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Biomedical subjects

J M Lang

Publications and source records attributed to J M Lang.

At least 91 records · Page 5Linked to original sources

[Pseudotumoral pneumocystosis: one case and a review of the literature].

Pneumocystis carinii pneumonia is one of these opportunistic infections that are so frequently observed in immunodepressed patients. The usual radiological image is one of interstitial pneumonia. We report the case of a misleading and unusual pseudotumoral form in a female patient with non-Hodgkin malignant lymphoma. The course of the pneumonia was favourable after cotrimoxazole therapy, partial surgical resection and prophylaxis of relapses by inhaled pentamidine.

Adult↗

[Endocrine consequences of infection by human immunodeficiency virus (HIV)].

The acquired immunodeficiency syndrome (SIDA) is a severe multivisceral affection that is sometimes composed of a clinical expression compatible with an endocrine insufficiency. The post-mortem verifications confirmed the high frequency of the suprarenal, pituitary and testicular lesions. The hormonal functional exploration confirmed the possibility of a decrease in the cortical suprarenal function that contrasts with a moderate hypercortisolemia and an hypogonadism without elevation of the gonadotrophins. The clinical expression of the deficits is unusual. Nevertheless a few cases of obvious suprarenal or antepituitary insufficiency bond to a secondary inflammatory necrosis, an infection by CMV, or a toxoplasmosis have been reported. More often, these hormonal alterations are moderate. There mechanisms are still imprecise. The non-specific response to the stress led by the disease doesn't give an explanation to the observed abnormalities. The described existence of antihormone antibodies in AIDS or the secretory potentialities of the activated lymphocytes might contribute to the physiopathology of the endocrine modifications outside of any infections or endocrine metastatical localisation.

Acquired Immunodeficiency Syndrome↗

The association of inter-pregnancy interval with small for gestational age births.

The association between small for gestational age (SGA) birth at term and inter-pregnancy interval was examined in a hospital cohort of 4489 multiparous women. The greatest risk of SGA birth was found in women with the shortest inter-pregnancy intervals. Even after adjusting for multiple confounding factors, women whose inter-pregnancy interval was 18 or fewer months (over one-third of women in the cohort) remained at twice the risk of giving birth to a term SGA infant when compared with women whose inter-pregnancy interval was 24-36 months. In a logistic regression analysis examining the occurrence of SGA birth in women with inter-pregnancy intervals of 36 months or less, a strong linear association was noted between these two factors. The association of term SGA birth with short inter-pregnancy interval could result from one or more physiologic factors that might act to limit fetal growth. In that case, short inter-pregnancy interval would represent a potentially preventable cause of SGA birth.

Birth Intervals↗

Elevated serum levels of soluble interleukin-2 receptors in HIV infection: no correlation with activated T cells.

Serum levels of soluble interleukin-2 receptors (sIL-2R) were measured in 105 HIV-seropositive individuals simultaneously with T cell subsets and activated T cells (CD3+ and HLA-DR+). Significantly elevated levels of serum sIL-2R were found (564 +/- 259 U/ml versus 258 +/- 87 U/ml in 70 controls, p less than 0.001), as well as increased numbers of activated T cells (mean numbers, 579/microliters in the patients versus 113/microliters in 26 controls, p less than 0.0001). Correlation analysis did not disclose any significant association between elevated sIL-2R and increased activated T cells, nor with decreased CD4+ lymphocytes. These data suggest that sIL-2R in HIV infection do not emanate from activated T cells and are not linked to CD4+ cell loss.

Adolescent↗

Randomised, double-blind, placebo-controlled trial of ditiocarb sodium ('Imuthiol') in human immunodeficiency virus infection.

83 patients with human immunodeficiency virus (HIV) infection (CDC groups II, III, or IV-A) were randomised in a crossover trial of sodium-diethyldithiocarbamate (ditiocarb sodium, 'Imuthiol') (10 mg/kg body weight given orally once a week) against placebo. Each arm of the trial lasted 16 weeks. The disease did not progress to CDC-defined acquired immunodeficiency syndrome in the ditiocarb group but did so in 4 patients in the placebo group (3 between week 0 and 16, 1 between week 17 and 32). Ditiocarb was also associated to a significantly greater extent than placebo with relief of constitutional symptoms, improvement in clinical status (including shrinkage of enlarged spleen and lymph nodes), and improvement in immune function (as measured by CD4+ cell count and skin test reactivity). When placebo was replaced by ditiocarb, similar improvements were observed, whereas symptoms slowly reappeared and CD4+ cell levels progressively declined when ditiocarb treatment was replaced by placebo.

