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Biomedical subjects

D Kodlin

Publications and source records attributed to D Kodlin.

14 recordsLinked to original sources
PubMed1981

Instability of immunoglobulins and complement (C3) as predictor of renal allograft rejection.

Ten renal allograft recipients were studied for a period of three months with weekly measurements of serum complement C3 including a baseline value before transplantation. Immunoglobulins (IgG, IgM, IgA) were studied in nine of these patients. Fifteen rejection episodes occurred, three patients losing their graft because of irreversible rejections. The patients were followed for 2.5 years. The degree of of change in serial C3 and immunoglobulin levels from baseline was determined by variability index s. Fourteen out of 15 rejections were preceded by si (C3) greater than .1, one to several weeks in advance. The si (Ig) was useful in week 1 and predicted the rejection missed by si (C3). We conclude that instability of immunoglobulins and complement as measured by s is not only associated with rejections but appears to be a precursor to rejection events. We suggest the following prognostic two-step procedure: (1) Week 1: If either si (C3) or si (Ig) greater than .1, predict rejection. (2) Cases that pass step 1 are monitored by C3 at weekly intervals. As soon as si (C3) greater than .1, predict rejection.

Complement C3↗
PubMed1980

Predictive value of serum complement (C3) in renal allograft rejection.

The purpose of this study was to investigate whether or not changes in serum concentrations of complement component C3 are of value in predicting the long term survival of the transplanted kidney. C3 was quantitated by radial immunodiffusion in fresh sera drawn immediately before transplantation and twice weekly thereafter from 10 recipients. Fourteen episodes of acute rejection occurred during the first 3 months postoperatively. These were diagnosed by the demonstration of graft tenderness, fever without evidence of infection and a rise in serum creatinine of 1 mg/dl in the absence of urinary or vascular obstruction. Five rejection episodes in 3 patients were associated with a fall in C3. In one of these patients, C3 returned to normal levels after the episode was reversed, and the kidney is functioning well 2 years after transplantation. In the other 2 patients, C3 remained at low levels regardless of anti-rejection therapy. Transplant nephrectomy was soon required for irreversible rejection. In contrast, only 1 episode unaccompanied by a fall in C3 was irreversible. Evidence is provided concerning the value of serial C3 complement determinations as a predictor of rejection in renal allografts. Using the variability measure Si, the cumulated standard deviation up to week i, Si > 10 not only predicts rejection but does so rather early, providing more than 90 per cent of the ideal lead time. This suggests that loss of a graft may be predicted, but this needs confirmation in additional cases.

Complement C3↗
PubMed1978

Reserpine and breast cancer.

After a series of studies on the linkage of reserpine with breast cancer, both evidence and interpretation appeared to be in conflict. Our case-control survey of long-term, comprehensive records from the Kaiser Foundation Medical Care Program, on 108 hypertensive breast cancer cases and 324 hypertensive controls, matched by year of birth and by race, produces a significant positive association between reserpine use and breast cancer. However, the association vanishes upon further matching with respect to the year of the first hypertension diagnosis and the subsequent length of follow-up. We thus fail to support suspicions of causality.

Age Factors↗
PubMed1978

Simulation experiments of tumor measurement in clinical trials.

A simple model of tumor growth involving stochastic growth factors as well as measurement errors in explored in the context of a simulated "clinical trial" comparing two treatments. The model shows how treatment effects on tumor growth translate themselves into "improvement rates" derived from measurement on diameters. Furthermore, it shows that treatment contrasts of considerable magnitude (such as doubling of mass or volume versus shrinkage to one half) may escape recognition in clinical trials. A number of "power" tables are presented that provide the probability of making correct judgments of treatment effects. The tables indicate that the actual power in trials of this nature is in satisfactory agreement with that claimed in the standard power tables which are currently used in guiding trial strategy based on improvement rates.

Clinical Trials as Topic↗
PubMed1977

Chronic mastopathy and breast cancer. A follow-up study.

Over an average period of seven years 2,9000 cases of benign breast lesions diagnosed by biopsy between 1948 and 1973 in the Department of Pathology, Kaiser Foundation Hospital, Oakland, were followed for breast cancer development. When classified according to traditional diagnostic categories, the cancer incidence per 1,000 person-years varies between 2.7 and 7.9 and appears to be elevated in comparison to expectations obtained from the Third National Cancer Survey, San Francisco Bay Area. Two thousand four hundred biopsies were also scored by the Black-Chabou method. There is an upward trend in the breast cancer incidence as the atypia score rises, a finding which confirms conclusions from a retrospective case-control study by Black et al.

Adenofibroma↗
PubMed1977

Expression and function of I region products on immunocompetent cells. II. I region products in T-B interaction.

The anti-Lac B precursor cells from BALB/c (H-2)d mice which survive cytotoxic treatment with anti-Iak and complement will respond to Lac-KLH in culture but require more KLH helper T cells than unselected B cell populations or B cells surviving anti-Ig killing. These findings are not explainable by the classical Poisson assumption of a constant target of T-B ionteraction. We propose a T-B interaction theory with variable Ia target on the B cell surface. The theory quantitatively predicts the observed dose response relationships, and implies that Ia molecules on B cells are cell interaction structures.

Animals↗
PubMedDate not supplied

Steroid treatment for routine immunosuppression in cadaver renal transplantation. A survey of hospitals.

A review of data from 22 hospitals in the U.S. and Canada, comprised of information on 1700 kidney transplant patients, shows a consistent pattern with respect to usage of steroids both as routine treatment and for rejection episodes. High doses are associated with greater patient mortality. Graft survival is also adversely affected by very high doses, but only in the immediate post-transplant period. Our data suggest that for optimal graft and patient survival the dosage of steroids should be less than 150 mg/day of methylprednisolone on days 1-3, less than 50 mg/day of prednisone on days 4-21, less than 30 mg/day on days 22-30, and less than 20 mg/day between one mo and one yr.

Cadaver↗