Asunto(s)
Anticuerpos Antinucleares/biosíntesis , Anticuerpos Monoclonales/efectos adversos , Antirreumáticos/efectos adversos , Artritis Reumatoide/complicaciones , Enfermedad Hepática Inducida por Sustancias y Drogas/inmunología , Enfermedad Hepática Inducida por Sustancias y Drogas/patología , ADN/inmunología , Adulto , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/inmunología , Enfermedad Hepática Inducida por Sustancias y Drogas/complicaciones , Femenino , Humanos , Inmunoglobulina A/biosíntesis , Inmunoglobulina G/biosíntesis , Inmunoglobulina M/biosíntesis , Infliximab , Hígado/patologíaRESUMEN
CNI-1493, an inhibitor of proinflammatory cytokines, was studied in a Phase I trial in melanoma and renal cancer patients receiving high-dose interleukin 2 (IL-2). Objectives of the study were to define the maximum tolerated dose (MTD) and toxicity of CNI-1493, to assess its pharmacological effects, and to define its pharmacokinetics. Twenty-four patients were treated in sequential cohorts with CNI-1493 doses from 2 through 32 mg/m2 daily. Patients first received only CNI-1493 daily for 5 days. After a 9-day rest, patients received two 5-day courses of IL-2 of 600,000 IU/kg every 8 h for up to 14 doses/course plus daily CNI-1493; courses were separated by a 9-day rest period. CNI-1493 administered alone was well tolerated at doses through 32 mg/m2; MTD was not reached. The only clinical toxicity attributed to CNI-1493 was occasional injection-site phlebitis. Grade 1 creatinine increases occurred in 1 of 7 patients at 4 mg/m2, in 1 of 1 patients at 25 mg/m2, and in 3 of 6 patients at 32 mg/m2 CNI-1493 alone. In combination with high-dose IL-2, CNI-1493 at > or = 25 mg/m2 seemed to exacerbate IL-2-induced nephrotoxicity: grade 3 or 4 creatinine increases developed in 3 of 6 patients at 25 or 32 mg/m2, as compared with 1 of 16 patients at doses < or = 16 mg/m2. The MTD for CNI-1493 given with high-dose IL-2 was 16 mg/m2. The dose-limiting toxicity of IL-2 was hypotension in 63% of patients; overall tolerance to IL-2 was not improved by CNI-1493. However, relative to changes seen in a reference group receiving high-dose IL-2 alone, at doses > or = 4 mg/m2 CNI-1493 did show evidence of pharmacological activity as an inhibitor of tumor necrosis factor production.
Asunto(s)
Antiinflamatorios no Esteroideos/farmacocinética , Antiinflamatorios no Esteroideos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Citocinas/antagonistas & inhibidores , Hidrazonas/farmacocinética , Hidrazonas/uso terapéutico , Interleucina-2/uso terapéutico , Neoplasias Renales/tratamiento farmacológico , Melanoma/tratamiento farmacológico , Adulto , Anciano , Antiinflamatorios no Esteroideos/administración & dosificación , Carcinoma/tratamiento farmacológico , Estudios de Cohortes , Creatinina/orina , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Hidrazonas/administración & dosificación , Interleucina-2/administración & dosificación , Riñón/efectos de los fármacos , Masculino , Dosis Máxima Tolerada , Persona de Mediana Edad , Factores de Tiempo , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
Cefotetan disodium-induced hemolytic anemia has been reported previously, and some of these cases have been severe or fatal. We describe a case of severe hemolytic anemia that occurred in an 80-year-old woman who received cefotetan prophylactically after surgery for a small bowel obstruction. Eight days after the first dose of cefotetan, the patient developed a severe Coomb test-positive hemolytic anemia. Using flow cytometry, we demonstrated cefotetan-specific antibodies in her posttreatment serum, which were detectable at a serum dilution up to 1:10 000. The patient received corticosteroid therapy and blood transfusions, with improvement of her hematologic parameters, but died 54 days after admission for respiratory failure. To our knowledge, this is the first use of flow cytometry for the detection of cefotetan-induced red blood cell antibodies. This technique offers a sensitive, rapid, objective method for detecting drug-induced antibodies.
