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71.
72.
A large-scale, randomised, multicentre single-blind clinical trial was conducted to assess the comparative efficacy and tolerance of ofloxacin, trimethoprim and co-trimoxazole in the treatment of uncomplicated urinary tract infection in general practice. A total of 1,069 patients from 76 centres across the UK were enrolled in the study, and randomised to one of the following treatment groups: ofloxacin (200 mg od), trimethoprim (200 mg bd) or co-trimoxazole (trimethoprim 160 mg and sulphamethoxazole 800 mg bd). Each patient received five days of medication. Clinically, ofloxacin was as effective as trimethoprim and co-trimoxazole. However, the bacteriological cure rate was significantly better for ofloxacin, with eradication of the initial causative pathogen by the end of treatment in 92% of patients in the ofloxacin group, compared with 81% for trimethoprim and co-trimoxazole (P = 0.0002). There was also a lower relapse rate for ofloxacin. Ofloxacin was well tolerated: adverse events were reported by 67 (12.4%) patients in the ofloxacin group, compared with 48 (18.7%) patients in the co-trimoxazole group and 37 (13.6%) patients in the trimethoprim group. Ofloxacin can therefore be considered a suitable alternative for the treatment of uncomplicated urinary tract infection. 相似文献
73.
Jun-Xiao Zhang Lei Fu Richarda M de Voer Marc-Manuel Hahn Peng Jin Chen-Xi Lv Eugène TP Verwiel Marjolijn JL Ligtenberg Nicoline Hoogerbrugge Roland P Kuiper Jian-Qiu Sheng Ad Geurts van Kessel 《World journal of gastroenterology : WJG》2015,21(14):4136-4149
AIM: To investigate whether whole-exome sequencing may serve as an efficient method to identify known or novel colorectal cancer(CRC) predisposing genes in early-onset or familial CRC cases.METHODS: We performed whole-exome sequencing in 23 Chinese patients from 21 families with nonpolyposis CRC diagnosed at ≤ 40 years of age, or from multiple affected CRC families with at least 1 firstdegree relative diagnosed with CRC at ≤ 55 years of age.Genomic DNA from blood was enriched for exome sequences using the Sure Select Human All Exon Kit, version 2(Agilent Technologies) and sequencing was performed on an Illumina Hi Seq 2000 platform.Data were processed through an analytical pipeline to search for rare germline variants in known or novel CRC predisposing genes.RESULTS: In total, 32 germline variants in 23 genes were identified and confirmed by Sanger sequencing.In 6 of the 21 families(29%), we identified 7 mutations in 3 known CRC predisposing genes including MLH1(5 patients), MSH2(1 patient), and MUTYH(biallelic, 1 patient), five of which were reported as pathogenic.Inthe remaining 15 families, we identified 20 rare and novel potentially deleterious variants in 19 genes, six of which were truncating mutations.One previously unreported variant identified in a conserved region of EIF2AK4(p.Glu738_Asp739insA rgA rg) was found to represent a local Chinese variant, which was significantly enriched in our early-onset CRC patient cohort compared to a control cohort of 100 healthy Chinese individuals scored negative by colonoscopy(33.3% vs 7%, P 0.001).CONCLUSION: Whole-exome sequencing of early-onset or familial CRC cases serves as an efficient method to identify known and potential pathogenic variants in established and novel candidate CRC predisposing genes. 相似文献
74.
Induction of NK activity in large granular lymphocyte leukemia: activation with anti-CD3 monoclonal antibody and interleukin 2 总被引:4,自引:0,他引:4
Large granular lymphocyte (LGL) leukemia is a rare disease characterized by clonal expansion of LGL associated with chronic neutropenia, multiple auto-antibodies, and occasionally polyarthritis. We studied cell surface antigen expression and functional activity of leukemic LGL from ten such patients. Using two-color flow cytometric analysis, we found that leukemic LGL from all ten patients expressed the CD3 and HNK-1 markers, while cells from only four patients expressed IgG Fc receptors (FcR). The LGL leukemic cells had little or no NK activity (defined as MHC-nonrestricted cytotoxicity against K562 target cells); however, NK activity could be induced in leukemic LGL by in vitro treatment with as little as 0.05 microgram/mL of anti-CD3 monoclonal antibody. Cell sorting experiments demonstrated that NK activity was induced in CD3+ leukemic LGL (either CD3+, HNK-1+ or CD3+, FcR+) with anti-CD3 monoclonal antibody but not in normal CD3+, FcR- T cells. Treatment with purified interleukin 2 (IL 2) also caused direct activation of some CD3+ leukemic LGL. Despite induction with anti-CD3 MAb or IL 2, activated leukemic LGL did not proliferate or express high density IL 2 receptors detectable by cell sorter analysis. Treatment with alpha interferon had minimal effect on NK activity of LGL leukemic cells. These results suggest that leukemic LGL may provide a useful model for examining the signals required for LGL maturation and activation. 相似文献
75.
