal change nephropathy. Until the exact nature of the inhibitor(s) is established, it is therefore not possible to state that impaired lymphocyte transformation by serum plays a pathogenetic role specifically in minimal change nephropathy. The susceptibility of nephrotic patients to infection may be due in part to the sera of the patients causing reduced lymphocyte function in vivo which leads to a defective immune response.

Adolescent↗
PubMed1976

Paradoxical embolism complicating massive pulmonary embolus.

Paradoxical embolism is an unusual but well recognized complication of venous thromboembolic disease. This case report of a patient with massive pulmonary embolism, who had a paradoxical embolus through a patent foramen ovale, emphasizes that in these circumstances surgical intervention is indicated.

Adult↗
PubMedDate not supplied

Major psychotherapeutic modalities for heroin addiction: a brief overview.

This article provides a brief overview of recent literature on major psychotherapeutic modalities for heroin addiction. These modalities include psychotherapy, behavior therapy, cognitive-behavioral therapy, family therapy, social skills training approaches, and therapeutic communities. It highlights studies with stronger research design and methodology, many of which are theory-based, and discusses what appear to be the "active ingredients" in these modalities which contribute to successful treatment outcome. It concludes that there is an increasing convergence of theory and research in the field of heroin addiction treatment, making the designing of treatment programs based on empirical knowledge more feasible.

Combined Modality Therapy↗