[Cardiopulmonary resuscitation].
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Biomedical subjects
Publications and source records attributed to J Pinkhas.
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Corticosteroids hasten relapse and shorten survival of patients with HBsAg positive chronic active hepatitis. A hypothesis is advanced suggesting that the steroid hormones, acting as interferon antagonists, may compromise the establishment of a cellular anti-viral state. under such circumstances the hepatitis virus replicates undisturbed, is propagated from cell to cell and precipitates terminal liver failure at a faster rate. The hypothesis provides a theoretical basis for condemning the administration of corticosteroids to patients with HBsAg positive chronic active hepatitis.
On the basis of immunologic and microbiologic data as well as recent observations it is postulated that interferon is responsible for many of the clinical signs and symptoms in systemic lupus erythematosus such as alopecia, joint manifestations, fever and leukopenia. Recognition of the important role of interferon in active systemic lupus erythematosus leads to some practical conclusions: a) a new therapeutic approach to active lupus must consider a treatment which will lead to reduced interferon activity; b) one of the laboratory parameters of activity of the disease may be interferon measurements.
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The skin biopsy specimens from six patients with primary mixed IgM-IgG cryoglobulinemia were examined by immunofluorescence, light and electron microscopy. The biopsy taken from the involved skin of one patient with leg ulcers revealed small blood vessel occlusions by cryoglobulin aggregates. Since a similar finding was not observed in the biopsy material taken from the other five patients who had no ulcerative skin lesions, it seems that the cryoglobulin aggregates play a role in the development of the skin ulcerations in primary mixed IgM-IgG cryoglobulinemia.
13 patients with adult non-lymphocytic leukemia (ANLL) who developed central nervous system (CNS) involvement during the course of their illness are reported and compared with a control group of 26 ANLL patients without CNS involvement. The incidence of CNS involvement was 13/510 patients (2.5%). Initial symptoms and signs and routine laboratory data were not helpful in predicting which patients would ultimately develop CNS involvement. Almost 1/2 of the patients were in clinical and haematological remission at the time of the diagnosis of CNS involvement. Specific treatment to the CNS including intrathecal cytotoxic drugs and/or radiotherapy failed to increase the survival rate significantly. Whether the establishment of an early diagnosis of CNS involvement and the institution of appropriate treatment may improve the prognosis of this complication is a question which presently remains unanswered.
The review of the pertinent literature disclosed 36 reports of familial multiple myeloma, described mostly in siblings, to which the authors add one more family. These patients did not differ significantly from those with non-familial myeloma with regard to sex, age, distribution of monoclonal proteins, clinical and laboratory data, and the course and prognosis of the disease. An increased incidence of immunoglobulin abnormalities was observed in healthy relatives of patients affected with familial myeloma. In most cases the time interval of the diagnosis of myeloma in a family member of a known patient was under 4 years. These observations, in conjunction with reports of myeloma occurring in clusters in a community and the appearance of myeloma in spouses raise the possibility of an environmental factor (virus?) which may contribute to the pathogenesis of myeloma in genetically predisposed individuals. Multiple myeloma should be added to the list of neoplastic diseases in which the family history is relevant and in which genetic and possibly environmental factors may be pathogenetically involved.
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A patient with thrombotic thrombocytopenic purpura was treated with 8 U of fresh frozen plasma, resulting in a rapid improvement in her condition and subsequently followed by a prolonged clinical remission. The transmission and scanning electron microscopic examinations of the platelets performed before treatment demonstrated marked anomalies of the platelet morphology, namely, an increased number of abnormally elongated pseudopods with terminal knobs, a decreased number of platelet granules and excess of glycogen and marked anisocytosis. These anomalies remained unchanged when reexamined 2 months after the achievement of the clinical remission. The question whether these platelet abnormalities are an integral part of thrombotic thrombocytopenic purpura and play a role in its pathogenesis, is raised.
The case of a patient with mixed-type cryoglobulinemia and cutaneous necrotizing vasculitis, who later suffered from relapsing polychondritis affecting the auricle and the nose, is described. To the best of our knowledge, this combination is unique.
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The activities of adenosine deaminase (ADA) and of purine nucleoside phosphorylase (PNP) were measured in thymocyte subpopulations separated by peanut agglutinin (PNA), in unseparated thymocytes, in lymph node and in spleen cells. The PNA+ thymocyte subpopulation exhibited the highest ADA activity of all cells studied. The lowest PNP activity was found in the PNA- subpopulation of thymocytes. PNA+ cells, moreover, exhibited a more intensive DNA synthesis than the PNA- cells, and a greater sensitivity to deoxyadenosine toxicity in the presence of erythro-9-(2-hydroxy-3-nonyl)-adenine (EHNA). The two thymocyte subpopulations exhibited a similar sensitivity to deoxyguanosine (dG) toxicity.