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Biomedical subjects

W Rozenbaum

Publications and source records attributed to W Rozenbaum.

At least 127 records · Page 7Linked to original sources

Lymphadenopathy in patients at risk for acquired immunodeficiency syndrome. Histopathology and histochemistry.

Lymph node biopsies of 12 patients at high risk for acquired immunodeficiency syndrome (AIDS) with generalized lymphadenopathy (AIDS-related complex [ARC]) and seven controls with conventional lymph node hyperplasia were examined by light microscopy and immunohistochemical staining of frozen tissue. The immunohistochemical results were quantified by planimetric means. Our findings show that the T helper/T suppressor-cytotoxic (Th/Tsc) ratio in lymph nodes from ARC patients is significantly decreased with respect to controls and that this decrease precedes the change in the Th/Tsc ratio in peripheral blood. Our findings distinguish between lymphadenopathy from patients with ARC and other forms of hyperplasia; the relation to AIDS is discussed.

Acquired Immunodeficiency Syndrome↗

Is there correlation of T cell proliferative functions and surface marker phenotypes in patients with acquired immune deficiency syndrome or lymphadenopathy syndrome?

We have investigated the respective role of quantitative T lymphocyte subset abnormalities, interleukin-2 (IL-2) production and responsiveness to IL-2, in the proliferative deficiency that is observed in acquired immune deficiency syndrome (AIDS) and Lymphadenopathy syndrome (LAS) patients or even in some apparently healthy male homosexuals. 83 subjects were evaluated: 35 symptom free male homosexuals (HC), 24 LAS and 24 AIDS patients. As expected, many HC and most patients presented with T lymphocyte subset imbalance. These quantitative defects were associated with decreased reactivity to PHA and reduced production of IL-2 by PHA stimulated lymphocytes. No correlation however could be found between these two functions and variations in the T lymphocyte subset distribution. On the other hand, PHA responsiveness appeared to closely depend on IL-2 activity. Addition of exogenous IL-2 to lymphocytes from patients with low proliferative responses, stimulated with suboptimal PHA concentration, enhanced proliferation in some but not all the cases. In most instances this increase never reached the levels observed with similarly treated cells from normal individuals. In these patients, the limited number of lymphocytes which express IL-2 receptors upon PHA stimulation may explain both low PHA reactivity and reduced IL-2 responsiveness. These data indicate some possible mechanisms of immunodeficiency in AIDS and LAS.

Acquired Immunodeficiency Syndrome↗

[Acquired immunodeficiency syndrome and related syndromes. Critical analysis of biological tests of cell-mediated immunity].

In order to assess the actual value of the in vitro tests of cellular immunity performed to provide diagnostic evidence for acquired immune deficiency syndrome (AIDS) or related syndromes, we have evaluated T-lymphocyte subsets and in vitro proliferative responses. The respective profiles of 44 symptom-free homosexual men, 30 patients with AIDS and 42 patients with lymphadenopathy were compared with each other and with profiles of blood bank volunteers, using stepwise discriminant analysis. At first investigation, control homosexuals, AIDS patients and lymphadenopathy patients displayed varying degrees of the same type of immunological abnormalities. The percentage of OKT4+ cells was the most discriminant variable between blood donors and control homosexuals, AIDS or lymphadenopathy patients. The latter differed from homosexuals by a higher percent of OKT8+ cells and from AIDS patients by a lesser reduction in T-lymphocyte counts. OKT4+ cell counts differentiated AIDS patients from control homosexuals. However, none of these major discriminant variables could classify correctly more than 70% of subjects in the homosexual and in the two patient groups. Thus, a single investigation of T-lymphocyte immune parameters does not provide substantial diagnostic and prognostic evidence.

Acquired Immunodeficiency Syndrome↗

[AIDS and associated syndromes: clinical manifestations].

Numerous clinical and immunological manifestations are commonly observed in AIDS patients. Among these, Kaposi's sarcoma and major opportunistic infections appear today as clinical "markers" of the disease. Other signs and symptoms such as fever, diarrhea, lymphadenopathy and immunological abnormalities are currently recognized as "associated" disorders. One of the main problems faced by clinicians is to evaluate the significance of these "associated" abnormalities, especially when they occur in at risk populations. Much work is still needed to clarify whether they actually imply an individual predisposition to contract the disease, a minor form or some early stage of AIDS.

Acquired Immunodeficiency Syndrome↗

[Problems raised by the treatment of Kaposi's sarcoma in subjects with AIDS].

Kaposi's Syndrome (K. S.) was defined as a virus induced immunogenic tumour responding to interferon. It can be used as a guideline for therapeutical trials in A. I. D. S. K. S. mortality is 13%. K. S. + O. I. (opportunistic infections) mortality reaches 70% and O. I. mortality is approximately 50%. Therefore treating O. I. is a must but it is not mentioned in the paper. Attempts made to modify immunodepression, usual K. S. treatments, experimental treatments based upon similar pathogenicity (like systemic lupus erythematosus, Hansen's disease, preneoplasia dyskeratosis) were unsuccessful. Trials with alpha recombinant interferon realised at the Sloan Kettering Memorial for Cancer in New York are summarized for 74 patients and are in preliminary interpretation. Our study is based upon 13 cases studied for 14 to 4 months and comes up to the same conclusions using 18 to 36 million units/day for 6 months (6 cases) and 3 to 4 months (7 cases). For 6 full treatments the results are: 2 K. S. were cleaned up after 8 and 3 months follow up, 4 K. S. with O. I.: 3 remissions and then relapses and 1 stabilization, for 7 current treatments: 2 had to be discontinued because of bad tolerance, 1 stabilization and 4 remissions. For all treatments a decrease and a lesser gravity of O. I. can be noted during treatment. Besides flu-like syndromes, main clinical side effects, are: asthenia, general condition impairment, 2 fits were observed for which I.N.F. cannot be clearly incriminated. Daily treatment compelling and surveillance are real drawbacks. Different types of better used interferon will probably yield interesting results (40% regression or improvement).

