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Biomedical subjects

B Teklu

Publications and source records attributed to B Teklu.

At least 19 recordsLinked to original sources

Humoral immunodeficiency in T-cell chronic lymphocytic leukemia. An immunologic assessment.

The humoral antibody immunodeficiency in two patients with T-cell chronic lymphocytic leukemia (T-CLL) appeared to be the result of immunoregulatory abnormalities in the leukemic T-cell populations. Both patients had CD4+ CD45R+ "virgin" or suppressor-inducer T-CLL, but Patient 1 had hypogammaglobulinemia and Patient 2, immunoglobulin (Ig) M hypergammaglobulinemia. Although, CD25+ interleukin-2 (IL-2) receptors were present on leukemic T-cells of both patient, OKT9+ (CD71) transferrin receptors and OKT10 (CD38) activation antigens were found only on Patient 2's cells. Highly elevated amounts of IL-2 was secreted from phytohemagglutinin-stimulated and concanavalin A-stimulated T-cells in both patients. In Patient 1 with hypogammaglobulinemia, immune defects involve T-cells, first an intense suppressor activity on B-cell-induced IgM and IgG synthesis and, second, deficient production of B-cell growth factor (BCGF) and B-cell differentiation factor (BCDF). In Patient 2, highly elevated BCGF and IgM-specific BCDF was secreted by T-cells, a mechanism leading to IgM hypergammaglobulinemia in this patient. These studies stress the importance of BCGF and BCDF activity of leukemic T-cells in humoral antibody immunodeficiency disorders in T-CLL cases.

Aged

T cell malignancy in Richter's syndrome presenting as hyper IgM. Induction and characterization of a novel CD3+, CD4-, CD8+ T cell subset from phytohemagglutinin-stimulated patient's CD3+, CD4+, CD8+ leukemic T cells.

A patient is described, having Richter's syndrome and immunodeficiency with hyper IgM, who developed suppressor T cell lymphoma (CD3+, CD4-, CD8+) following untreated helper-suppressor T cell chronic lymphocytic leukemia (CD3+, CD4+, CD8+). The neoplastic T cells in both malignancies expressed interleukin (IL) 2 receptors but were deficient in typical CD2+ and CD5+ pan T antigens. Additionally, a large percentage of malignant lymph node T cells expressed HLA-DR+ activation antigens. In vitro immunoglobulin-production experiments demonstrated that the patient's leukemic blood T cells had an excess helper function for IgM synthesis but a suppressor function for IgG and IgA synthesis by normal B and T cells. The leukemic blood T cells demonstrated a poor response to phytohemagglutinin (PHA). A defect in IL 2 receptor expression was evident in PHA-stimulated leukemic blood T cells. Of interest was the observation that PHA stimulated the induction of a novel CD3+, CD4-, CD8+ T cell subset from patient's CD3+, CD4+, CD8+ leukemic blood T cells. These PHA-induced CD3+, CD4-, CD8+ T cell subsets produced an elevated proliferative response to PHA and concanavalin A, had a helper cell function for IgM synthesis and produced highly elevated amounts of IL 2.

Aged

Severe T lymphocyte immunodeficiency associated with hypogammaglobulinemia: defective lymphokine secretion but enhanced autologous mixed lymphocyte reaction.

The multiparameter immunologic study of T cells of a patient with acquired hypogammaglobulinemia was investigated, since he had a normal B-cell number and function. His peripheral blood lymphocytes were found to contain predominant CD4+ CD45R+ T cells with a clear deficiency of CD4+ CDw29+ as well as CD8+ T cells. His T cells proliferated in response to phytohemagglutinin (PHA) and pokeweed mitogen (PWM), but no immunoglobulin was secreted in PWM-induced patient's T-cell and normal B-cell differentiations. His T cells were also found to possess concanavalin A (Con A)-induced suppressor function when cocultured with normal T cells, as well as IgG-, IgA-, and IgM-specific suppressor function on PWM-induced normal T- and B-cell differentiations. The patient's T cells were found to secrete elevated amounts of interleukin-2 but failed to secrete two important B-cell stimulating factors, B-cell growth factor and B-cell differentiation factor, in response to PHA. An investigation of immunoregulatory T-cell function in the autologous mixed lymphocyte reaction (AMLR) and allogeneic mixed lymphocyte reaction (MLR) indicated that the patient's T cells produced an enhanced AMLR but were deficient in MLR. These results suggest that the abnormalities we have identified in this patient with hypogammaglobulinemia reflect an intrinsic defect of T cells in the humoral immune response to produce three major immunoglobulins.

Agammaglobulinemia

Bronchial asthma at high altitude: a clinical and laboratory study in Addis Ababa.

In a study designed to throw light on the natural history of asthma in Ethiopia, 91 patients living at 2500 metres and attending asthma clinics in Addis Ababa underwent spirometric and skinprick testing. Only eight had had symptoms of asthma before the age of 16. Sixty two had a history of allergic rhinitis and 16 had a family history of allergic rhinitis; 33 had a family history of asthma. In 30 cases asthma was worse from August to October. All patients had tried traditional remedies, usually without success; and all took modern drugs, oral combination bronchodilators being the most frequently used.

Adolescent

The use of sputum cultures in the evaluation of immigrants classified as tuberculosis suspects.

