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J Widder

Publications and source records attributed to J Widder.

21 records · Page 2Linked to original sources

The immunoregulatory influence of transforming growth factor beta in thyroid autoimmunity: TGF beta inhibits autoreactivity in Graves' disease.

The immunoregulatory influence of transforming growth factor beta (TGF beta) was studied in patients with Graves' disease and in normal controls. Special attention was given to determine how TGF beta affects the interaction between thyroid epithelial cells and T lymphocytes. Human recombinant TGF beta 1 (rTGF beta 1) was immunosuppressive in patients with Graves' disease and in controls. In both groups it inhibited the proliferation of peripheral blood mononuclear cells and of peripheral and thyroid derived T cell lines and clones in response to non-specific stimuli. It also decreased the number of serine esterases expressing cytotoxic T cells and suppressed the recognition of thyroid epithelial cells by thyroid autoantigen specific T cell clones. Inhibition of autoantigen recognition was not only observed when rTGF beta 1 was added to the thyroid epithelial cell/lymphocyte co-culture, but was also found when thyroid epithelial cells were preincubated with rTGF beta 1, which was then removed before the initiation of co-culture. This was probably as a result of a decrease in the antigenicity of the target cells, as rTGF beta 1 also suppressed thyroid peroxidase as well as HLA class II autoantigen expression, in cultured thyroid epithelial cells. These results demonstrate that TGF beta may exert a variety of down-regulatory influences in Graves' disease. It may be of importance for the suppression of autoaggression in persons predisposed to autoimmunity; may be quantitatively overrun by immunostimulatory influences in the acute phase of the disease; and may be important for the induction of remission in patients with Graves' disease.

Adolescent↗

[Relation of symptoms and theories of pathology].

The evaluation of symptoms, syndromes and diseases with regard to the explanations which medicine provides for the illness of a certain patient deals with the epistomological dimension of medicine. The central problem of this endeavour is how to apply general theories of diseases (pathological theories) to individual patients. Part of this problem is the structure of the relation between the empirical and the theoretical level, which is the subject of the present investigation. We provide evidence that the two levels are not deductively connected. This is of special importance for practical medicine since it follows that scientifically inexpressible elements must play a part in coming to a rational clinical decision.

Diagnosis↗

The predictive value of behavioural risk factors for sudden infant death.

In order to examine the predictive value of risk factors for the Sudden Infant Death Syndrome (SIDS), we have interviewed the parents of 80 SIDS victims and 80 parents of a healthy control group. From these interviews a list of 24 clinical and behavioural symptoms was assembled which appeared to be associated with the risk for SIDS. Out of this list of 24 symptoms the average number of symptoms reported to be observable in SIDS victims was twice as large as the average number of symptoms reported for healthy controls. The following symptoms appeared markedly more often in SIDS victims than in the controls: difficulties in awakening the baby, shrill crying, apathy, few movements during sleep, and cyanosis. We have attempted to consider a possible bias in the report of the parents of deceased infants by the introduction of an "exaggeration factor". By application of Bayes' theorem the highest predictive probability, 2.7%, was found for difficulties in awakening the baby. This is approximately nine times the assumed a priori probability of SIDS of 0.3%. We conclude that behavioural risk factors have a low but still remarkable predictive probability. A behavioural pattern of apathy and sleepiness indicates risk with a high probability.

Austria↗