Allogeneic hematopoietic stem cell transplantation (HSCT) is established therapy for selected patients with acute leukemia. After transplantation, antileukemic immune responses are believed to eliminate residual leukemia cells and decrease the likelihood of relapse. However, the clinical effect of successful antigen-specific immune reconstitution after HSCT on the likelihood of leukemic relapse and overall survival is not known. Pediatric recipients of unrelated cord blood transplants who underwent transplantation for acute leukemia were sequentially evaluated for their development of antigen-specific T-lymphocyte immunity to herpes viruses. The clinical effect of a positive antigen-specific response on relapse-free survival was determined. The presence of an antigen-specific response resulted in a relapse-free survival advantage (P = .0001), which was primarily due to a decrease in leukemic relapse (P = .003). Proportional hazards modeling for time to relapse and time to relapse or death defined 3 variables that were strongly associated with a poor outcome: female gender, poor remission status before transplantation, and negative antigen-specific T-lymphocyte proliferation. Notably neither acute nor chronic graft-versus-host disease had any effect on the incidence of leukemic relapse. Successful antigen-specific immune reconstitution after unrelated cord blood transplantation results in decreased leukemic relapse and improved overall survival. 相似文献
Public concern surrounding antibiotic contamination in food and food products has made it imperative to develop analytical methods for their detection. Polyclonal antibodies were used in the development of a surface plasmon resonance (SPR)-based inhibition immunoassay for cephalexin. A conjugate consisting of cephalexin-bovine serum albumin (BSA) was immobilized on the dextran gel surface of the sensor chip. Binding/regeneration studies of antibody to immobilized cephalexin were studied and dissociation of the antibody from the immobilized cephalexin was easily achieved with 10 mmol l-1 NaOH. Forty surface regeneration cycles were carried out and found to be reproducible with only a 7.4% decrease in binding over this number of regenerations. Model inhibition immunoassays for cephalexin were developed in PBS and spiked milk samples with detection ranges of 4.88 to 2,500 ng ml-1 and 244 to 3,906 pg ml-1, respectively. 相似文献
Screening for osteoporotic vertebral fractures traditionally involves X-ray of the thoracic and lumbar spine. We evaluated use of dual energy X-ray technology in patients with osteoporosis. We found this technology useful in the clinic setting and it has advantages in that less radiation is delivered to the patient. 相似文献
Critics of Kohlberg's moral theory today focus on the content of his theory and more specifically on its justice-orientated moral concept. This has led to the well-known 'justice-care debate'. The purpose of this article is to critically examine the validity of Kohlberg's moral theory for research in nursing ethics from a caring perspective (referring to the content) as well as from a cognitive-structural perspective (referring to the basic assumptions of the model). The analysis points to the usefulness and value of the cognitive-structural model to empirically study nurses' ethical behaviour; the content of Kohlberg's model, however, needs to be adapted by adding a caring perspective as well as some personal and situational variables. An adjusted version of Kohlberg's model is proposed and discussed. 相似文献
Our work concerned 15 patients (9 males, 6 females) with a mean age of 29.5 years, having a hematologic malignant disease and undergoing allogenic bone marrow transplantation.We studied :
1. The metabolic disorders induced by the conditioning regimen (chemotherapy and total body irradiation) pregraft accompanying cytolysis (day −7, −5, −2).
2. The corrective effect of a total parenteral nutrition introduced 2 days before the transplantation and pursued during 30 days post-graft (day −2 to day 30).
3. The interest of a high calorie intake (BEE × 2) and, after randomisation, of a variable nitrogen intake (24% of the total calorie intake for group A [8 patients] and 14% for group B [7 patients]). The patient characteristics of these two groups were closely comparable. Urinary parameters were studied daily (3-methylhistidine, cratinine, nitrogen) and blood parameters weekly (transferrin, pre-albumin, albumin, retinol binding protein).
We observed globally :
-- An excellent result of the nutritional support without significant weight loss;
-- protein catabolism stopped with a recovery of synthesis of RBP after day 7 and pre-albumin from day 7;
-- a decrease in muscle catabolism.
The randomized study showed :
-- a significant difference in nitrogen excretion between group A and group B;
-- earlier and better protein synthesis recovery in group A, particularly with regard to RBP and pre-albumin.
In conclusion, we recommend for the patients undergoing bone marrow transplantation :
-- nutritional support should be introduced before the conditioning regimen;
-- a high calorie intake (BEE × 2) with a nitrogen intake between 14% and 24% of the total calorie intake;
-- cyclic parenteral nutrition should be pursued during the second and third month post-graft.
