The syndrome of persistent generalized lymphadenopathy: experience with 101 patients.
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Biomedical subjects
Publications and source records attributed to S Knight.
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A newborn female infant presented with hypotonia, joint hyperextensibility, cardiac murmur, macroglossia, and hepatosplenomegaly. Karyotype of the child revealed partial trisomy of chromosome 11p derived from a paternal balanced translocation. Echocardiogram obtained in the newborn period suggested interatrial aneurysm, which was confirmed on post-mortem examination. Interatrial septal aneurysm is a rare abnormality not previously described in partial trisomy 11p.
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To investigate the dream characteristics associated with a major life change, 29 women (ages 30-55) undergoing divorce were studied six nights in a sleep laboratory. The group was stratified on a self-report depression scale (the Beck Depression Inventory) into a depressed (N = 19, mean = 23.2) and nondepressed (N = 10, mean = 8.2) group and compared to a nondepressed married group who had never considered divorce. The dreams of those divorcing without major mood upset were longer and dealt with a wider time frame than those of the other two groups. They also dealt with marital status issues which were absent in the dreams of the depressed group. On follow-up those who had been depressed showed positive dream changes in mood, dreamlike quality, and identification of dream self with the marital role. The study suggests that some dream characteristics respond adaptively during life changes but that this is delayed when subjects are depressed. This raises the possibility of a corrective intervention for such persons.
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Modern materials and a better understanding of the biomechanical requirements enable adaptations to shoes to be make quickly and easily in cases where the deformed foot is small enough to fit satisfactorily into standard shop-bought or standard deep footwear. A flexible self-generating polyurethane foam is used inside the shoe. It expands to the internal shape of the shoe and the external shape of the foot. It can be used either against the patient's own foot or against a positive cast of the foot. The technique has been used for 75 patients and has proved successful. The insert so made is durable and economical.
Peripheral blood mononuclear cells from patients with clinically active Behçet's disease or juvenile chronic arthritis (JCA) gave high responses to phytohaemagglutinin (PHA) in vitro prior to prednisolone therapy and low responses when taking prednisolone in comparison with cells from control individuals. Such effects were not significantly different at the six concentrations of cells or the four times in culture studied. Differences from controls were also seen with cells from clinically controlled, prednisolone treated Behçet's patients; the cells responded better than controls at low cell concentrations and early times in culture, the reverse occurring at higher concentrations and later times. This pattern of response suggests the presence of a higher than normal proportion of responsive cells in these patients. These studies suggest that not only is a still wider range of culture conditions required to assess fully the differences in lymphocyte function related to disease activity and prednisolone treatment in JCA or Behçet's, but also that the use of a narrow set of 'optimized' conditions may be misleading.
Out of 184 patients who were infected or colonised with gentamicin-resistant enterobacteria, 17 (9%) harboured more than one strain. Single antibiotic-resistance plasmids were common to more than one of the different organisms isolated from nine patients, strongly suggestive of in-vivo conjugation. An "epidemic" plasmid with a molecular weight of approximately 110 megadaltons was found in 11 distinct strains isolated from four patients. Seven of the organisms harbouring this plasmid were Klebsiella aerogenes. Spread of multiple-resistance plasmids among endemic gentamicin-resistant enterobacteria is not uncommon, and these organisms provide a reservoir of plasmids that may ultimately spread to more pathogenic genera.
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The incidence of trimethoprim resistance in enterobacteria causing infection in a London hospital increased from 5.6% in 1970 to 16% in 1979. The proportion of gentamicin-resistant aerobic Gram-negative bacilli had risen to 6.5% by 1979. During a 5-month period in 1977, during which no epidemic was recognized, all isolates resistant to either trimethoprim, gentamicin, tobramycin or amikacin were studied. The proportion of enterobacteria resistant to both trimethoprim and gentamicin (3.8% of the total) was significantly higher than expected assuming no correlation between acquisition of resistance characters. The resistance was transferable in 23% of trimethoprim-resistant and 76% of gentamicin-resistant strains. Trimethoprim resistance was carried by plasmids of seven different incompatibility groups and in at least four instances was part of a transposon. Gentamicin resistance was determined by plasmids of three groups - IncC, IncFII and IncW. Transposition of gentamicin resistance was not shown, though this may have been the means of evolution of the gentamicin R plasmids of InW, which determined aminoglycoside acetyltransferase, AAC(3). Some bacterial strains with their plasmids were endemic. There was evidence for these plasmids (i) acquiring new resistance genes by transposition, (ii) losing resistance genes by deletion and (iii) being transferred between bacterial species in the hospital.
A simple method has been developed for harvesting lymphocytes from Terasaki microplates based on a culture technique where the plates are inverted and the cells grown on the hanging meniscus of the medium in each well. Sixty individual filter discs were prepared in wells in a polycarbonate harvesting plate. A dry Terasaki plate was used to cut these filters with the harvester acting as a die. The inverted culture plate was then lowered onto the harvester to allow the cells on the meniscus from each well to be absorbed on the appropriate filter disc. The culture plate was then discarded and the cells on the filters washed in the harvester. The wash solutions were removed by suction through holes below each filter. The time taken to harvest the cultures from 60 wells of a plate was 3--5 min.
Orthoses which fit inside shoes have, in many cases in the past, been fashioned to the shape of the patient's foot. It is suggested that improved stability and comfort is achieved if, instead, the outside shape of the foot-piece of the orthosis is fashioned to the inside shape of the footwear. A method for achieving this is described.
The meat processing industry has great incentive to push for the lifting of the ban on MDM. By using MDM equipment, much meat now being lost could be salvaged for human consumption with great economies and world food shortage implications. The properties of mechanically deboned meat vary with the percentage of bone and marrow in the original products, the equipment, and by other factors. The question of future use of MDM hinges on its readmission to the market, based on safety and health aspects. Dietiticians and others in health care service may be asked to give an opinion concerning the use of MDM. Consideration of the possible addition of nutrients over and above those usually supplied in meats may be a positive factor. Certainly, if its use is reinstated, health care professionals will need to be aware of the implications of including such products in the foods chosen for themselves and their patients.
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There is a significant association with HL-A3 type and pernicious anaemia. In addition there is a negative association with HL-A2. There is no association between HL-A type and the presence or absence of immunity to intrinsic factor.
Immunosupprissive therapy was carried out using steroids, azathiprine and antilymphocyte globulin in one patient with systemic lupus erythematosus (SLE) and four with dermatomyositis. Response to treatment was based upon clinical evaluation. The patients with SLE and two of the four with dermatomyositis responded favourably to the regime. It is suggested that this preliminary study is sufficiently promising to warrant the creation of a rigidly controlled investigation.