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1.
The second part of this review addresses the treatment and prognosis of the vasculitides Wegener's granulomatosis, microscopic
polyangiitis, Churg–Strauss syndrome and polyarteritis nodosa. Treatment regimens consist of an initial remission phase with
aggressive immunosuppression, followed by a more prolonged maintenance phase using less toxic agents and doses. This review
focuses on the initial treatment of fulminant vasculitis, the mainstay of which remains immunosuppression with steroids and
cyclophosphamide. For Wegener's granulomatosis and microscopic polyangiitis plasma exchange can be considered for first-line
therapy in patients with acute renal failure and/or pulmonary haemorrhage. Refractory disease is rare and is usually due to
inadequate treatment. The vasculitides provide a particular challenge for the critical care team. Particular aspects of major
organ support related to these conditions are discussed. Effective treatment has revolutionized the prognosis of these conditions.
However, mortality is still approximately 50% for those requiring admission to intensive care unit. Furthermore, there is
a high morbidity associated with both the diseases themselves and the treatment. 相似文献
2.
Thomas L. Patterson Shirley J. Semple Lydia R. Temoshok J. Hampton Atkinson J. Allen McCutchan Kristy A. Straits-Trster James L. Chandler Igor Grant 《Journal of Applied Biobehavioral Research》1993,1(1):64-87
The significance of life stress, coping, and social support was examined in relation to depressive symptomatology in a sample of 160 asymptomatic and mildly symptomatic HIV-antibody-positive (HIV+) men. The participants (mean age = 32 years) were interviewed about the life stress that they had experienced in the previous 6 相似文献
3.
Granulomatous Pneumocystis carinii pneumonia in a patient with the acquired immunodeficiency syndrome. 总被引:2,自引:2,他引:0
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A patient with an unusual granulomatous response to infection with Pneumocystis carinii is described. The diagnosis was made by open lung biopsy after two negative bronchoalveolar lavages. 相似文献
4.
Monaural inhibition in cat auditory cortex 总被引:13,自引:0,他引:13
5.
P Coni G Pichiri-Coni G M Ledda-Columbano E Semple S Rajalakshmi P M Rao D S Sarma A Columbano 《Cancer letters》1992,61(3):233-238
The present study was undertaken to determine the effect of two different types of liver cell proliferative stimuli, namely compensatory regeneration and direct hyperplasia on DNA synthesis of normal and preneoplastic isolated hepatocytes. Platelet-poor plasma (PPP) isolated from male Wistar rats treated with three different hepato-mitogens, lead nitrate (LN), cyproterone acetate (CPA) and ethylene dibromide (EDB), or subjected to surgical partial hepatectomy (PH), was tested for its ability to stimulate DNA synthesis in normal and preneoplastic hepatocytes in primary cultures. Induction of DNA synthesis was detected as early as 30 min after CPA, EDB and PH administration and persisted up to 5 days after the LN administration. In addition, hepatocytes isolated from preneoplastic liver nodules were also able to respond in culture to the DNA synthesis stimulus induced by these factors. 相似文献
6.
P F Goyer P M Schulz W E Semple M Gross T E Nordahl A C King T A Wehr R M Cohen 《Neuropsychopharmacology》1992,7(3):233-240
Positron emission tomography scans of nine patients diagnosed with summer seasonal affective disorder (SSAD) were compared with scans of 45 normal control subjects to investigate differences in brain glucose metabolism. All subjects performed an auditory discrimination task beginning several minutes before injection of F-18-deoxyglucose and continuing for 30 minutes after injection. Regional glucose metabolic rates were extracted from 60 rectangular regions of interest measured in five planes selected as atlas matches from 28 total slices. Statistically significant differences between patients with SSAD and normal control subjects were found in cerebral glucose metabolic rate and also in normalized regional glucose metabolic rates in the orbital frontal cortex and in the left inferior parietal lobule. 相似文献
7.
Sulfated beef insulin treatment elicits CD8+ T cells that may abrogate immunologic insulin resistance in type I diabetes.
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P Naquet J Ellis A Kenshole J W Semple T L Delovitch 《The Journal of clinical investigation》1989,84(5):1479-1487
The in vitro responses of T cells from 13 insulin-nonresistant and 1 immunologically insulin-resistant (IIR) type I diabetes patients to sulfated beef insulin (SBI) were analyzed. Insulin A-loop specific CD4+ T cells from these patients did not respond to SBI. After 1 yr of treatment with SBI the IIR patient's T cell and antibody responses to beef, pork, and human insulin progressed from very high to nondetectable levels. This occurred in parallel to the appearance of her insulin-specific CD8+ T cells, which inhibited the response of her A-loop-specific CD4+ T cells to insulin. A transient increase in her CD8+ anti-insulin antibody activity coincided with a relative lack of her CD8+ T cell activity. CD8+ T cells that regulate T cell responsiveness to insulin are probably present but difficult to detect in most type I diabetes patients. These T cells were identified in only 2 of 13 insulin-nonresistant patients who presented with lipoatrophy and insulin allergy, respectively, and who possessed high-titered, anti-insulin antibodies. Our data demonstrate that CD8+ T cells play an important role in controlling peripheral tolerance to insulin and may abrogate IIR in a diabetic patient treated with SBI. 相似文献
8.
9.
Chronic autoimmune thrombocytopenic purpura (ATP) is a common autoimmune-mediated bleeding disease in which autoantibodies are directed against platelets, resulting in their enhanced Fc-mediated destruction by macrophages in the spleen. While there has been extensive studies relating to the autoantibodies in this autoimmune disorder, relatively few have dealt with cell-mediated immunoregulation of the anti-platelet autoantibody response. Nonetheless, there is accumulating evidence that suggests the production of these anti-platelet autoantibodies is under the influence of several abnormal lymphocyte-mediated mechanisms, i.e. enhanced anti-platelet T helper cell activity with concomitant reduced T suppressor cell activity. This review focuses on these cellular events and presents a working model which attempts to explain their close interrelationships. 相似文献
10.