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61.
Pui CH; Ip SH; Iflah S; Behm FG; Grose BH; Dodge RK; Crist WM; Furman WL; Murphy SB; Rivera GK 《Blood》1988,71(4):1135-1137
The clinical significance of interleukin 2 receptor (IL2R) concentrations in serum was determined for 344 children with newly diagnosed acute lymphoblastic leukemia (ALL). Serum levels of IL2R in patients (267 to 80,000 U/mL, median 2,007 U/mL) were significantly higher than normal control values (170 to 738 U/mL, median 347 U/mL) (P less than .0001). Measurements in cases of T cell ALL were lower than in the non-T, non-B cases (P = .02). Among the 264 patients with non-T, non-B ALL, but not in those with T cell disease, higher serum IL2R levels (greater than 2,000 U/mL) were associated with a poorer treatment outcome (P = .04). In a multivariate analysis, serum IL2R level contributed independent prognostic information beyond that conveyed by leukocyte count, race, and age (P = .04). One explanation for these results is that soluble IL2R competes with normal lymphocyte- integrated IL2R for the ligand and thus could suppress host antitumor immunity. 相似文献
62.
A case of transcobalamin II (TCII) deficiency in which a total absence of TCII was demonstrated both functionally and immunologically is reported. Unlike previously described patients, this child has been maintained on oral hydroxocobalamin, 2 mg daily, without any parenteral supplementation for the last five years. At the age of six years her development is normal and her health is good. Plasma cobalamin levels are in the range of 3,000 ng/L and most of this appears to be bound to a molecule, which on gel filtration, elutes with albumin. In an extended family study, a clear separation of heterozygotes from both the propositus and from normal subjects suggests that the underlying defect in this condition is confined to a single gene. 相似文献
63.
64.
Axonal degeneration in diphtheritic neuropathy 总被引:1,自引:0,他引:1
65.
66.
67.
FG K?ln 《MedR Medizinrecht》2008,26(5):320-322
Abstrakt Bedient sich ein Arzt nicht nur vorübergehend der Mithilfe eines Berufskollegen, so erzielt er
Einkünfte aus Gewerbebetrieb, wenn er nicht eigenverantwortlich dessen T?tigkeiten überwacht
und wenn der Berufskollege auch nicht als Mitunternehmer t?tig ist. 相似文献
68.
van den Berg LH van den Berg JP Mathus-Vliegen EM Kampelmacher MJ van Kesteren RG Jennekens FG 《Nederlands tijdschrift voor geneeskunde》2004,148(11):513-518
Patients with amyotrophic lateral sclerosis (ALS) have symptoms of progressive muscle weakness, of disturbed speech and swallowing, and in the terminal phase those of respiratory weakness. Treatment options, in particular those for excessive weight loss and respiratory weakness, should be introduced to the patients and their families when the patient is emotionally capable and before dysarthria severely hampers communication. Special equipment for keeping the patient as mobile as possible should be made available much earlier than in the case of other diseases of the muscles as in ALS progression is much faster. Cramps, pathological crying or laughter, spasms, and spasticity can all be treated by medication. When speech can no longer be understood, adaptive strategies such as sign language, mime, posture and communication apparatus varying from a note pad to advanced computer systems can be used. Sialorrhoea, caused by difficulty swallowing with its accompanying danger of aspiration can be halted by the use of medication, by radiotherapy and by the injection into the salivary glands of botulin A toxin. Weight loss, also a result of dysphagia, can be avoided by eating frequent small meals or if necessary performing a percutaneous endoscopic or radiological gastroscopy. Excess mucus in the respiratory tract can be treated with anticholinergics. Difficulty in coughing up thick and sticky mucus cannot always be adequately helped. Respiratory weakness is treatable by external respiratory supportive therapy using a nasal mask, as well as invasive respiratory support via a trachcostoma and by treating the symptoms of respiratory weakness. The latter form of treatment is palliative and forms part of terminal care. During the terminal phase restlessness, anxiety, pain, and dyspnoea require the most attention. Treatment requires careful multidisciplinary cooperation. 相似文献
69.
The central nervous system in systemic lupus erythematosus. Part 1. Clinical syndromes: a literature investigation 总被引:5,自引:0,他引:5
OBJECTIVES: To establish the central nervous system (CNS) manifestations of systemic lupus erythematosus (SLE) as described in the literature and to compare the results with two previously published classifications. METHODS: Using PUBMED, a systematic search was performed for publications from 1980 onwards on CNS syndromes of patients with SLE. A distinction was made between CNS syndromes induced by SLE and the CNS autoimmune diseases associated with SLE. Criteria were defined for inclusion of CNS syndromes or diseases as SLE-induced or SLE-associated. RESULTS: The literature search yielded names of 30 syndromes and two diseases, but only 16 syndromes and one disease fulfilled the set of predefined criteria. Two syndromes-depression and anxiety-were predominantly psychological in origin in most patients; other syndromes were biological. DISCUSSION: Strengths and weaknesses of two classifications of CNS syndromes are evaluated. The older of the two is long and has not been accepted fully. Brevity is an advantage of the American College of Rheumatology (ACR) nomenclature system. A disadvantage of this system is the concealment of differences in health risks by the pooling of items. Furthermore, the items of the system do not all belong to the same dimension: one is pathological and the others are clinical. To remedy these drawbacks, we suggest the rephrasing and subdivision of items and that the predominantly psychopathological syndromes should be dealt with separately in epidemiological studies. CONCLUSIONS: SLE may induce 16 different clinical syndromes of the CNS and is occasionally associated with one other CNS autoimmune disease. A modification of the ACR nomenclature system is proposed. 相似文献
70.
Metabolism of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) by human cytochrome P4501B1 总被引:1,自引:1,他引:1
Cytochrome P4501B1 (CYP1B1) is the most recently identified member of the
dioxin-inducible CYP1 family. CYP1B1 is constitutively expressed in most
human tissues, including colon and breast, and can activate numerous
chemically diverse carcinogens. We evaluated the metabolism of the dietary
heterocyclic amine carcinogen 2-amino-1-methyl-6-
phenylimidazo[4,5-b]pyridine (PhIP) by microsomes from yeast expressing the
human CYP1B1 protein. PhIP metabolites were analysed by HPLC with
fluorescence and absorbance detection. We found that human CYP1B1
metabolizes PhIP to three products: N2-OH-PhIP, a mutagenic activation
product; 4'-OH-PhIP, a detoxification product; and 2-OH-PhIP, the mutagenic
potential of which is unknown. Metabolite identity was confirmed by
co-elution with authentic standards and synchronous fluorescence
spectroscopy. The identity of the 2-OH-PhIP standard was additionally
confirmed by mass spectrometry. Kinetic studies of the formation of
N2-OH-PhIP, 4'-OH-PhIP and 2-OH-PhIP by CYP1B1 indicated apparent Km values
of 5.7 +/- 1.3, 2.2 +/- 0.5 and 1.3 +/- 0.2 microM, respectively. Apparent
turnover rates were 0.40 +/- 0.03, 0.93 +/- 0.02 and 0.04 +/- 0.00 nmol
product/min nmol P450, respectively. At saturating levels of substrate,
CYP1B1-mediated formation of the non- mutagenic metabolite 4'-OH-PhIP was
favored two-fold over that of the mutagenic metabolite, N2-OH-PhIP and
>10-fold over that of 2-OH-PhIP. The formation of N2-OH-PhIP, a potent
mutagen implicated in the etiology of human colon and breast cancer,
indicates that CYP1B1 may play an important role in PhIP-mediated
carcinogenesis.
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