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Biomedical subjects

J M Edwards

Publications and source records attributed to J M Edwards.

At least 109 records · Page 6Linked to original sources
PubMed1986

Rheumatoid arthritis, juvenile arthritis, iridocyclitis and the Epstein-Barr virus.

In order to examine the relation of Epstein-Barry virus (EBV) infection to chronic arthritis in children antibodies to EB virus capsid antigen (EBVCA) and rheumatoid arthritis nuclear antigen (RANA) were analysed in sera from 133 patients classified as juvenile rheumatoid arthritis (JRA) or pauciarticular, polyarticular, or systemic juvenile chronic arthritis. Except for an increased frequency in the systemic subgroup, the prevalence of antibodies to EBVCA and titres of anti-RANA antibodies was similar in patients and controls. These data do not support an aetiological role for EBV in chronic arthritis in children, including JRA, and suggest that the mechanisms which may account for the higher titres of anti-RANA antibodies in adult RA do not occur in children.

Adolescent↗
PubMed1986

Long-term hemodynamic and clinical sequelae of lower extremity deep vein thrombosis.

Forty-seven patients with phlebographically confirmed lower extremity deep vein thrombosis (DVT) were reexamined 5 to 10 years (mean, 7 years) after the thrombotic event. Clinical symptoms were recorded and the following noninvasive venous vascular laboratory tests were performed: Doppler examination to determine venous valve competence and photoplethysmography to measure ambulatory venous pressure and venous recovery time. Twenty-eight control subjects underwent similar examination. Although only 10 of 47 patients (21%) were asymptomatic, venous ulceration had developed in only two patients. The symptomatic patients had varying degrees of edema, pigmentation, and varicosities. Eighty-three percent of DVT patients had abnormal vascular laboratory findings. Both the severity of clinical symptoms and the magnitude of the hemodynamic abnormalities generally correlated with the extent of the initial thrombus. However, only 47% of patients whose initial thrombus appeared limited to the calf were asymptomatic, and only 25% of this group had normal venous hemodynamic findings. This study indicates that 5 to 10 years after lower extremity DVT 80% of patients will have both symptoms and abnormal venous hemodynamics regardless of the initial site of the thrombosis.

Female↗
PubMed1986

Intravenous, intralesional and endolymphatic administration of lymphokines in human cancer.

Starting in 1976 we have given two types of lymphokine preparation to 78 individual patients with cancer with no evidence of long-term toxicity. Lymphokine from the 1788 lymphoblastoid line (1788-LK) was given intravenously and intralesionally to 39 of these patients and buffy coat interleukin (BC-IL) to 40 of the patients. On intravenous injection both preparations produced pyrexia and other acute phase changes but with an earlier time course after BC-IL. Feelings of well-being were volunteered and the patients often remained in a steady clinical state for a long time when previously their condition had been deteriorating. Histological studies after intralesional injection into recurrent breast nodules (1788-LK and BC-IL) and prostate (1788-LK) showed an inflammatory cell infiltrate and tumour cell necrosis. Endolymphatic infusion of BC-IL in 23 patients with malignant melanoma was followed by clinical, radiological and histological evidence of lymph node activation. 10 of these patients had had excision of poor prognosis primary tumour only and during the follow-up period (5-17 months) none had a recurrence. Our experience suggests that administration of lymphokines has a place in the total management of cancer patients.

Breast Neoplasms↗
PubMed1985

Critical hand ischemia caused by forearm fibromuscular dysplasia.

This article describes our experience with the management of a 79-year-old woman who had abrupt onset of unilateral critical hand ischemia associated with advanced localized fibromuscular dysplasia of the forearm arteries and thrombotic occlusion of the palmar arch. The patient was successfully managed with local infusion of streptokinase, which was followed by excision and grafting of the radial and ulnar arteries. To our knowledge this represents the first case of hand ischemia associated with forearm fibromuscular dysplasia.

Aged↗
PubMed1985

Incidence of anti-intermediate filament antibody in serum samples of students with suspected glandular fever.

