Crohn's disease in husband and wife.
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Adult↗
Biomedical subjects
R Wright
Publications and source records attributed to R Wright.
Pre-filled adrenaline syringes.
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Anaphylaxis↗
Prognostic indicators of ultimate long-term survival following advanced life support.
In an attempt to establish prognostic indicators for ultimate long-term survival following advanced life support (ALS), a two-year (1978-79) retrospective study was made of 92 survivors. The survivors were divided into two groups: the first survived admission to the intensive care unit, but subsequently died in the hospital; the second survived to ultimate discharge from the hospital. The groups were compared for sex, age, basic and advanced provider response time, scene an transport time, witnessed versus unwitnessed arrest, traumatic versus medical arrest, type of airway, presence of aspiration, initial cardiac rhythms, post-arrest vital signs, number of defibrillations, post-arrest ECG changes, essential and useful drugs used, and duration of basic and advanced life support. Of all prognostic indicators studied, duration of ALS correlated most closely with ultimate survival. This article advances the definition of ultimate survival of ALS to mean discharge of the patient from the hospital, and advocates this as the most objective evaluation of successful ALS. The article furthermore offers duration of ALS as an effective prognostic indicator of a patient's chance for ultimate survival.
Critical Care↗
Human monoclonal antibodies to lung-cancer antigens.
Lymphocytes obtained from hilar and bronchial lymph nodes from 23 patients undergoing radical surgery for carcinoma of the bronchus were fused with established rat or mouse myeloma lines. 62% of the resultant hybrids were found to be secreting human Ig detected by a sensitive staphylococcal Protein A-coupled SRBC assay. Immunoglobulins synthesized by such hybrids were internally labelled with 3H-lysine and their antibody activity against a variety of membrane preparations determined. Nine monoclonal antibodies were found which bound to molecules on lung-cancer membranes and not on normal lung membranes from the same patient.
Aged↗
HLA A and B locus antigens in patients with unexplained hepatitis following halothane anaesthesia.
HLA A and B locus antigens were determined in 17 patients who had recovered from unexplained hepatitis following halothane anaesthesia. The greatest deviations from expected frequencies were observed with A1, A11 and BW22, but these differences were not statistically significant when the P values were corrected for the number of antigens tested. Although a larger series might show such deviations to be significantly different, HLA typing is of no predictive value in determining those at risk to hepatitis following repeated halothane exposure.
Adult↗
Penicillin-binding proteins in Haemophilus influenzae.
The penicillin-binding proteins (PBPs) of Haemophilus influenzae were studied by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and fluorography. Eight major PBPs, ranging in molecular weights from 90,000 to 27,000, were detected. The pattern of molecular weights was different from that determined fro Escherichia coli or Pseudomonas aeruginosa. A study on the binding of several beta-lactam antibodies to the PBPs at their minimal inhibitory concentrations and at lower and higher concentrations revealed that all had highest affinity for PBP 2. Amdinocillin (mecillinam) was an exception; it had highest affinity for PBP 3. The morphological effects of several penicillins, cephalosporins, and amdinocillin on H. influenzae were similar to those reported for E. coli.
Bacterial Proteins↗
Diffuse enterochromaffin-like (ECL) cell hyperplasia and multiple gastric carcinoids: a complication of pernicious anaemia.
A man with long-standing pernicious anaemia developed multiple gastric carcinoid tumours with a background of diffuse enterochromaffin-like cell hyperplasia. There is evidence that enterochromaffin-like cells synthesis and store histamine and that their proliferation is stimulated by high serum gastrin levels. Gastric carcinoid tumours can be difficult to differentiate from the more common adenocarcinomas and may be a more frequent complication of pernicious anaemia than is currently recognised.
Anemia, Pernicious↗
A double-blind controlled trial of the effect of sodium cromoglycate in preventing relapse in ulcerative colitis.
A double-blind controlled trial of the effect of sodium cromoglycate (SCG) in preventing relapse in ulcerative colitis has been completed in 100 subjects. In patients already taking sulphasalazine, SCG did not prove to be of any additional benefit. However, in patients not on any other maintenance therapy, the relapse rate was 40% for SCG as compared with 75% for placebo. A large study of the effect of SCG in patients intolerant of sulphasalazine is indicated.
Adult↗
Monocyte function in Crohn's disease and ulcerative colitis.
Monocyte function as reflected by phagocytosis of Candida albicans and chemotaxis towards zymosan-activated serum has been assessed in Crohn's disease and ulcerative colitis. Phagocytosis and random movement were significantly increased to a similar degree in both diseases when compared with controls (p less than 0.001). There was no significant difference in chemotaxis between the disease and control groups, although there was a trend towards its being increased in ulcerative colitis. There was no correlation between the results obtained and disease activity or medication.
Adult↗
Rape--a comparison of group offences and lone assaults.
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Adolescent↗
Pilot experiments with a reaction time audiometer.
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Acoustic Stimulation↗
Lymphocyte transformation to specific antigens associated with Crohn's disease.
Specific lymphocyte transformation to three micro-organisms that have been implicated in Crohn's disease was performed. These were Pseudomonas maltophilia, Mycobacterium kansasii and Rotavirus. No significant differences were observed for any of the antigens tested. Simultaneous testing of nonspecific stimulation by PHA also showed no difference between patients and controls. These results do not support an aetiological role for these organisms mediated by a purely cellular mechanism.