Asunto(s)
Anemia Hemolítica/inducido químicamente , Cefotetán/efectos adversos , Cefamicinas/efectos adversos , Corticoesteroides/uso terapéutico , Anciano , Anciano de 80 o más Años , Anemia Hemolítica/terapia , Anticuerpos/inmunología , Transfusión Sanguínea , Cefotetán/inmunología , Cefamicinas/inmunología , Eritrocitos/inmunología , Resultado Fatal , Femenino , HumanosRESUMEN
The cyano-bridged complexes [L14CoIIINCFeII(CN)5]-, [L14CoIIINCFeIII(CN)5], [L15CoIIINCFeII(CN)5]-, and [L15CoIIINCFeIII(CN)5] (L14 = 6-methyl-1,4,8,11-tetraazacyclotetradecan-6- amine, L15 = 10-methyl-1,4,8,12-tetraazacyclopentadecan-10-amine) are prepared and characterized both structurally and spectroscopically. In each complex, the pendant amine is trans to the bridging CN ligand, as determined by spectroscopy and X-ray crystallography: Na(trans-[L14CoIIINCFeII(CN)5]).8H2O, monoclinic space group P2(1)/c, a = 15.58(1) A, b = 19.797(4) A, c = 19.830(6) A, beta = 91.62(4) degrees, Z = 8; trans-[L14CoIIINCFeIII(CN)5].4H2O, monoclinic space group P2(1)/m, a = 9.9690(9) A, b = 13.316(1) A, c = 10.1180(8) A, beta = 90.720(6) degrees, Z = 2; [L15CoIIINCFeIII(CN)5].4H2O, triclinic space group P1, a = 9.454(1) A, b = 9.778(1) A, c = 9.865(2) A, alpha = 60.37(1) degrees, beta = 62.60(1) degrees, gamma = 65.82(1) degrees, Z = 1. A precursor to the 14-membered macrocyclic complexes is prepared for the first time, and its crystal structure is also reported: trans-I [CoL14Cl](ClO4)2, orthorhombic space group Pbca, a = 11.833(3) A, b = 13.363(2) A, c = 26.015(2) A, Z = 8. These compounds form part of a novel series of discrete CN-bridged dinuclear compounds. The mixed-valent CoIII-FeII compounds exhibit metal-to-metal charge-transfer (MMCT) transitions in the region 510-530 nm.
RESUMEN
The CD40/CD40L (CD40 ligand) axis regulates several interactions between T cells and B cells. Blocking of CD40 engagement by CD40L inhibits Ig class switch by B cells as well as diminishes T cell response to an immunizing Ag. For these reasons, disruption of CD40/CD40L interactions by anti-CD40L administration or by genetic disruption of CD40L has ameliorated a variety of autoimmune conditions. More recent findings suggest that a direct signal can be transmitted to T cells via their expressed CD40L, which can costimulate proliferation with CD3 or promote germinal center formation. It is therefore possible that treatment with anti-CD40L Ab might produce a different outcome than observed in genetically CD40L-deficient mice. In this regard, we observe that in contrast to the genetic deletion of CD40L in MRL-lpr mice, which diminishes autoimmune disease but has little effect on adenopathy, administration of anti-CD40L to MRL-lpr mice accelerates both of these parameters. This difference appears to result from anti-CD40L actively delivering a signal that inhibits T cell apoptosis in lpr mice. This was confirmed by in vitro studies demonstrating that CD40L cross-linking on lpr thymocytes inhibited apoptosis and surface TCR down-modulation induced by CD3 ligation.
