Erosion of the duodenum by a biliary T-tube: an unusual complication of liver transplantation.
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Biomedical subjects
Publications and source records attributed to A Mir.
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OBJECTIVE: To investigate the effect of short-term glucocorticoid administration on embryotoxicity of sera from infertile patients with mild to moderate endometriosis. DESIGN: Prospective longitudinal study. SETTING, PATIENTS: Eight infertile patients with mild to moderate endometriosis and a control group of eight infertile patients with tubal infertility were selected on the basis of laparoscopic examination. INTERVENTIONS: Basal (B) serum collection and day 1 (T1), day 3 (T2), day 6 (T3), and day 12 (T4) serum drawn after a 3-day glucocorticoid treatment in endometriosis patients. MAIN OUTCOME MEASURE: Embryotoxicity of endometriosis sera, before and after glucocorticoid treatment, was investigated using a bioassay performed on two-cell mouse embryos. Interleukin 1 alpha (IL-1 alpha) and antismooth muscle, antimitochondrial, and antinuclear autoantibodies were also tested in these sera. RESULTS: At 50% concentration, endometriosis serum is embryotoxic in comparison with control; 0% versus 61% of the embryos reached the blastocyst stage at 72 hours, respectively (basal versus control, P less than 0.001). However, this embryotoxicity significantly decreases 12 days after glucocorticoid treatment in comparison with untreated sera; 32.4% versus 0% of the embryos reached blastocyst stage at 72 hours, respectively (T4 versus basal, P less than 0.001), although they did not reach nontoxic levels (greater than 50%). Interleukin 1 alpha was undetectable in all samples analyzed. In endometriosis sera, antismooth muscle antibody was detected. CONCLUSIONS: At 50% concentration, serum from infertile patients with minimal to moderate endometriosis appears to be embryotoxic to the in vitro development of two-cell mouse embryos. However, this embryotoxicity significantly decreases 12 days after a 3-day treatment with glucocorticoids.
Between 1985 and 1989, 16 patients under anticoagulant therapy developed a haematoma in the psoas or iliac muscle, 60% of them with a severe femoral nerve entrapment syndrome. Six patients were operated, all with a femoral nerve paralysis, and 5 of them had a quick and complete recovery. Only one still has some complaints in the femoral nerve territory. Among the 10 patients with a nonoperative approach, none of those with a femoral nerve paralysis was completely cured at 6 months. The surgical treatment is the best way to a quick recovery, provided it is done at an early stage.
Thoracic trauma is uncommon in children. It should not be managed any more as adult's trauma. We present our experience with 85 children form 1 to 16 years of age, presenting severe thoracic trauma treated in Lausanne, Switzerland, between 1976 and 1990. The specific features of diagnosis, treatment and outcome are presented. Most of them were involved in traffic accidents (62%), 55% had multisystemic injuries. The mortality rate was not a function of the Injury Seventy Score as in adults, but was only related to the Glasgow Score. Only 3 patients (3.5%) had hemodynamic instability on admission in relation with their thoracic injury. Patients with intrathoracic lesions showed dyspnoea (65%), cyanosis (25%), or clinical suspicion of a pleural effusion or a pneumothorax (47%). However 12 children had an asymptomatic severe thoracic injury. In 53 patients (62%) the auscultation was found abnormal either with absent or diminished breath sounds or other pathological findings. 10 out of 26 cases of pneumothorax could be suspected by percussion dullness. Chest X-rays showed a lesion in 76% of cases. Only 30% of the pneumothorax were associated with visible rib fractures. 10 children suffered from 4 to 12 fractures of the ribs (mean 6.6). None of these patients presented a flail chest as in adults, even when multiple rib fractures existed. 31 thoracic drainages were performed, during a mean period of 3.3 days. 30 patients were intubated and ventilated, 22 of these due to a neurosurgical condition. All patients had physiotherapy starting on day 2, under analgesia if necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
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We have obtained mannans from four Candida species: C. albicans A, C. albicans B and C. tropicalis; anti-mannan sera against C. albicans A, C. albicans B and C. tropicalis were obtained by immunizing rabbits subcutaneously with the respective yeast extract. The efficacy of these sera in reacting with mannans obtained from three Candida sp. has been proven by indirect ELISA-inhibition. Any of three immune sera can be used to detect mannan antigen from the three Candida sp. tested. This confirms the existence of crossed reactivity and the possibility of detecting mannan antigen in serum from patients infected by different Candida sp., although we had only one immune serum and one Candida mannan.
