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61.
The significance of HLA-DRB1 matching on clinical outcome after HLA-A, B, DR identical unrelated donor marrow transplantation 总被引:11,自引:14,他引:11
Petersdorf EW; Longton GM; Anasetti C; Martin PJ; Mickelson EM; Smith AG; Hansen JA 《Blood》1995,86(4):1606-1613
Despite matching for serologically defined HLA-A, B, DR antigens, acute graft-versus-host disease (GVHD) is a major complication contributing to increased morbidity and mortality in patients who undergo marrow transplantation from unrelated donors. The extent to which unrecognized mismatching for alleles that encode DR1-DR18 contribute to the increased risk of acute GVHD and overall survival is unknown. We analyzed 364 patients and their HLA-A, B, DR serologically matched donors to determine whether molecular typing of DRB1 alleles can allow more accurate donor/recipient matching and thereby improve clinical outcome after marrow transplantation. DRB1 alleles were typed by sequence-specific oligonucleotide probe hybridization methods. Selected alleles were confirmed by DNA sequencing. Of the 364 pairs, 305 were matched and 59 were mismatched for DRB1. The probability of moderate to severe acute GVHD was .48 for the matched and .70 for the mismatched patients. Compared with mismatched patients, the estimated relative risk (RR) of GVHD for matched patients was .58 (95% confidence interval [CI], .40 to .85). DRB1 matching decreased the risk of transplant- related mortality (RR, .66; 95% CI, .44 to .97) and was associated with decreased overall mortality (RR, .71; 95% CI, .51 to 1.0). Therefore, matching DRB1 alleles of the donor and recipient decreases the risk of acute GVHD and improves survival after unrelated marrow transplantation. These results indicate that prospective matching of patients and donors for DRB1 alleles is warranted. 相似文献
62.
Biochemical markers of bone turnover in seronegative spondylarthropathy: relationship to disease activity 总被引:1,自引:0,他引:1
MacDonald AG; Birkinshaw G; Durham B; Bucknall RC; Fraser WD 《Rheumatology (Oxford, England)》1997,36(1):50-53
To investigate bone turnover in patients with seronegative
spondylarthropathy, a bone formation marker, type 1 procollagen carboxy-
terminal propeptide (P1CP), and resorption markers, the pyridinium
cross-links of collagen [urinary free (f) PYR and DPYR], were measured. The
median f-PYR, f-DPYR and P1CP (+/-interquartile range) were 15.8 (6.00)
nmol/mmol creatinine, 3.8 (2.2) nmol/mmol creatinine and 101.5 (38)
micrograms/1, respectively. There was a positive correlation between
resorption markers and acute-phase reactants such as C-reactive protein (r
= 0.42 for PYR, r = 0.42 for DPYR, P < 0.05), and a negative correlation
observed between P1CP and the erythrocyte sedimentation rate (r = -0.64, P
< 0.05). In the subgroup of patients with an elevated CRP concentration,
the concentration of PYR and DPYR was significantly increased (f-PYR 25.7
vs 15.8 and f-DPYR 6.6 vs 3.8, P < 0.01 for f-PYR, P < 0.05 for
f-DPYR). This study suggests than an elevation in acute-phase response in
patients with seronegative spondylarthropathy is associated with increased
concentration of bone resorption markers with a tendency for reduction in
bone formation markers. This may represent uncoupling of bone formation and
resorption, leading to bone loss in such patients.
相似文献
63.
AG Frankfurt a.M. 《MedR Medizinrecht》2005,23(6):361-362
Abstrakt 1. Wird ein Fremdlabor vom Zahnarzt mit Reparaturarbeiten beauftragt, so ist es dann nicht Verrichtungsgehilfe des Zahnarztes, wenn es an dem für die Zurechnung erforderlichen Abhängigkeitsverhältnis zwischen Arzt und Labor fehlt.2. Fehlt es an einem Weisungsrecht des Zahnarztes gegenüber dem Labor, so ist eine Haftung für das Labor als Verrichtungsgehilfe selbst dann ausgeschlossen, wenn der Zahnarzt das Labor im eigenen Namen und auf eigene Rechnung beauftragt hat. (Leitsätze des Bearbeiters) 相似文献
64.
Postappendectomy fluid collections in children: incidence, nature, and evolution evaluated using US 总被引:1,自引:0,他引:1
At the authors' medical center, most patients with postappendectomy fluid collections are treated conservatively. Thirty-two (15%) of 216 children underwent postoperative sonography following appendectomies. In ten patients (31%), a total of 16 fluid collections were found on the initial postoperative sonogram. In the seven patients (70%) whose fluid collections were confined to the pelvis, the condition was treated conservatively and it resolved in 2-9 weeks. In three patients, fluid collections required surgical drainage and proved to be abscesses. In two of the three patients, abscesses were multiple and widely distributed in the abdomen, and the patients were clinically ill. The authors conclude that clinically symptomatic fluid collections develop postoperatively in approximately 5% of children who have undergone appendectomy for acute appendicitis and that the size and course of the fluid collection can be objectively monitored using sonography. Such fluid collections confined to the pelvis ultimately resolve with conservative, nonoperative therapy, although resolution may take up to 2 months. 相似文献
65.
66.
67.
AG Meldorf 《MedR Medizinrecht》2004,22(5):274-275
Ohne Zusammenfassung 相似文献
68.
AG Detmold 《MedR Medizinrecht》2003,21(6):351-352
Ohne Zusammenfassung 相似文献
69.
AG Affleck SM Littlewood 《Journal of the European Academy of Dermatology and Venereology》2005,19(3):360-363
INTRODUCTION: The diagnosis of adult-onset Still's disease (AOSD) can be very difficult. There are no specific tests and reliance is usually placed on a symptom complex and the well described typical rash seen in most patients. In recent years, however, other cutaneous manifestations of AOSD have been reported but these are not so well known. OBSERVATIONS: We report a patient with urticaria and fixed plaques and review the other 'atypical' cutaneous findings associated with AOSD. CONCLUSIONS: The diagnosis of AOSD can be made in the absence of the typical Still's rash but in the presence of other atypical cutaneous features. 相似文献
70.
AG Hamburg-Blankenese 《MedR Medizinrecht》2005,23(10):607-609
Abstrakt Ein Vertragsarzt darf seine psychotherapeutischen Leistungen bis zur H?he der EBM-Betr?ge bei dem Kassenpatienten liquidieren,
wenn die Krankenkasse die erforderliche Zustimmung versagt und der Patient in Kenntnis der Ablehnung die Therapie fortführt.
(Leitsatz des Bearbeiters) 相似文献