Serum samples from 40 students with suspected infectious mononucleosis were tested for the presence of antibodies to intermediate filaments (AIFA) of the cytoskeleton. Twenty had antibodies to the Epstein-Barr virus capsid antigen before their illness, and during it their sera remained negative by the Paul-Bunnell test. The other 20 patients did not have antibodies to the Epstein-Barr virus capsid antigen before their illness and seroconverted during the illness. These patients (true infectious mononucleosis group) developed positive Paul-Bunnell tests. Sera from normal subjects (blood donors) were also tested for AIFA. AIFA was present in titres greater than 1/10 in 80% of the infectious mononucleosis group (mean titre 1/40-1/80), 10% of the Paul-Bunnell negative glandular fever group, and 8.5% of the normal blood donors.

Adult↗
PubMed1984

The immunoglobulin M response to rubella vaccine in young adult women.

Rubella vaccination histories were taken from 333 young women working in the head office of a retail organization: 29% said they had had vaccine and 47% said they had not. The remainder did not know. Forty-six per cent of those less than or equal to 25 years old (who should have been offered vaccine at school), and 6% of those greater than 25 years old, said they had been vaccinated. When screened for immunity to rubella by radial haemolysis (RH) 3% had a low level of antibody (less than 15 i.u./ml) and 11% had no antibody. After immunization with Cendevax the specific rubella IgM response was measured by an IgM antibody capture radioimmunassay (MACRIA). It was only detectable in the group without RH antibody, and was present in 26/31 of them. The IgM response to Cendevax was strongest in specimens taken 20-39 days after immunization, but in 10 out of 11 cases tested was still present at around 71 days. The specific IgM responses to Cendevax were very similar to those in women given Almevax in an earlier study, when measured in parallel tests. Taking both vaccines together, specific IgM was present in 35 out of 36 vaccinees without pre-existing antibody tested between 40 and 77 days post-immunization. Detection of specific IgM by MACRIA would therefore be an effective means of determining susceptibility retrospectively in rubella vaccinees found to be pregnant.

Adult↗
PubMed1984

Infectious mononucleosis-like response in common marmosets infected with Epstein-Barr virus.

Callithrix jacchus marmosets infected with Epstein-Barr virus (EBV) with or without concurrent treatment with cyclosporin A (CySA) remained healthy. Five marmosets given virus alone developed lymphocytosis and heterophile antibody. Antibody to EBV capsid antigens (VCA) appeared and remained at titers of 1:40-1:80 from 15 weeks onward. Two animals produced antibody to the R component of early antigens (EA) from six weeks onward. Five CySA-treated EBV-infected marmosets showed no increase in total lymphocyte counts; only two developed heterophile antibody. Four developed persistent antibody to the EA-R component. All developed antibody to VCA, and mean titers were higher than in animals given EBV alone. Antibody to VCA also appeared in animals given EBV into Waldeyer's ring. Because these responses to EBV resemble those of humans, C. jacchus may provide a useful model for exploring the potential of cofactors in inducing EBV-associated malignancy.

Animals↗
PubMed1984

Axillofemoral bypass in poor risk patients with critical ischaemia.

While there is an abundance of information about the results of axillofemoral grafting in the North American literature there is little published data from this country. This may reflect a reluctance on the part of British surgeons to use the technique. In the years 1976-1981 we have performed 30 axillofemoral bypasses in 27 patients to alleviate critical ischaemia of the lower limb. Grafts were inserted to bypass aortoiliac occlusive disease in patients too old or too ill for an intra-abdominal operation. Thirty-three limbs were at risk of major amputation, 10 because of gangrene and 23 because of rest pain. Operative mortality was nil and complications were few. Only 38% of grafts remained patent for 2 years but results in terms of limb salvage were satisfactory. Only 3 major amputations were necessary and this confirms our view that the operation is a valuable alternative to intra-abdominal reconstruction in poor risk patients.

Adult↗
PubMed1983

Oral cholecystographic findings and the incidence of wound infection after cholecystectomy.