Asunto(s)
Anticuerpos Monoclonales/administración & dosificación , Apoptosis/inmunología , Antígenos CD40/inmunología , Glomerulonefritis/inmunología , Enfermedades Linfáticas/inmunología , Glicoproteínas de Membrana/inmunología , Subgrupos de Linfocitos T/inmunología , Animales , Autoanticuerpos/biosíntesis , Antígenos CD40/biosíntesis , Ligando de CD40 , Femenino , Glomerulonefritis/etiología , Glomerulonefritis/mortalidad , Inyecciones Intraperitoneales , Ligandos , Ganglios Linfáticos/citología , Ganglios Linfáticos/metabolismo , Enfermedades Linfáticas/etiología , Ratones , Ratones Endogámicos MRL lpr , Receptores de Antígenos de Linfocitos T alfa-beta , Análisis de Supervivencia , Subgrupos de Linfocitos T/citología , Subgrupos de Linfocitos T/metabolismo , Timo/citología , Timo/metabolismoRESUMEN
The cholesterol-fed Richardson's ground squirrel (Spermophilus richardsonii) has proven to be an effective animal model in which to study factors that influence cholesterol gallstone formation and associated alterations in the gallbladder epithelium. Ground squirrels of either sex, fed a 2% cholesterol-enriched diet, exhibit cholesterol monohydrate crystal precipitation within 24 hours and macroscopically visible cholesterol stones by 3 weeks. Data on bile chemistry, biliary cholesterol precipitation, and various mucosal alterations occurring prior to, during, and after stone formation were collected using sampling intervals from 6 hours to 20 weeks on the diet. The results indicate that mucin hypersecretion appears to be more closely related to the initiation of nucleation than does either bile calcium of pH. Mucus hypersecretion begins within 18 hours of diet initiation and continues throughout the 20 week experimental period. Apical excrescences became more common and were larger in size during the early stages of cholelithiasis. Administration of aspirin during the experimental period demonstrated an inhibition of mucin synthesis and release. Gallstones were not formed in these aspirin-treated animals. A lectin-binding panel for 10 epithelial glycoprotein-related sugars indicated the mucin secreted by the gallbladder epithelium of 7 day experimental animals differed from that of controls. The most obvious difference was the abolition of WGA binding in the experimental animals, suggesting an absence of sialic acid expression in the mucin during the lithogenic process. Ultrastructural histochemistry indicated that both sulphomucin and sialomucin were present in the secretory granules and within the surface mucus layer of both experimental and control animals. Experimental animals, however, exhibited a significant predominance for sulphomucin. This pattern varies from that typically seen in other regions of the gastrointestinal tract where sialomucins predominate during pathologic processes.
Asunto(s)
Colelitiasis/metabolismo , Colelitiasis/patología , Glicoproteínas/metabolismo , Alimentación Animal , Animales , Antiinflamatorios no Esteroideos/farmacología , Aspirina/farmacología , Bilis/química , Calcio/metabolismo , Colelitiasis/prevención & control , Colelitiasis/ultraestructura , Colesterol/metabolismo , Suplementos Dietéticos , Epitelio/metabolismo , Epitelio/patología , Epitelio/ultraestructura , Femenino , Vesícula Biliar/metabolismo , Vesícula Biliar/patología , Vesícula Biliar/ultraestructura , Histocitoquímica , Lectinas/metabolismo , Lectinas/ultraestructura , Masculino , Microscopía Electrónica , Microscopía Electrónica de Rastreo , Microscopía Fluorescente , Mucinas/efectos de los fármacos , Mucinas/metabolismo , Moco/metabolismo , Ácido N-Acetilneuramínico/biosíntesis , Sciuridae , SialomucinasRESUMEN
A complex set of social, economic, cultural and environmental circumstances affecting native Canadians in northern regions has resulted in the dietary replacement of indigenous foods with marketed products not always of equivalent nutritional value. This article examines the current food supply in three northern Manitoba Cree communities by looking at the availability and preservation of traditional foods, the price of marketed foods and perceptions of the food supply. Data were obtained by questionnaire from older adults (over 55 years) and younger women (16-45 years) in each community. The food supply comprised a mix of traditional and marketed foods, with limited use of traditional methods of food preservation. Marketed food prices were high in communities without all-weather road access. Respondents expressed a desire for more traditional food. Promotion of traditional foods could increase nutrient intake, decrease food costs and contribute to a revival of interest in Cree culture.
Asunto(s)
Abastecimiento de Alimentos , Indígenas Norteamericanos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Manitoba , Intoxicación por Mercurio/prevención & control , Persona de Mediana EdadRESUMEN
Fibrillary glomerulonephritis is an unusual, but not rare cause of glomerulonephritis. Hypocomplementemia in association with fibrillary glomerulonephritis has been reported only once previously. A patient with hypocomplementemia and fibrillary deposits as demonstrated by electronmicroscopy is reported. The clinical and pathologic features of fibrillary glomerulonephritis and immunotactoid glomerulopathy are reviewed.
Asunto(s)
Proteínas del Sistema Complemento/deficiencia , Glomerulonefritis/inmunología , Glomerulonefritis/patología , Citoesqueleto de Actina/ultraestructura , Anciano , Anciano de 80 o más Años , Humanos , Glomérulos Renales/ultraestructura , MasculinoRESUMEN
Patient anxiety is often increased by poor communication from health-care staff. This paper describes an initiative in a radiology department to improve patients' knowledge of the nature of any investigations, before and during attendance at the department, using a combination of written and verbal explanations.