Acquired Immunodeficiency Syndrome↗

Critical analysis of T cell subset and function evaluation in patients with persistent generalized lymphadenopathy in groups at risk for AIDS.

In order to determine whether there exists a distinct immunological profile that discriminates between healthy homosexual men and those expressing persistent generalized hyperplastic lympadenopathy GHL and which of the observed abnormalities in GHL would be most indicative of patients who would eventually develop AIDS, we evaluated T lymphocyte subset and in vitro proliferative responses. The respective profiles of 44 symptom free homosexual men (HC), 42 patients with GHL and 30 cases of AIDS were compared to that of blood bank volunteers (BBV) and to each other, using stepwise discrimination analysis. HC, GHL and AIDS patients demonstrated upon their first investigation varying degrees of the same type of abnormal immunological characteristics. The percentage of OKT4+ cells was the most discriminant variable between BBV and HC, GHL or AIDS. GHL was distinguished from HC primarily by a higher percentage of OKT8+ cells and from AIDS by higher T lymphocyte counts, while the OKT4+ cell count discriminated between AIDS and HC. However, none of these major discriminant variables could classify correctly more than 71% within the HC and the two patient groups. Thus, there exists a continuity between GHL and AIDS in the range of observed immunological abnormalities without clearcut boundaries. This, together with the existence of abnormal background values in HC will not permit a single investigation of T lymphocyte immune parameters to provide substantial diagnostic and prognostic evidence.

Acquired Immunodeficiency Syndrome↗

Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS).

A retrovirus belonging to the family of recently discovered human T-cell leukemia viruses (HTLV), but clearly distinct from each previous isolate, has been isolated from a Caucasian patient with signs and symptoms that often precede the acquired immune deficiency syndrome (AIDS). This virus is a typical type-C RNA tumor virus, buds from the cell membrane, prefers magnesium for reverse transcriptase activity, and has an internal antigen (p25) similar to HTLV p24. Antibodies from serum of this patient react with proteins from viruses of the HTLV-I subgroup, but type-specific antisera to HTLV-I do not precipitate proteins of the new isolate. The virus from this patient has been transmitted into cord blood lymphocytes, and the virus produced by these cells is similar to the original isolate. From these studies it is concluded that this virus as well as the previous HTLV isolates belong to a general family of T-lymphotropic retroviruses that are horizontally transmitted in humans and may be involved in several pathological syndromes, including AIDS.

Acquired Immunodeficiency Syndrome↗

[Acquired immunodeficiency syndrome in 4 homosexuals].

Two young homosexual men apparently without any obvious cause of immunosuppression suddenly developed a series of opportunistic infections. Two others presented with prolonged fever and multiple lymph node enlargement of obscure origin. Immunological investigations in these 4 patients showed skin anergy and inversion of helper/suppressor lymphocyte ratio. Proliferative responses to mitogenic agents, soluble antigens and allogenic cells were altered only in the 2 patients with opportunistic infections. Humoral immunity seemed to be preserved in all cases. These 4 patients had previously suffered from many sexually-transmitted infections, had spent some time in the United States and had signs of past or present cytomegalovirus infection. As in the U.S.A., where this "acquired immunodeficiency syndrome" suddenly developed during the past 2 years, one may suspect, among several hypotheses, that it is caused by a transmissible agent now present in France.

Acquired Immunodeficiency Syndrome↗

[Effect of socio-occupational category on iterative hemodialysis treatment of advanced chronic renal insufficiency. Results of the DIAPHANE computerized Dialysis Registry cooperative program].

The hypothesis that inequalities may be observed between patients of different socio-professional categories (S.P.C.) was assessed in a group of 1267 men treated by chronic haemodialysis (C.H.) in 34 dialysis centers throughout France and followed up in the computerized DIAPHANE Dialysis Registry. The percentages of manual workers and farmers were found lower than those calculated on the whole active french population. In contrast, the percentages of senior executives and patient with liberal professions were higher. Primary renal disease was detected sooner in patient of the higher S.P.C. than in other groups. Patients of the higher S.P.C. were more frequently treated in university or in private hospitals than in general hospitals. They were more likely on evening or night dialysis schedules than on daylight schedules; they more frequently received hypotensive drugs, vitamin D, calcium, iron, prescriptions of blood transfusions than patients of the lower categories. Survival rates were not correlated with the S.P.C., but the rehabilitation rate, expressed as the percentage of part or full time employments, was greater in patients of the higher S.P.C. Results indicate that, in patients treated by chronic haemodialysis, inequalities in favor of the patients of the higher socio-economic categories are observed and that these inequalities concern both the access and the delivery of care.

France↗