Steven Goldberg M.D. Seymour Katz M.D. James Naidich M.D. Jerome Waye M.D. 《The American journal of gastroenterology》1984,79(4):304-307
Isolated bleeding gastric varices due to a spontaneous idiopathic thrombosis of the splenic vein was found to be the cause of obscure, painless recurrent bleeding in our patient. The diagnosis of spontaneous splenic vein thrombosis should be considered in the presence of gastrointestinal bleeding with unexplained splenomegaly. Prominent gastric folds may be the only barium contrast or endoscopic finding often lacking esophageal varices. Arteriography is essential in demonstrating an obstructed splenic vein. Splenectomy is the treatment of choice of "left-sided" portal hypertension. 相似文献
76.
CD3+ large granular lymphocyte (LGL) leukemia is a disease of unknown etiology characterized by clonal proliferation of T cells that usually express T-cell receptor (TCR) alpha beta heterodimers. The purpose of this study was to identify the variable (V), joining (J), and diversity (D) region TCR beta-chain genes expressed by CD3+ LGL leukemic cells in an attempt to gain insights into the etiology of this disorder. Twelve patients with LGL leukemia were studied, including seven with both LGL leukemia and rheumatoid arthritis (RA). RA is also a disease of unknown etiology that occurs frequently in patients with LGL leukemia. Clonally expanded T cells that express specific TCR V beta genes have been identified in fluid and tissue specimens from the joints of patients with RA. In this study, V beta expression was determined by PCR using a panel of 22 unique V beta primers to amplify cDNA prepared from peripheral blood mononuclear cells (PBMC). A dominant V beta gene product was readily apparent in all patients. To confirm that the dominant V beta gene originated from a clonal expansion, DNA fragments corresponding to the dominant V beta genes were subcloned into plasmids and independently isolated recombinants were sequenced. V-D-J region sequences that occurred repeatedly indicated clonality. The V beta and J beta genes expressed by the leukemic cells showed a pattern of distribution that followed the frequency with which these genes are represented in the peripheral blood. The residues corresponding to the third complementarity-determining region of the TCR beta chain were different in all cases. A specific pattern of VDJ usage was not identified for those patients with both LGL leukemia and RA; however, utilization of V beta-6 by LGL clones (N = 3) was observed only in the setting of RA. These data suggest that leukemic CD3+ LGL cells have been clonally transformed in a random fashion with respect to the TCR beta chain. 相似文献
77.
This study examined the effects of cyclical etidronate, when used in
routine clinical practice, on the prevention of fracture. Information was
obtained from 550 general practices in the UK that provide their medical
records to the General Practice Research Database. A total of 7977 patients
taking cyclical etidronate treatment and 7977 age-, sex- and
practice-matched control patients with a diagnosis of osteoporosis were
analysed. People taking cyclical etidronate had a significantly reduced
risk of non-vertebral fracture (by 20%) and of hip fracture (by 34%)
relative to the osteoporosis control patients. The relative risk of
non-vertebral fracture was 0.80 (95% confidence interval 0.70-0.92), that
of hip fracture 0.66 (0.51-0.85) and that of wrist fracture 0.81
(0.58-1.14). When fracture incidence rates were compared between the two
groups, the rate of non-vertebral, hip and wrist fracture decreased
significantly (P < 0.05) with increasing etidronate exposure. The
results of this study complement and extend clinical observations
supporting the anti-fracture efficacy of cyclical etidronate therapy.
相似文献
78.
D E Weese-Mayer R T Brouillette T P Naidich D G McLone C E Hunt 《The American review of respiratory disease》1988,137(2):393-398
Central hypoventilation syndrome (CHS) is a disorder of respiratory control. It may be an idiopathic primary disease or it may be the secondary consequence of an infectious process or Chiari II malformation. Clinical data suggest that the primary defect involves the brainstem respiratory centers. To date, pathologic evaluation has linked primary CHS with decreased density of neurons and myelinated nerve fibers in the medulla and brainstem gliosis, and absence of the external arcuate nucleus. Magnetic resonance imaging (MRI) is now considered the most reliable imaging technique for evaluating the brainstem. In the hope of finding gross structural abnormalities that might correlate with the clinical and pathologic features of CHS, we used MRI and computerized tomography (CT) to evaluate the brain, brainstem, and spinal cord of 17 infants and children with central hypoventilation (11 primary, 6 secondary). Each of the 11 children with primary CHS demonstrated a normal brainstem and spinal cord by MRI. However, 9 of 11 infants had mild ventricular dilatation and modest prominence of the sulci interpreted as either mild atrophy or mild extraventricular obstructive hydrocephalus. Results of studies in the one child with postinfectious disease were normal. The 5 infants with Chiari II malformation demonstrated characteristic brainstem changes. MRI results modified clinical care, resulting in symptomatic improvement after hindbrain decompression by cervical laminectomy in 1 infant and surgical drainage of syringobulbia in 1 child. In summary, in primary CHS, the MRI and CT provided evidence for a more diffuse CNS process rather than a specific brainstem lesion. Such a lesion may be too small or too subtle to resolve with MRI or CT. In secondary central hypoventilation, MRI modified surgical management in 2 cases, resulting in symptomatic improvement of hypoventilation.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
79.
80.