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Biomedical subjects

L Arens

Publications and source records attributed to L Arens.

6 recordsLinked to original sources

[Case report on management of grade 4 infected open comminuted tarsus fracture by tibio-Chopart arthrodesis].

We report on the treatment of a 39 year old patient who suffered from subtotal amputation of the middle foot area after fall from tall height. He was treated by an arthrodesis between ventral tibia and distal Chopart-joint which was carried out as late-primary care. Therefore calcaneus and talus were totally and os cuboideum and os scaphoideum were partially removed. This form of arthrodesis is a rare indication. With remaining blood flow and sensibility in the fore foot it is an alternative to amputation/exarticulation in the tibiotalar joint. Advantages are the improved plantar weightbearing area, a simplified supply of orthopedic shoes and a better tactile ground contact.

Adult↗

CD4 and CD8 subsets defined by dual-color cytofluorometry which distinguish symptomatic from asymptomatic blood donors seropositive for human immunodeficiency virus.

As part of a larger study to characterize immune alterations in blood donors seropositive for human immunodeficiency virus (HIV), we measured subsets of CD4 (T helper/inducer) and CD8 (T suppressor/cytotoxic) cells by 2-color cytofluorometry. Alterations observed in asymptomatic seropositive donors (ASP) included: 1) decreased mean levels of Leu 8+ CD4 cells, although the proportion of Leu 8+ cells within the CD4 population was unchanged; 2) a selective increase in Leu 8- CD8 and Leu 18- CD8 cell levels; and 3) increased levels of both CD8 subsets defined by Leu 7, Leu 17, or HLA-DR expression. Alterations observed in symptomatic seropositive donors (SSP) were: 1) a further decrease in Leu 8+ CD4 cell levels, with a decrease in the proportion of Leu 8+ CD4 cells; 2) decreased levels of both Leu 18- and Leu 18+ CD4 subsets; 3) selective increases in Leu 8- and Leu 18- CD8 cell levels; and 4) increases in Leu 7+ CD8, Leu 17+ CD8, and HLA-DR+ CD8 subsets but not the reciprocal negative CD8 subsets. Thus, changes merely reflective of HIV infection included decreased levels of Leu 8+ CD4 cells and increased levels of Leu 8- CD8, Leu 18- CD8, Leu 7+ CD8, Leu 17+ CD8, and HLA-DR+ CD8 cells. Development of symptoms were associated with a further, preferential loss of Leu 8+ CD4 cells, proportional losses of both CD4 subsets defined by Leu 18 expression, and a return to normal levels of Leu 7- CD8, Leu 17- CD8, and HLA-DR- CD8 cells.

Adult↗

The ambulatory electro-encephalogram as a diagnostic tool in a children's hospital.

The neurophysiology laboratory at the Red Cross War Memorial Children's Hospital provides a diagnostic electro-encephalogram (EEG) service for the hospital and surrounding community. In selected cases ambulatory EEG monitoring is undertaken. The present study is a review of the findings in 55 children thus investigated using the Oxford monitor. Indications included unexplained aberrant behaviour outbursts, erratic school performance, atypical absence episodes and the need to distinguish between real and simulated seizures in children with epilepsy. During reporting, correlations were noted between EEG appearances and the child's behaviour. Abnormalities were noted in 35 of the records. These included paroxysmal spike and wave discharge, focal cortical abnormalities and unequivocal seizure episodes. It is felt that the investigation made a significant contribution to correct diagnosis in 32 cases, and that ambulatory monitoring should be available in all laboratories which offer a diagnostic EEG service for children.

Ambulatory Care↗

Effect of storage on lymphocyte surface markers in whole blood units.

Pretransplant transfusions of stored donor-specific blood have been shown to improve renal allograft survival while reducing the frequency of lymphocytotoxic antibody production when compared with fresh blood. As part of studies to define the mechanism(s) of this phenomenon, we have monitored lymphocyte surface markers during storage of four units of whole blood. Both mononuclear cell preparations (obtained by density gradient centrifugation) and whole blood preparations were analyzed using monoclonal antibodies and a flow cytometer enabling lymphocytes to be distinguished from other white cells and nonviable cells. In both cell preparations, the percentage of viable lymphocytes expressing CD3 (all T cells), CD4 (T helper cells), CD8 (T suppressor cells,) HLA-class I (A,B,C), or HLA-DR antigens remained stable for at least 14 days, although median fluorescence intensity declined for the first three markers. After day 14, the number of viable lymphocytes recovered from a standard volume of whole blood was insufficient for further assessment of surface markers, even though the white cell count (determined by cell volume) remained near original levels. Thus the distribution of viable lymphocyte subpopulations defined by surface markers was stable for at least two weeks in stored blood; however, a nonspecific loss of lymphocyte viability began after 10 days of storage. These findings suggest that loss of cell viability, rather than loss of specific lymphocyte subpopulations, may be related to the mechanism by which pretransplant transfusion of stored blood improves renal allograft survival without inducing a high incidence of lymphocytotoxic antibody.

Antigens, Differentiation, T-Lymphocyte↗

Clinical experience with methylphenidate.

The indications for the use of methylphenidate in 250 children are reviewed, and the effect of the drug is examined. Concentration was improved or hyperactive behaviour diminished in 89% of the children with normal intelligence and with no gross physical defect, in 72% of the children with cerebral palsy, and 68% of the children with subnormal intelligence. In children with emotional disturbance, response to methylphenidate was seldom satisfactory. Significant side-effects occurred infrequently and only 2 children lost weight during the period of medication.

Adolescent↗