Laryngeal obstruction in HIV infection.
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Biomedical subjects
Publications and source records attributed to S Mackenzie.
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We have examined the role of Ts cels and APC in regulating the tolerance of systemic DTH in mice fed OVA. Oral tolerance to OVA was prevented by eliminating Ts with dGuo and by treating mice with anti-I-J antiserum. In addition, activating the reticuloendothelial system (RES) with oestradiol, muramyl dipeptide (MDP) or GvHR prevented the induction of tolerance. Further studies showed that prevention of oral tolerance correlated with the ability to enhance APC activity and that oestradiol also abrogated the induction of Ts after feeding OVA. Our results show that the tolerance of systemic DTH in mice fed OVA reflects complex interactions between APC and Ts and suggest that defects in these regulatory events may be responsible for clinical food sensitive enteropathy.
The authors review the available data concerning the pharmacokinetics and clinical use of lithium carbonate in old age. Guidelines for lithium prophylaxis are provided including a recommendation to maintain 12 hour blood levels at approximately 0.5 mmol/l using a single bedtime dosing regimen. The value of a specialized clinic to manage and monitor elderly patients maintained on lithium is discussed. Empirical clinical findings on the use of lithium may help to elucidate issues of classification in the affective disorders of old age. Increasing clinical data supports a spectrum theory of affective disorder.
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A 65 year old man with recurrent ventricular tachyarrhythmias post myocardial infarction developed dysarthria and visual hallucinations due to flecainide toxicity. A readily available assay is required for estimating serum flecainide levels in patients with diminished renal or hepatic function or failed arrhythmia suppression.
A prospective study was made of 135 patients having cerebral angiography for suspected carotid atheroma. The aim was to assess the value of a technique in which selective injections were used to show the origins of the vessels from the aortic arch and three views were taken of each of the carotid bifurcations. Disease was frequently asymmetrical and was shown in only one of the three views of the carotid bifurcation in 44% of 181 patent atheromatous internal carotid arteries. Atheroma was seen on a single view significantly more often (p less than 0.01) than was complicated atheroma, indicating that the technique was showing more early lesions than would be seen with fewer views of the region. Disease was not shown significantly more often in any one particular view, so that all three are essential to examine the bifurcation completely.
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A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.
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Grey-scale ultrasound is a useful investigation in selected patients with a painful swollen leg. It is of particular value in cases in which there is a clinical suspicion of deep vein thrombosis (DVT) but other features, such as an atypical history or equivocal radiology, suggest alternative pathology. Five such cases are presented in which ultrasound showed transonic lesions. The cause of the swelling of the leg was thus shown to be "cystic' in nature and therefore not due to DVT. This enabled inappropriate and potentially harmful therapy to be avoided and the correct therapy, such as surgical drainage, to be undertaken.
Forty three cases of psittacosis infection were identified retrospectively over a five year period. The commonest clinical presentation was of a bronchitic illness with a productive cough and features of systemic upset. In 12 (28%) cases no radiographic abnormality was detected on the chest film. Segmental shadowing was the commonest abnormality but lobar and more extensive consolidation occurred. There were no radiographic features that allowed confident differentiation from other causes of pneumonia. The total and differential white cell counts were usually normal and this feature may help to differentiate psittacosis from bacterial pneumonia.
Impairment of urea cycle function in hyperornithinemia-hyperammonemia-homocitrullinuria syndrome is presumably caused, in some patients, by deficient transport of ornithine from cytoplasm into mitochondria. We studied the effect of L-ornithine on L-alanine-induced hyperammonemia in a French-Canadian proband with the syndrome by giving: a 90-min intravenous alanine load (6.6 mmol/kg) together with ornithine (1.1 mmol/kg); an intravenous ornithine bolus (0.3 mmol/kg) followed by ornithine infusion (1.1 mmol/kg) 90 min prior to loading with alanine and ornithine; ornithine supplementation per os (1 g, four times daily X 2 wk) prior to loading with alanine and ornithine. Blood ammonia increased from high normal values to 975, 990, and 750 mumol/liter (normal less than 70) and urinary orotic acid from trace to 539, 494, and 1296 mumol/mmol creatinine (normal 5-11) after the respective loads. Plasma alanine peaked at 1.56-4.24 mmol/liter and ornithine at 1.29-1.95 mmol/liter, but other amino acids were stable. Therefore, ornithine loading did not protect this hyperornithinemia-hyperammonemia-homocitrullinuria patient from hyperammonemia induced by amino-nitrogen loading. Renal fraction excretion of citrulline, lysine, ornithine, glycine, alanine, and tyrosine increased more than 3-fold during ornithine priming, whereas all amino acids were excreted in excess after alanine + ornithine loads; homocitrulline excretion remained unchanged; some urine collections indicated "negative reabsorption" (i.e. apparent secretion) of lysine, histidine, and citrulline. Dietary supplementation with ornithine could deplete lysine pools by impairing lysine reabsorption.
Healthy multiparous women having elective interval (N = 69) or postpartum (N = 69) sterilization were interviewed pre-operatively and 6 weeks and 6 months post-operatively, using standardized instruments. They did not differ significantly from control samples of comparable non-sterilized women with respect to mental state (Present State Examination) or subjectively-assessed mental or physical health or abdominal pain. More sterilization subjects than control subjects reported subjectively experienced improvement in sexual satisfaction at the later follow-up. Reports of poor physical health and abdominal pain increased over time within both the sterilization and the control groups. Reports of adverse effects at follow-up were often associated with higher PSE scores initially. Regrets and wish for reversal were rare and were also associated with higher initial PSE scores. Since the adverse effects were more common among postpartum subjects, it is suggested that subjectively experienced sequelae of sterilization may sometimes be attributable to 'normal' postnatal events.
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Rabbit antisera have been produced to an acute myelomonocytic leukaemia (AMML)-derived cell line (RC2a) and a histiocytic lymphoma derived cell line (U937) having macrophage characteristics. The antisera were screened by complement-mediated cytotoxicity and immunofluorescence (cytofluorograph analysis) against separated leukaemic (122 patients plus 13 cell lines) and normal haematologic cell populations (60 preparations from 20 donors plus 10 B-lymphoblastoid cell lines). The sera were absorbed with pooled B-lymphoblastoid cell lines including the autologous B-lymphoblastoid cell line to RC2a (CESS-B) or alternatively with B-CLL and T-CLL cells. All leukaemic cell populations were confirmed using the markers SIg, E-rosette receptor, cALL antigen, alpha-naphthyl butyrate esterase and myeloperoxidase. Rabbit anti-RC2a (Adherent cells) (RARC2a(Ad) ) and rabbit anti-U937 (RAU937) recognised antigens common to immature myeloid monocyte and T-lymphocyte lineage but did not react by cytotoxicity, absorption or cytofluorographic analysis with cells of B-lymphocyte lineage (B-lymphoblastoid or B-CLL) and reacted only occasionally with cALL patients' cells (includes pre B phenotype). These sera reacted with peripheral blood monocytes but not with other mature blood leucocytes. RAU937 reacted with a major mononuclear population from normal marrow and with more differentiated myeloid leukaemia cells. RARC2a(Ad) and RAU937 detected overlapping subgroups of myeloid leukaemia (AMoL, AMML, AML and CML) patients and Null-ALL and T-ALL patients. These subgroups are now being examined for prognostic significance.
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