Chronic Epstein-Barr virus infection and human immunodeficiency virus infection.
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Biomedical subjects
Publications and source records attributed to B Emmerich.
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The value of computed tomography in the assessment of subdiaphragmatic spread was studied prospectively in 72 patients with so far untreated, histologically confirmed Hodgkin's disease. In 17 patients (23.6%) computed tomography (CT) diagnosed subdiaphragmatic involvement, with no false-positive results. In 55 (76.4%) CT was within normal limits. In 30 patients exploratory laparotomy gave false-negative results in 7 (23.4%). The causes of false-negative results in CT are that lymph-nodes which were not enlarged but involved were not demonstrated and spleen involvement was not identified. Including those correctly positively diagnosed cases (17), CT had a sensitivity of 70.8% and a false-negative rate of 29.2%. It is concluded that when CT is within normal limits only exploratory laparotomy can with certainty exclude subdiaphragmatic involvement.
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The results of cytogenetic analyses of bone marrow and peripheral blood cells in a 67-year-old male with chronic eosinophilic leukemia (EL) are described. Although the patient showed leukocytosis with marked eosinophilia, initial chromosome findings in bone marrow revealed a normal male karyotype. Seven months later, more than 80% of bone marrow cells had a hyperdiploid karyotype (48,XY, +7, +8), the remaining cells being normal. Seven weeks later, the identical abnormal karyotype was observed in about 30% of banded metaphases of stimulated peripheral blood cells. No mitoses were found in unstimulated cultures. No Ph chromosome was observed. So far, trisomy 8 has been described for only two cases of EL, whereas trisomy 7 has never been observed.
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The case of a patient with erythrocyte pyruvate kinase (PK) deficiency hemolytic anemia leading to extramedullary hematopoiesis in a paravertebral myelolipoma is presented.
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Glycoproteins of leukemic cells and 24-hour urinary proteins were subjected to SDS polyacrylamide gel electrophoresis followed by affinity labelling I125 with Concanavalin A, indicating glycoproteins with mannose and/or glucose carbohydrate residues. Among the cellular glycoproteins a 41 000 dalton glycoprotein appeared under induction therapy in close correlation to the reduction of leukemic cells in ALL as well as in AML.
Plasma cells are occasionally encountered in peripheral blood during fibrinolytic treatment with streptokinase. Leukaemoid plasmocytosis and increase of immunoglobulins were observed in a 44-year-old patient in connection with streptokinase treatment. Mature stages of plasma cells could be demonstrated in peripheral blood. The observed phenomena are considered as exaggerated immune response to foreign protein. They are of no disease value as they are only concomitant reactions to streptokinase treatment. Spontaneous regression occurred.
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A case of hairy-cell leukemia in which protein synthesis by the leukemic hairy cells could be followed-up before and after splenectomy is presented. After splenectomy a remarkable reduction of initially enhanced protein synthesis was found. This observation supports the view that the splenic microenvironment has an important influence on the proliferative activity of hairy cells.
A case involving a 67 year old man with an immunocytoma initially presenting as Waldenström's macroglobulinemia which transformed into a high grade malignant lymphoma of immunoblastic type after treatment with cyclophosphamide and corticosteroids over 5 months is presented. IgM (kappa) present in the serum in the phase of immunocytoma was demonstrated also on the less differentiated cells of the high grade lymphoma. The permanent production of the same immunoglobulin molecule suggests that both morphologically different malignancies derived from one B cell clone.
In a phase I study on the toxicity and toleration of alkyllysophospholipids, tumor and leukemia responses have been noted in the first treated patients. Six patients with solid malignomas of different histologic types and one patient with acute myeloid leukemia are evaluable so far. All of them suffered from metastatic or wide-spread disease, were refractory to adequate polychemotherapy or other treatment modalities, or have been found untreatable because of poor general condition. Four cases revealed objective tumor and leukemia response with a minor response in a hypernephroma, two partial remissions in nonsmall cell bronchogenic carcinomas and reduction of leukemic blasts to less than 10% in acute myeloid leukemia. Limiting toxicity started with doses of 20 mg/kg given daily showing transient injury of renal and liver functions.
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