Résumé
Nous avons étudié chez 15 malades (9 hommes, 6 femmes) d'âge moyen 29,5 ans, présentant une hémopathie maligne et nécessitant une greffe de moelle osseuse allogénique :
1. Les désordres métaboliques induits par la chimiothérapie et l'irradiation corporelle totale en période de prégreffe au cours de la cytolyse (J −7, J −5, J −2).
2. L'effet correcteur d'une nutrition parentérale introduite deux jours avant la greffe et exclusive durant les 30 jours post-greffe (J −2, J + 30).
3. L'intérêt d'un apport calorique élevé (BEE × 2) et, par randomisation, d'un apport azoté variable (24 % de l'apport calorique total pour le groupe A et 14 % pour le groupe B).
Nous avons étudié quotidiennement certains paramètres urinaires (3MeH, créatinine, azote) et les paramètres sanguins (transferrine, préalbumine, albumine, RBP) l'ont été de façon hebdomadaire.Nous avons constaté globalement un excellent résultat du support nutritif sans perte de poids significative, un arrêt du processus catabolique protéique avec reprise de synthèse après J +7 pour la RBP et pour la préalbumine et une réduction du catabolisme musculaire.L'étude randomisée a mis en évidence :
-- une différence statistique dans l'excrétion axotée, plus intense dans le groupe A,
-- une reprise des synthèses protéiques, plus précoce et plus performante dans ce même groupe pour la RBP et la préalbumine.
En conclusion et compte tenu de l'ensemble des éléments, nous préconisons chez ces malades devant subir une greffe de moelle osseuse allogénique :
-- une attitude préventive en ce qui concerne la nutrition à débuter avant le conditionnement,
-- un apport calorique élevé (BEE × 2) et un apport azoté situé entre 14 % et 24 % de l'apport calorique total,
-- une étude prospective quant à l'intérêt de certains acides aminés et d'une nutrition parentérale cyclique poursuivie au 2e et au 3e mois post-greffe.
Mots clés: greffe de moelle osseuse; nutrition parentérale totale; apport azotéKey-words: bone marrow transplantation; total parenteral nutrition; nitrogen intake 相似文献
The effectiveness of galactomannan detection with the Platelia test was evaluated in a prospective study of 3,327 sera from 807 patients. The specificity was 99.6% (748 of 751 cases). For the groups of patients with proven and probable invasive aspergillosis, the sensitivity was 50.0% (17 of 34 cases). The disappointing sensitivity associated with the presence of rare false-positive cases underlines the limits of this test. 相似文献
The 7th International Workshop on Human Leucocyte Differentiation Antigens (HLDA7) studied a number of newly characterised molecules relevant to human leucocyte differentiation and function. The HLDA organisation, which devised and continues to maintain the CD nomenclature, is responsible, under the auspices of IUIS and WHO, for the nomenclature of all leucocyte differentiation markers. The 7th Workshop redefined a number of (principally carbohydrate) molecules, and assigned CD names to approximately 80 new molecules. This update lists, in tabular form, the redefined and newly assigned names, together with antibodies, which have been confirmed under Workshop conditions as specific for the new and redefined molecules. The major features of the cellular expression patterns are summarised, and a LocusLink accession number provided to enable the reader to access more detailed information through http://www.ncbi.nlm.nih.gov/LocusLink. 相似文献
Examined the adjustment of 6- to 18-year-old children and adolescents(n = 38) 2 to 5 years postdiagnosis of brain tumor with respectto standardized measures of anxiety and depression; self-perceptions;and adaptive living skills. Child, mother, and teacher reportdata were used. Maternal adjustment (anxiety and depression,parenting stress) was also assessed. Children and adolescentssurviving brain tumors reported themselves to be generally withinthe normal range. However, maternal ratings of social problemswere higher than normative scores and significantly lower thannorms on social problems, scholastic competence, and communicationskills. Teacher ratings on the Teacher Rating Form were allwithin normal limits. Maternal adjustment measures were withinthe normal range, although the Parent-Child Dysfunctional Interactionsubscale of the Parenting Stress Index was elevated. No differencesin scores were found between children in regular and specialeducation, or between children who had received radiation andthose who did not. This sample of survivors of pediatric braintumors and their mothers had relatively mild problems in adjustment,supporting a competency-based view of the adaptation of pediatricpatients and their families. 相似文献