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Biomedical subjects

C R Tribe

Publications and source records attributed to C R Tribe.

At least 19 recordsLinked to original sources

Treatment of bladder carcinoma with tumor-immune pig lymph node cells. Phase I study.

A total of 77 patients with invasive TCC of the urinary bladder each received a single arterial injection of tumor-immune pig lymph node cells (LNC), into the tumor blood supply. The patients were divided into 4 groups: those receiving pig LNC as the only treatment (16 patients); those who received pig LNC on relapse (judged by EUA cystoscopy and biopsy) following radical radiotherapy, 5,500 cGy (34 patients); those who received pig LNC followed after an interval of six weeks by radiotherapy, 4,000 cGy (10 patients); as in Group 3 but with the dose of radiotherapy increased to 5,500 cGy (17 patients). Complete remission was characterized by complete disappearance of the tumor (for a varying time) following treatment. Partial remission was defined as: a reduction in the level of symptoms and a decrease in tumor size on EUA and/or cystoscopy. There were 1 complete and 3 partial remissions among the patients in Group 1, 5 complete and 7 partial in Group 2, 6 complete and 2 partial in Group 3, and 8 complete and 1 partial in Group 4. Of the 20 patients showing complete remission, 7 lived for more than five years after treatment.

Animals↗

Ten years' experience of an amyloid clinic--a clinicopathological survey.

The aetiology, clinical course and affected organs were studied in 124 patients with acquired systemic amyloidosis and seven patients with organ-limited amyloid deposits. Seventy-five patients had reactive systemic AA amyloidosis, which was associated with rheumatic disease in 55 and with chronic infection in 13 cases. Forty-nine patients had systemic AL amyloidosis. Thirteen of these cases were associated with myelomatosis and 11 with non-malignant immunocyte dyscrasias. In 25 patients with systemic AL disease no immunocyte dyscrasia was identified. Renal involvement dominated the clinical course of both forms of systemic amyloidosis, and renal failure was the most common cause of death. Gastrointestinal disturbance and hepatosplenomegaly were found in both AA and AL disease, although differences were noted in the distribution of amyloid protein within rectal biopsies. Amyloid cardiomyopathy, neuropathy and macroglossia were present in patients with AL amyloidosis only. These clinical patterns were reflected by tissue distribution at necropsy in 67 patients.

Adolescent↗

Amyloidosis and systemic lupus erythematosus.

A patient with systemic lupus erythematosus who developed reactive amyloidosis associated with high levels of serum amyloid-A protein (SAA) is reported. The possible relevance of elevated SAA levels in the aetiology of amyloidosis is discussed.

Amyloidosis↗

Glomerulonephritis, non-Hodgkin's lymphoma and leucocytoclastic vasculitis.

2 cases of active focal proliferative glomerulonephritis, lymphocytic malignant lymphoma and leucocytoclastic vasculitis are described. 1 presented with the nephrotic syndrome and progressive renal impairment, the other with acute renal failure. Cryoglobulins were detected in the serum of 1 patient, but not in that of the other. Initial renal and skin biopsies in the 2 patients were strikingly similar. As well as demonstrating glomerular lesions, the renal biopsies contained interstitial lymphomatous infiltrate which, in 1 case, was initially incorrectly interpreted and resulted in delay in specific treatment. Immunosuppressive therapy markedly improved renal function and induced remission of the vasculitis and lymphoma. Repeat renal biopsy in 1 case confirmed regression of the glomerulonephritis. A common immunological aetiology may explain the co-existence of these three conditions in the 2 patients.

Biopsy↗

Renal biopsy in the elderly: clinicopathological correlations in 143 patients.

The clinical presentation and spectrum of renal histopathology is described in 143 patients aged 60 years or more, with renal disease. In 82 patients renal biopsy revealed primary renal disease. In the remainder, changes associated with systemic conditions were found. These included amyloidosis, polyarteritis nodosa and hypertension. Fifty patients present with the nephrotic syndrome, one third of whom had a membranous glomerulonephritis on the renal biopsy. Three patients had a carcinoma associated with this renal histology. Two patients had a minimal change lesion and their nephrotic syndrome responded to corticosteroids. Renal biopsies from the 45 patients present with renal failure revealed a variety of histopathology which included idiopathic crescentic nephritis and antiglomerular basement membrane disease. Percutaneous renal biopsy is a valuable diagnostic aid in elderly patients with renal disease.