Six hundred and sixty-one patients undergoing cholecystectomy were reviewed, and the over-all incidence of postoperative wound infection was found to be 18.6 per cent. Of the 274 patients who underwent cholecystography preoperatively, 150 were found to have functioning nonobstructed stone filled gallbladders. There were 12 postoperative wound infections in this group, 8 per cent. One hundred and twenty-four patients had nonfunctioning and obstructed gallbladders, 31 of whom, 25 per cent, had wound infections develop. The finding of an obstructed gallbladder upon oral cholecystography was associated with a high incidence of wound infection. This group should be considered for prophylactic antibiotics.

Adolescent↗
PubMed1982

Intralymphatic steroid therapy for lymphoedema: preliminary studies.

Lymph node fibrosis is a significant feature in patients with primary lymphoedema. Its importance in causing obstruction to the flow of lymph has lead to this study which is an attempt to reduce the effect of fibrosis by treatment with a corticosteroid preparation administered by direct intralymphatic infusion. In a pilot study, twenty patients received an intralymphatic infusion of Clobetasol propionate in Ultra-fluid Lipiodol (18 lower limb, 2 face). Clinical improvement occurred in eight of the patients with leg oedema over a period of up to nine months. Both face-affected patients were helped by this form of therapy. In patients with lymphoedema of the lower limb with lymph node abnormalities, it was advantageous if the lymph vessels leading up to the nodes were patent.

Adolescent↗
PubMed1981

Long-term T-cell-mediated immunity to Epstein-Barr virus in renal-allograft recipients receiving cyclosporin A.

Peripheral-blood mononuclear cells from renal-allograft patients receiving cyclosporin A (CSA) were tested for their ability to produce T cells cytotoxic for EB-virus-infected B-cell targets in culture and compared with those from healthy seropositive subjects. Whereas in the control cultures the proliferating foci of EB-virus-transformed B cells regressed after 2 weeks, no such regression was seen in cultures from CSA-treated patients. These results indicate that patients receiving CSA cannot mount a cytotoxic response to EB-virus-infected B cells in vitro. It is suggested that suppression of memory-T-cell proliferation contributes to the high incidence of lymphomas in CSA-treated renal-allograft recipients.

Adolescent↗
PubMed1981

Titers of antibodies to RANA in rheumatoid arthritis and normal sera. Relationship to Epstein-Barr virus infection.

The disease specificity of antibodies to rheumatoid arthritis nuclear antigen (RANA) was examined by comparing anti-RANA titers in sera from 100 patients with rheumatoid arthritis (RA) with sera from 93 healthy controls. Anti-RANA antibodies were found in 86% of the RA sera and 56% of the controls. The higher titers in the RA sera were unrelated to clinical features or to measurements of circulating immune complexes or rheumatoid factors. To study the relationship of these antibodies to previous Epstein-Barr virus (EBV) infection, antibodies to the EB virus capsid antigen (VCA) were examined and found in 94% of the RA sera and 97% of the adult controls. Four of the six RA sera without anti-VCA antibodies had detectable anti-RANA antibodies, so that we might suggest anti-RANA can arise in the absence of EBV infection. From absorption experiments with non-EBV transformed extracts, we inferred that high anti-RANA titers could be due to reactions with non-Epstein-Bar virus related nuclear antigens. These data cast doubt on current speculation about a possible pathogenic role for Epstein-Barr virus in this disease.

Adolescent↗
PubMed1981

Studies on long-term T-cell-mediated immunity to Epstein-BArr virus in immunosuppressed renal allograft recipients.

Peripheral blood lymphocytes from normal seropositive donors and renal transplant recipients on various immunosuppressive regimens have been tested for their ability to mount a cytotoxic response when cultured with autologous EB virus-infected B cells and thereby to cause regression of proliferating b-cell foci. Cultures from 10 normal seropositive donors all showed the normal pattern of regression. Lymphocytes from patients receiving Cyclosporin A therapy with or without prednisolone completely failed to cause regression, thus allowing B-cell lines to proliferate unchecked. Cells from two of 17 patients treated with azathioprine and prednisone also failed to cause regression. The cells from the remaining 15 individuals showed regression response varying from minimal to normal. These results suggest a mechanism by which EB virus-related tumours may arise in immunosuppressed renal allograft recipients.

Azathioprine↗