Acquired Immunodeficiency Syndrome↗

[Treatment using lymphocytapheresis of severe forms of Crohn's disease. Preliminary results].

We report our experience in the treatment of severe Crohn's disease by lymphocytapheresis (LCTPH). Twelve patients with severe Crohn's disease unresponsive to prednisone for two years were treated by twelve sessions of LCTPH over a three-week period. Approximately 4.5 x 10(9) lymphocytes were removed at the end of each session, total lymphocyte removal per patient ranging from 1.9 to 10.7 x 10(8)/kg. Sessions were well tolerated. Clinical improvement was observed in all patients at the end of their LCTPH courses. However only fifty per cent of these patients achieved clinical remission of three months and for two of them the remission lasted 8 and 9 months. We examined the immediate effects of cytapheresis on peripheral blood lymphocytes and monocytes. No correlation was noted between the clinical efficacy of LCTPH and the quantity of lymphocytes (T3, T4, T8, NK) and/or monocytes removed. The only significant change was a partial recovery of NK activity in the good responders. The optimal modalities of depletion and the advantages of this treatment in severe Crohn's disease have to be defined in multicentric controlled studies.

Adult↗

[Treatment of metastatic renal adenocarcinomas with combined recombinant alpha-2a interferon and vinblastine].

The results of treatment of metastatic renal cell carcinoma have so far been very poor. Many phase II studies have shown that interferon alpha therapy is active in a significant proportion of patients (approximately 10 to 15% complete and partial remission). In the hope of improving these results we have conducted a phase I-II study of the combination of interferon alpha-2a and vinblastine in 21 patients with metastatic renal cell cancer. Side-effects were pronounced and the mean tolerated doses were 12.5 x 10(6) U/m2 interferon alpha three times per week and 0.10 mg/kg vinblastine once every three weeks. We observed a 43% response rate, with 1 complete remission, 8 partial remissions, 4 stabilizations and 8 progressions. These very encouraging results need to be confirmed by large scale studies.

Adenocarcinoma↗

Cyclic AMP and cyclic GMP phosphodiesterase activities in Hodgkin's disease lymphocytes.

Cyclic nucleotide phosphodiesterase (PDE) activities were studied in peripheral blood monocyte-depleted lymphocytes and enriched T-lymphocyte suspensions from thirteen patients with previously untreated Hodgkin's disease (HD) and fourteen age and sex matched healthy volunteers. Monocyte-depleted lymphocytes from HD patients showed PDE-activities which were two times higher than in their normal counterpart cells. The mean cAMP-PDE activity present in enriched HD T-lymphocyte suspensions was four times higher than in control T-lymphocytes, and the mean cGMP-PDE associated with HD T-lymphocytes was three times higher than in the controls. The hydrolytic activities present in both monocyte-depleted and T-lymphocyte enriched cells suspensions remained unchanged in absence or in the presence of calmodulin and calcium. Since depressed cAMP and cGMP resting levels have been observed in HD lymphocytes and lymphocyte subpopulations, our results suggest that the elevated PDE activities are, at least in part, responsible for the alterations in lymphocyte cyclic nucleotide levels.

3',5'-Cyclic-AMP Phosphodiesterases↗

Glucose transport in a kinaseless Saccharomyces cerevisiae mutant.

Wild-type Saccharomyces cerevisiae organisms contain three kinases which catalyze the phosphorylation of glucose: two hexokinase isozymes (PI and PII) and one glucokinase. Glucose transport measurements for triple-kinaseless mutants, which lack all three of these kinases, confirm that the kinases are involved in the low apparent Km transport process observed in metabolizing cells. Thus kinase-positive cells containing one or more of the three kinases exhibit biphasic transport kinetics with a low apparent Km (1 to 2 mM) and high apparent Km (40 to 50 mM) component. Triple-kinaseless cells, however, exhibit only the high apparent Km component of kinase-positive cells (60 mM). Kinetic analysis of glucose transport in the triple-kinaseless cells shows that glucose is transported by a facilitated diffusion process which exhibits trans-stimulated equilibrium exchange and influx counterflow.

Diffusion↗