Age Factors↗

Localized amyloid of the ureter--case report and review of the literature.

An unusual case of localized amyloidosis of the ureter is described and a review of the 12 previously reported cases is presented. No case had been diagnosed prior to surgery. Loin pain, with or without haematuria, associated with a sterile pyuria and an abnormal pyelogram were the commonest clinical signs. In the case reported an incidental small renal cell carcinoma was also present and the association of amyloidosis and neoplasia is discussed.

Adenocarcinoma↗

The effect of bromhexine on experimentally induced diabetic nephropathy.

Diabetes was induced in male Wistar rats by a single i.v. injection of streptozotocin (40 mg/kg). Animals were treated with bromhexine at 2 dose levels (2.5 mg/kg/day and 25 mg/kg/day) for 13 months thereafter and compared to non-diabetic controls and untreated diabetic animals. Renal pathology showed a significant increase in glomerular volume and basement membrane thickening in untreated diabetic animals. The higher dose bromhexine treated diabetic animals showed a significant decrease in glomerular volume as compared with diabetic animals not given bromhexine.

Animals↗

Systemic vasculitis in a district general hospital 1972-1980: clinical and laboratory features, classification and prognosis of 80 cases.

Between 1972 and 1980 a histological diagnosis of vasculitis was made on 80 patients from a district general hospital. These were divided into a polyarteritis nodosa (PAN) group, a rheumatoid vasculitis (RV) group and a heterogeneous group of other vasculitides. There was considerable overlap between the clinical and laboratory features in the three groups. Non-specific symptoms (fever and myalgia), leucocytosis and eosinophilia were the most useful features for distinguishing PAN from the other two groups. Hepatitis B infection was rare (two patients) and hypocomplementaemia was a feature of RV but not of PAN. The overall mortality was similar in each group. However, in PAN deaths due to vasculitis were more common within six months of diagnosis. Features associated with a poor prognosis were renal impairment, cutaneous and intestinal vasculitis in PAN; and neuropathy, weight loss and histological evidence of vasculitis at rectal biopsy in RV. Cytoxic drugs combined with corticosteroids were associated with an improved prognosis compared with corticosteroids alone in the PAN group. Pulmonary involvement was associated with less severe renal disease but with a six month mortality similar to that in the whole PAN group. Systemic vasculitis is not uncommon in a district general hospital population. The overlapping clinical and laboratory features in different vasculitic diseases stress the problems in classification between PAN and other groups. Patients with systemic disease complicated by necrotizing arteritis have a severe, life threatening disease which may respond to aggressive cytotoxic therapy.

Adolescent↗

Rectal biopsy in the diagnosis of systemic vasculitis.

Vasculitis has been seen in rectal biopsies from 22 patients over a six year period. The most common finding was a necrotising vasculitis of small arteries, indistinguishable from that seen in polyarteritis nodosa (PAN). Sub-acute, chronic ("burnt out") and leucocytoclastic changes were also seen. Sixteen patients had vasculitis complicating rheumatoid arthritis (RA), 3 PAN and 3 overlap syndromes. Patients with RA and rectal vasculitis had a higher mortality, and a greater incidence of neuropathy than those with negative biopsies. An adequate biopsy is positive in 40% of patients with clinical vasculitis and RA but was only positive in one of a control series of 46 RA patients with no clinical vasculitis. Rectal biopsy in experienced hands is a safe, and repeatable procedure. It is useful as a "blind" biopsy site in the diagnosis of systemic vasculitis, especially that complicating RA. It can also be used for serial studies of the evolution of vasculitis. Serial sections of the entire biopsy may be required to reveal the vasculitis which is often focal in nature.

Adult↗