Eating disorders. A multidisciplinary approach.
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Biomedical subjects
Publications and source records attributed to L Silber.
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Clinical and laboratory features were evaluated in 48 patients with lupus anticoagulants and the efficiency of three different assays in the detection of lupus anticoagulants was compared. The diagnosis of lupus anticoagulants was based on a prolonged activated partial thromboplastin test not corrected in a mixture of 1:1 with normal plasma and lack of specific inhibitors against coagulation factors. Platelet neutralization procedure was positive for lupus anticoagulants in 98% of the patients, tissue thromboplastin inhibition ratio in 79%, and kaolin clotting time index in 77%. At least one of the assays was positive in 100% of the cases. The largest minority of the patients (31%) suffered from systemic lupus erythematosus. The others had a variety of non-immunological disorders. In the 13 patients who had been operated on, only 1 with renal failure developed hemorrhagic complications after renal biopsy due to thrombocytopathy. The incidence of recurrent spontaneous miscarriage, immune thrombocytopenia and positive direct antiglobulin test, anti-nuclear and anti-DNA antibodies and VDRL was significantly higher in patients with lupus anticoagulants and systemic lupus erythematosus compared to patients with lupus anticoagulants but without systemic lupus erythematosus.
Venom sac extract of the Oriental hornet significantly prolongs the prothrombin time and the activated partial thromboplastin time both in vitro in human plasma and in vivo in cats. Activity of factors VIII and IX in plasma is reduced to less than 1% within 5 min even with 1 microgram of venom sac extract per ml. The activity of purified factor VIII, as well as semipurified factors IX and X, in factor IX complex was also significantly reduced after incubation with the venom. The decrease of factors II, V, VII, X, XI and XII activity to 9%, 11%, 11%, 29%, 1.7% and 0.7% of normal, respectively, is dose- and time-dependent. Thrombin time, plasma fibrinogen and fibrin degradation products are not affected. The anticoagulant activity is not reversed by dialysis and is abolished completely by heating; it resides mainly in fractions with mol.wts above 5000. The venom has a proteolytic activity on 14C-globin which is partially inhibited by trasylol and ethylenediaminetetraacetic acid. Thus, the venom sac extract exhibits both serine and metaloprotease activities which may affect the activity of the plasma coagulation factors.
We report the case of a seventy-four-year-old woman with advanced squamous cell carcinoma of the urethra who achieved complete biopsy-proved regression of the tumor for more than thirty months after therapy with 5-fluorouracil, mitomycin-C, and radiotherapy.
To date, only two cases of renal angiomyolipoma with associated lymph node involvement have been described. The authors report a third instance of this unusual entity.