Asunto(s)
Educación del Paciente como Asunto , Servicio de Radiología en Hospital , Comunicación , Humanos , Modelos TeóricosRESUMEN
We performed a retrospective analysis of flow cytometry as a platelet crossmatching procedure. Sera from 17 alloimmunized refractory patients were tested against 32 donor platelets, which had been stored as platelet-rich plasma for up to 36 months. Overall, 14/32 (44%) crossmatches were positive. The mean 1 h posttransfusion corrected count increments (CCIs) were 9,195 and 2,269 for a negative and a positive crossmatch, respectively. The predictive value of a positive crossmatch was 86%, whereas the predictive value of a negative crossmatch was 56%. When samples with low background fluorescence or with high panel-reactive antibody (PRA) levels were evaluated separately, the accuracy of the crossmatch improved from 69% to 80%. When compared to the platelet adhesion immunofluorescence test (PAIFT) and the standard and antiglobulin-enhanced lymphocytotoxicity tests for the detection of HLA antibodies, flow cytometry appeared to be more sensitive. We conclude that flow cytometry is a useful technique for platelet crossmatching, particularly for alloimmunized patients for whom HLA compatible platelets may not be readily available.
Asunto(s)
Tipificación y Pruebas Cruzadas Sanguíneas , Plaquetas/inmunología , Citometría de Flujo , Estudios de Evaluación como Asunto , Humanos , Valor Predictivo de las Pruebas , Estudios RetrospectivosRESUMEN
To determine whether oral midazolam is a safe and effective alternative to our current standard premedication for children with cyanotic congenital heart disease (CCHD), 30 children aged 1-6 yr, scheduled for elective cardiac surgery, were studied. The children were randomly assigned to one of two groups: Group I received oral midazolam 0.75 mg.kg-1 30 min before separation from their parents in the surgical waiting area, and Group II received oral or rectal pentobarbitone 2 mg.kg-1 at 90 min, and morphine 0.2 mg.kg-1 and atropine 0.02 mg.kg-1 im at 60 min before separation. Heart rate, haemoglobin oxygen saturation (SpO2) and anxiolysis and sedation scores were recorded at four times during the study: at baseline (immediately before premedication), immediately after administration of the premedication, at separation of children from parents in the waiting area and at the time of application of the face mask in the operating room. We found that in Group I, anxiolysis improved at separation from parents compared with baseline (P < 0.05) and sedation increased both at separation and on mask application (P < 0.05), whereas in Group II anxiolysis did not change at any time and sedation increased only at separation (P < 0.05). Intramuscular injection of morphine produced a transient decrease in mean SpO2 (from 84% to 76%) (P < 0.05) that did not occur after ingestion of oral midazolam. The results of this study indicate that oral midazolam is a safe and effective replacement for the standard premedication for children with CCHD undergoing cardiac surgery and avoids the decrease in SpO2 associated with im injections.
Asunto(s)
Cardiopatías Congénitas/cirugía , Midazolam/administración & dosificación , Medicación Preanestésica , Administración Oral , Administración Rectal , Ansiedad de Separación/prevención & control , Atropina/administración & dosificación , Atropina/farmacología , Concienciación/efectos de los fármacos , Niño , Conducta Infantil/efectos de los fármacos , Preescolar , Cianosis , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Lactante , Inyecciones Intramusculares , Masculino , Midazolam/farmacología , Morfina/administración & dosificación , Morfina/farmacología , Consumo de Oxígeno/efectos de los fármacos , Satisfacción del Paciente , Pentobarbital/administración & dosificación , Pentobarbital/farmacologíaRESUMEN
To determine the minimum time interval between oral midazolam (0.5 mg.kg-1) premedication and separation from parents that ensures a smooth separation, 30 children were assigned randomly to one of three groups (ten children per group). The groups differed only in the time interval between administration of midazolam and separation from their parents: 10, 20 or 30 min. Heart rate, systolic blood pressure, and sedation and anxiolysis scores were assessed before midazolam premedication (baseline), at the time of separation from parents, and during the application of a face mask at the induction of anaesthesia. We found that heart rate and systolic blood pressure changes were similar for all three groups throughout the study period. Sedation scores at the time of separation from parents and on application of the mask for all three groups were greater than baseline values. Sedation scores at separation did not differ among the three groups. Anxiolysis values did not differ from baseline values at any time for all three groups. We conclude that children may be separated from their parents as early as ten minutes after receiving oral midazolam, 0.5 mg.kg-1.