Because of possible deficiencies in the evaluation, based on symptoms and chest roentgenogram review, of new immigrants classified during the visa application process as tuberculosis suspects, a prospective (cohort) and a retrospective (case control) study were done to test the usefulness of routinely obtaining sputum specimens for culture in that setting. In the prospective study, 249 consecutive classified immigrants who were considered on the basis of clinical and roentgenographic findings to have nonprogressive tuberculosis submitted at least two sputums for culture: 13 (5.2%) had at least one culture positive for M. tuberculosis. Immigrants younger than 50 yr of age and refugees from Kampuchea and Laos had a fivefold to tenfold elevated risk of having a positive sputum culture. The cost per case detected of obtaining and processing sputum cultures was estimated to be +1,996 to +2,994. In the case-control study, 37 classified immigrants evaluated from 1981 through 1986 who had sputum cultures positive for M. tuberculosis even though they fulfilled clinical and roentgenographic criteria for nonprogressive tuberculosis served as control subjects. Several demographic, clinical, and roentgenographic factors were associated with an increased risk of being culture-positive: age younger than 50 yr, a positive tuberculin test, report of a cough, and a cavitary lesion on chest roentgenogram. The history of prior receipt of antituberculosis drugs was associated with having a negative culture, including a marked dose-response effect.

Asia, Southeastern

Peak expiratory flow in normal Ethiopian children and adults in Addis Ababa.

The peak expiratory flow rate was determined using the Wright peak flow meter in normal Ethiopian children and adults residing in Addis Ababa (altitude 2500 m). The sample studied was of 84 boys, 69 girls (4-17 years) and 177 men, 148 women (18-70 years). Normality was determined by history alone. Linear multiple regression analysis was used to construct prediction equations that depended upon height and age. The results serve as reference values specifically for Ethiopians residing at altitude. Comparison of the PEFR values determined in 47 Caucasians (22 males, 27 females) working in Addis Ababa, with those from a group of Ethiopians matched for age and height indicated that the mean PEFR was significantly greater in the Caucasians by 7.3% in males and by 8.2% in females.

Adolescent

Flexible fibreoptic bronchoscopy in Addis Ababa: a 4-year experience.

The paper describes a 4-year experience (August 1981 to July 1985) of flexible fibreoptic bronchoscopy (FFB) at Tikur Anbessa Hospital. Two hundred and eighteen bronchoscopies were done in 199 patients. There were 133 males and 66 females. The youngest patient was 14 and the oldest 70. FFB was done twice in 14 patients and three times in three patients. There were 27 primary pulmonary neoplasms, five secondaries, two tuberculosis, one interstitial fibrosis, one carcinoma of the larynx and five chronic inflammation. There was only one patient who developed haemoptysis after a transbronchial lung biopsy which resolved quickly. The flexible fibreoptic bronchoscope is a simple and useful tool to diagnose endobronchial lesions and also diffuse diseases of the lungs even in developing countries.

Adult

Lung biopsy with the high speed drill in a developing country.

The results of high speed air drill lung biopsy during 38 months in Addis Ababa is reported. Even though the diagnostic yield was only 49%, trephine lung biopsy has a place in the investigation of diffuse and accessible localised lesions of the lung. It has proved to be a relatively safe and simple procedure. Nineteen male and 20 female patients were studied and in addition eight postmortem specimens of lung tissue were included. The chest radiograph showed diffuse pulmonary infiltrates in 42 and localised in six, with diagnostic biopsy specimens in 20 and five respectively. Biopsy of the inferior lung in the lateral decubitus position in patients with diffuse lung lesions has yielded larger specimens than has routine biopsy performed in the sitting position. Since the only patient who developed appreciable haemoptysis was the single patient with chronic cor pulmonale, caution should be exercised in such cases. A chest radiograph is indicated after biopsy only when the clinical condition of the patient warrants it.

Adolescent

A critical appraisal of a rapid radiographic method of determining total lung capacity.

We have demonstrated that the total lung capacities of normal caucasian adults, can be satisfactorily estimated by means of a regression equation derived from a single set of three measurements taken from a specially exposed plain X-ray film of the chest. However, these equations differ from those found by workers who have studied patients with lung disease. It is concluded from this that different regression equations are to be expected for normal and diseased lungs, and that, the appropriate equation will depend not only on the presence of disease, but also on its type and severity. It is also concluded that the rapid radiographic method of estimating total lung capacity can make little contribution to the diagnostic assessment of lung disease. However, the regression equations appropriate to particular ethnic groups could be used to measure TLC in normal subjects rapidly and inexpensively in places where specialised respiratory equipment and trained personnel are lacking.

Adult

Glucose and insulin homeostasis during the Jarisch-Herxheimer reaction.

Plasma concentrations of glucose and insulin were measured in ten patients during the Jarisch-Herxheimer reaction of tetracycline-treated louse-borne relapsing fever. Plasma glucose fell significantly in eight of the ten patients associated with the peak of the reaction, but plasma insulin remained low. Glucoregulation by insulin was therefore normal. This evidence questions the role of macrophage mediator-induced pancreatic insulin release in causing hypoglycaemia in borreliosis or bacterial endotoxicosis.

Adolescent