In vitro CR1-dependent phagocytosis of C3b-coated erythrocytes, by monocytes and PMN, was found to be significantly decreased in SLE patients. This was in many cases related to a specific defect of CR1 receptors, since the FcR-ingestion of EIgG was normal. On the other hand, CR1 levels of PMN stimulated by FMLP were also found to be decreased in SLE patients, while both the expression of circulating PMN (cells isolated at 4 degrees C) and the total cellular CR1 content were normal. On the basis of the available data, we propose that the impaired phagocytosis is due to a functional defect of CR1 or a defective anchorage of the receptor to the plasma membrane, possibly related to the decreased capacity of CR1 to be up-regulated by FMLP. To study the importance of the genetic background in the CR1 abnormalities, the families of 22 young SLE patients, in which the onset of the disease had occurred before the age of 15, were studied. The expression of CR1 on erythrocytes, and the total CR1 content of PMN, in parents and siblings of these patients did not differ significantly from normal controls. By contrast, the ingestion of EIgGC3b by PMN from healthy relatives of these patients was decreased (65% of the normal mean of PI), while EIgG phagocytosis was normal. A relation between this CR1 functional defect and the familial occurrence of autoimmune disorders is therefore possible.
Upon incubation at 37 degrees C with purified human C3b (500 micrograms/ml), polymorphonuclear neutrophils (PMN) were found to express up to 50% more C3b receptors (CR1) than PMN incubated with buffer alone. This up-regulation of CR1, assessed by the binding of radiolabeled CR1-specific monoclonal antibody, was dependent on the dose of C3b, occurred within 10-20 min and was stable for at least 90 min. PMN incubated with C3b also demonstrated enhanced CR1-dependent binding functions, such as EC3b rosette formation and phagocytosis of EIgGC3b particles. C3b at a concentration of 500 micrograms/ml induced up to 90% increase in the attachment or the phagocytic index. However, CR1 remained unable to promote phagocytosis of EC3b intermediates. Fc receptor-mediated functions were unaffected by the treatment with C3b. The active factor was characterized as monomeric C3b and, in particular, shown to be distinct from C5a. C3b purified by anion-exchange fast protein liquid chromatography on a Mono Q column or eluted from a monoclonal anti-C3b-Sepharose retained its modulating activity, while native C3 or C3 fragments such as iC3b, C3c or C3d,g were ineffective.
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Antigens of different origins were used in the investigation of anti-Candida albicans antibodies. This can influence the results obtained. We have assayed three different antigenic preparations weekly for 8 weeks in the study of anti-C. albicans antibodies induced by cutaneous, digestive, and systemic inoculations with C. Albicans ATCC 26555 in rabbits free of specific antibodies, and using indirect immunofluorescence (IIF), direct agglutination (DA) and counterimmunoelectrophoresis (CIE) as serological methods. In IIF and DA, two antigens were used (C. albicans ATCC26555 and C. albicans NCPF3153). In CIE we also used a third commercial antigen. All three somatic antigens were used at three different concentrations. Using IIF and DA the titres obtained with both antigens were similar in different inoculations. The IIF was somewhat earlier in the detection of antibodies, and the titre reached was higher when the antigen used was obtained from the inoculated strain. The detection of precipitins by CIE was in most cases only positive with the antigen obtained from the homologous strain, the highest level being reached in the systemic inoculation.
Candida albicans colonization induces antibodies, which must be taken into account in the serological diagnosis of candidiasis. In order to determine the degree of this effect, an experimental study in rabbits free of specific anti-Candida antibodies by cutaneous and digestive inoculation has been carried out. The evolution of humoral response was studied over 8 weeks by indirect immunofluorescence (IIF), direct agglutination (DA), counterimmunoelectrophoresis (CIE) and double diffusion (DD). The cutaneous colonization detectable by culture was maintained until the second week in 70% of the animals and the presence of antibodies detectable by IIF and DA was observed after the 2nd week. The highest antibody titre by IFF and DA was 1/64, and was reached in the 5th week, with a tendency to drop in the following weeks. Precipitins were only detected by CIE in 15% of the animals in the 7th week. Elimination of yeast in stools continued only in 20% of the animals in the 2nd week of the experiment. Antibodies were detected by IIF and DA after the 2nd week, with the highest titres detectable by IFF in the 5th week. Precipitant antibodies detectable by CIE appeared in 15% of the animals in the 8th week.
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Caryopses and isolated embryos from Rice (Oryza sativa L.) and Tobacco seeds (Nicotiana tabacum L. variety Xanthi) were studied in the Biobloc III container aboard the Soviet orbital space station SALYUT 7. The recovery from radiation damage under conditions of space flight was observed for rice caryopsis and embryos gamma irradiated (Co 60, 50 grays) prior to launch. There was a large decrease in the percentage of germinating seeds from the Tobacco strain tested when the seeds were exposed to heavy ions. Among the germinating plantlets there were few morphological anomalies. Furthermore, there was a significant greater amount of genetic change in those samples held in grids as compared to those in bags.
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