Adult↗
The effect of plasma exchange on the in vitro monocyte function of patients with immune complex diseases.
In vitro function tests were performed on peripheral blood monocytes isolated from patients with putative immune complex diseases undergoing therapeutic plasma exchange. Bacterial killing by monocytes improved significantly after plasma exchange (pre: 29 +/- 5%; post: 39 +/- 3%). The intracellular content of the acid hydrolase N-acetylglucosaminidase (NAG) after in vitro culture rose significantly following plasma exchange (pre: 48.3 +/- 21 nmol mg protein-1 hr-1; post: 76.6 +/- 30.6), although the amount of NAG released into the supernatant was unchanged. Plasma exchange also resulted in reduced levels of immune complexes (IC) and clinical improvement in most patients. The beneficial effect of plasma exchange in patients with IC diseases may be partly due to removal of IC which are known to influence the functional activity of cells of the mononuclear macrophage series.
Acetylglucosaminidase↗
Proteolytic enzymes released by liver macrophages may promote hepatic injury in a rat model of hepatic damage.
Using macrophages isolated from the livers of normal rats and from rats injected intravenously with Corynebacterium parvum 6 days previously, N-acetyl-glucosaminidase (NAG) and plasminogen activator (PA) production have been measured during in vitro culture. There was a significant increase (p less than 0.02) in the supernatant activity of NAG by the C. parvum recruited macrophages 8.05 +/- 1.17 nmol product/mg protein/h as compared with normal, 3.86 +/- 0.77 nmol product/mg protein/h. There was a similar increase in cellular NAG content by recruited macrophages 412 +/- 66 nmol product/mg protein compared with 153 +/- 35 nmol product/mg protein (p less than 0.01) in normals. When macrophages of either group were exposed in vitro to endotoxin alone or a combination of endotoxin followed by latex particles, NAG values were similar to those obtained from nonexposed cells. In contrast, PA supernatant production increased significantly (p less than 0.02) on exposure to endotoxin with a corresponding reduction in cellular PA content, but the cellular PA content and supernatant release were similar for each group of cells. There was a fourfold increase in the number of macrophages isolated from the C. parvum-treated livers/g liver weight. Thus, the hepatocytes in this model of liver injury are potentially exposed to a 10-fold increase in the concentration of the acid hydrolase NAG; potentiation of cell damage by the administration of endotoxin may be mediated through the observed increase in production of secretory enzymes such as plasminogen activator. In conclusion, this study supports the hypothesis that proteolytic products released by recruited and activated macrophages may result in hepatocyte damage.
Acetylglucosaminidase↗
Fulminant lupus pneumonitis with acute renal failure and RBC aplasia. Successful management with plasmapheresis and immunosuppression.
Acute interstitial pneumonitis is a well-recognized, although rare, complication of systemic lupus erythematosus (SLE) that has been associated with a poor prognosis. Fulminant lupus pneumonitis, acute renal failure, and RBC hypoplasia occurred in a 14-year-old girl. The patient's condition was managed with large-volume plasmapharesis, dialysis, and immunosuppressive therapy. Her respiratory, renal, and hematologic changes all resolved, and response was maintained with cyclophosphamide and prednisolone therapy. Although serologic evidence of SLE persisted, clinically, the patient was well four years after the initial appearance of SLE. There are several acute pulmonary manifestations of SLE, and plasmapheresis may be useful in the management of some of these conditions.
Acute Kidney Injury↗
A comparative study of lysosomal enzyme activity in monocytes and Kupffer cells isolated simultaneously in a rat model of liver injury.
Macrophages have been isolated and cultured in vitro from normal rat livers and from livers into which macrophages have been recruited in vivo, following an intravenous injection of killed Corynebacterium parvum. Simultaneously, peripheral blood monocytes have been isolated and cultured in vitro. After 24 hr in culture, supernatants and cell lysates were harvested and the activity of a lysosomal enzyme, N-acetyl-glucosaminidase (NAG), measured. NAG activity in the cell lysates of the recruited tissue macrophages was significantly higher than that measured in control tissue macrophages. Increased NAG activity was also observed in the supernatants from the recruited macrophages. In contrast, the NAG activity in cell lysates and supernatants of peripheral monocytes was not significantly changed after C. parvum injection. In this animal model, measurement of a lysosomal enzyme produced by peripheral monocytes did not reflect the magnitude of the changes observed for the tissue macrophages.
Acetylglucosaminidase↗
Natural killer activity in patients with biopsy-proven liver disease.
Most previous studies of lymphocyte-mediated cytotoxicity to animal and human hepatocytes have not taken into account the ability to human lymphoid cells to kill spontaneously cultured cell lines, particularly those of malignant origin (the natural killer or NK effect). We have studied spontaneous killing to a human target (erythromyeloid cell line K562) in patients with biopsy-proven liver disease and from normal controls. Patients with chronic active hepatitis were shown to have a significant reduction in NK activity unrelated to immunosuppressive therapy (P less than 0.01). Other groups showed normal values. These results imply that cytotoxic effectors reported active in chronic liver disease are K cells and not NK cells, with which they share many characteristics, and suggest that a cytotoxic mechanism considered to be of importance in immunosurveillance may be reduced in chronic aggressive hepatitis.
Adult↗