Non-Hodgkin's lymphoma of high grade malignancy revealing acquired immunodeficiency syndrome. Report of a case.
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Biomedical subjects
Publications and source records attributed to P Wettendorff.
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Biochemical tests (serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase, alkaline phosphatase, gammaglutamyltranspeptidase, bilirubin, and serum amylase) were performed upon admission in 84 patients with suspected (36) or proven (48) acute pancreatitis at the time of the first episode of acute abdominal pain suspected clinically as acute pancreatitis. These parameters all increased significantly more in patients with gallstone pancreatitis. Among them, the SGPT was the most discriminant test between biliary and nonbiliary pancreatitis. The positive predictive value of SGPT was 92%, when the cutoff point was chosen at twice the upper limit of normal. In patients with increased SGPT, a SGOT-SGPT ratio less than 1 is the rule (88%) for those with gallstone pancreatitis. This enzymatic determination allowed us to select more accurately the patients suitable for morphological procedures to confirm the biliary origin of the pancreatitis.
In this prospective study, antithrombin III, plasminogen and alpha 2 antiplasmin which are synthetised by the liver were measured and compared with the Normotest, Thrombotest and fibrinogen concentrations in 92 consecutive jaundiced patients. Antithrombin III appeared to be the most discriminant coagulation test in differentiating hepatocellular from cholestatic jaundice. A high correlation was observed between antithrombin III, plasminogen and alpha 2 antiplasmin values suggesting that the liver synthesis of these parameters was closely linked. The prognostic significance of the blood coagulation tests in patients with jaundice has been studied. In parenchymatous liver disease, antithrombin III, plasminogen and alpha 2 antiplasmin were superior to the Normotest, Thrombotest and fibrinogen concentrations in predicting the prognosis of the patients at the time of admission. In cholestatic jaundice, however, none of the blood coagulation tests studied had a prognostic significance.
The transfer test (TT) measures by means of thromboelastography the capacity of a plasma to shorten the coagulation time of a control plasma. The value of the TT was compared to that of fibrin(ogen), degradation products (FDP), and ethanol gelatin test (EGT) in various diseases (group I), in confirmed deep venous thrombosis (group II), and in confirmed pulmonary embolism (group III). In 211 consecutive patients admitted for various diseases the results of the TT, FDP, and EGT were abnormal in 12.3, 11.3, and 66.6%, respectively, of the cases. In 59 consecutive patients with deep venous thrombosis confirmed by radiological phlebography the results of TT, FDP, and EGT were abnormal at admission time in 96.6, 89.8, and 44%, respectively, of the cases. In 45 consecutive patients with pulmonary embolism confirmed by lung scintigraphy the results of TT, FDP, and EGT were abnormal at admission time in 97.7, 97.6, and 88%, respectively, of the cases. Among the three parameters which were evaluated, the TT seems to be the most sensitive screening procedure for thrombotic diseases. A normal result of TT is a strong argument against a recent thrombotic venous phenomenon.
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During infusion of caerulein, the output of gamma-glutamyl transpeptidase and biliary alkaline phosphatase is significantly more increased in chronic pancreatitis patients than in normal subjects. The presence of the gall-bladder is necessary to observe this effect of caerulein. It is not related to the discharge of large amounts of both enzymes by the diseases pancreas.
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At a certain level of stimulation of the enzymatic secretions of the pancreas utilizing duodenal hormones and caerulein in normal subjects, the hourly urinary amylase output increases beyond normal values. Under these conditions, the so-called evocative pancreatic function test becomes unusable for the diagnosis of chronic pancreatitis in the early stages.
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