Immunologic basis of preeclampsia and eclampsia.
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Biomedical subjects
Publications and source records attributed to G Simpson.
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A computerized drug-review system both reviews drug orders and notifies clinicians of orders that are considered exceptions to some clinical guidelines. The impact of this system in a psychiatric center in which it has been used since December 1975 is examined in terms of the reduction of the percentage of orders of psychotropic drugs that involve polypharmacy or dose-range exceptions. The results show a substantial reduction in orders in exception since the implementation of the system.
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Fulminant aspergillosis of the nose and paranasal sinuses represents a new clinical entity occurring in individuals with depressed immunological responses. It is marked by a rapid malignant course, requiring early recognition, aggressive surgery and chemotherapy. Clinical manifestations include a rapidly progressive gangrenous mucoperiostitis advancing relentlessly to destruction of the nasal cavity and the paranasal sinuses within a few days. The recent emergence of this form of aspergillosis appears to be directly related to the increased intensity of chemotherapy and immunosuppression in the treatment of previously fatal neoplastic diseases. Control of this disease process requires aggressive therapy. This may include radical sinus ablation, debridement of nasal structures, chemotherapy and possible correction of immunological deficits, i.e., bone marrow transplantation. Four cases are discussed in detail to present the clinical spectrum of this new disease entity.
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The lymphocytic infiltrate in the renal parenchyma is a consistent histological feature of pyelonephritis, but the role of the lymphocytes in the immunobiology of pyelonephritis is not known. In this investigation the influence of the local environment on the potential function of T lymphocytes in the kidney was investigated. The experiments have demonstrated that the response of rat lymphocytes to stimulation in vitro with phytohaemagglutinin (PHA) can be entirely ablated by normal kidney cells. Even when the number of kidney cells added to cultures of lymphocytes was less than 2% of the cells present some ablation of T-lymphocyte function could be detected. The biological characteristics of the factor causing ablation of the PHA responsiveness of T lymphocytes were partially characterized and the factor appears to have unique features that differentiate it from lymphocyte chalones and other tissue factors influencing lymphocyte function. The results may explain recent findings where T lymphocytes were found to be the predominant lymphocyte in the inflammatory infiltrate but were not responsive to PHA in vitro.
In these experiments the effect of experimental pyelonephritis on the distri-ution of B lymphocytes in the peripheral blood and lymphoid sites in the rat has been determined and the functional capacity of T cells during the course of infection has been investigated. The studies have shown that renal infection affects the distribution of lymphocytes and has a marked effect on the functional capacity of splenic T lymphocytes early in infection. Most of the lymphocytes forming the round cell infiltrate in the kidney have been identified as thymus-derived lymphocytes on their surface labelling characteristics. Evidence is presented to demonstrate the inability of T lymphocytes to function normally in the environment of the kdiney. It is suggested that ablation of cell-mediated immunity may be a factor contributing to the persistence of renal infection.
A comparison has been made of a number of different elution conditions for the separation by ion-exchange chromatography of the glycopeptides released by the action of rennin on whole milk. It was found that the most satisfactory separation was achieved using an NaCl gradient (0.10-0.18 M) in 0.049 M-KH2PO4+0.001 M-Na2HPO4 at a constant pH of 5.1.
Pyelonephritis was induced in experimental animals derived of thymus-derived (T) lymphocytes by adult thymectomy and serial sublethal irradiation. In this model T lymphocytes were reduced to less than 1% of normal adjudged by the in vitro Phytohemagglutinin (PHA) responsiveness of lymphoid cells from deprived animals compared with control animals. Pathologic, bacteriologic and immunologic aspects of renal infection were studied in the T cell-deprived animals during the acute, resolving and chronic stages of pyelonephritis. The experiments have shown that the ablation of lymphocytes did not appreciably alter the course of the disease.
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