Asunto(s)
Ansiedad de Separación/prevención & control , Conducta Infantil/efectos de los fármacos , Midazolam/administración & dosificación , Medicación Preanestésica , Administración Oral , Procedimientos Quirúrgicos Ambulatorios , Anestesia por Inhalación , Niño , Preescolar , Sedación Consciente , Femenino , Humanos , Lactante , Masculino , Relaciones Padres-Hijo , Factores de TiempoRESUMEN
Mesangial cells of the renal glomerulus are thought to have contractile properties, resembling those of smooth muscle cells. Since actin synthesis in mesangial cells is increased in selected animal models of glomerulonephritis, we evaluated the expression of alpha-smooth muscle actin (ASMA), the principal actin isoform found in smooth muscle cells, in biopsy specimens from patients with primary glomerular disorders and in control tissues. Normal glomeruli and glomeruli in acute tubulointerstitial disorders showed few or no ASMA-positive cells in the glomeruli. In contrast, ASMA expression in mesangial cells was increased in minimal change disease, focal segmental glomerulosclerosis, mesangial proliferative glomerulonephritis, membranous glomerulonephritis, and immunoglobulin A nephropathy. In membranoproliferative glomerulonephritis and cryoglobulinemic glomerulonephritis both mesangial and capillary loop ASMA-positive cells were observed with a segmental distribution. In addition, ASMA-positive interstitial cells were seen in many biopsy specimens and often were increased in number in biopsy specimens showing early interstitial fibrosis and tubular atrophy. We conclude that ASMA synthesis in mesangial cells is upregulated in a variety of glomerular disorders, frequently associated with increased cell proliferation and mesangial matrix production. This phenotypic change may be an indicator of mesangial cell activation after injury and may have important pathophysiologic consequences.
Asunto(s)
Actinas/análisis , Enfermedades Renales/patología , Glomérulos Renales/patología , Actinas/inmunología , Adulto , Anciano , Anticuerpos Monoclonales , Preescolar , Femenino , Humanos , Inmunohistoquímica , Enfermedades Renales/inmunología , Enfermedades Renales/metabolismo , Glomérulos Renales/química , Glomérulos Renales/inmunología , Masculino , Persona de Mediana Edad , Músculos/químicaRESUMEN
A multi-site clinical study compared platelets chosen for refractory patients by prospective platelet crossmatching using stored donor platelets and HLA-based selection. Seventy-three patients who were refractory to random-donor platelets received two plateletpheresis components, one chosen by HLA-based criteria and the other by crossmatching. Patients were carefully evaluated to exclude nonimmune factors that could adversely affect transfusion results. Each of the five study sites used a crossmatch procedure with which it had experience. Results from this study indicate the following: 1) The overall rate of successful transfusion was similar when an HLA-based method of donor selection that includes all grades of matching and mismatching was compared to a crossmatch-based method of donor selection. 2) HLA-based selection that restricts recipients to grade A and BU matches was superior to a selection method based upon crossmatching alone. Donor selection based on HLA matching (grades A or BU) was also superior to selection based on any degree of HLA mismatching (grades BX, C, or D). 3) Selection of donors based on HLA-cross-reactive groups (defined by in vitro serologic crossreactivity) was no more successful than that based on grade C and D mismatches and was no more successful than selection by crossmatching alone. 4) Lymphocytotoxic and platelet antibodies were not detected in many of the enrolled patients, even though patients demonstrating nonimmune factors were eliminated from the study. It can be concluded that HLA-compatible (grades A and BU) platelets provide optimal support for refractory patients, but that crossmatch-selected platelets are acceptable as an alternative component.
Asunto(s)
Transfusión de Componentes Sanguíneos , Tipificación y Pruebas Cruzadas Sanguíneas , Antígenos HLA/sangre , Trombocitopenia/sangre , Adulto , Anciano , Anfotericina B/farmacología , Suero Antilinfocítico/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vancomicina/farmacologíaRESUMEN
New compounds with a greater potency than cyclosporin A (CyA) for thwarting host rejection of organ transplantation are being sought. Suramin sodium may be a novel drug to prevent or delay graft rejection and graft-vs-host disease (GVHD), because of its in vitro and in vivo immunosuppressive properties. Since the allogeneic mixed lymphocyte reaction (MLR) is considered to be the in vitro counterpart of the initial T-lymphocyte recognition and response to allogeneic histocompatibility antigens on grafted tissue or organ and to GVHD, we initially evaluated the in vitro suppressive effect of suramin in the allogeneic MLR. Suramin inhibited the H-2- and HLA-incompatible MLR in a dose-dependent manner. The suppressive effect was observed both in the primary and in the secondary MLR. The suppression of the MLR by suramin is due predominantly to the inhibition of interleukin-2 (IL-2) production by the responding T cells.
Asunto(s)
Interleucina-2/antagonistas & inhibidores , Linfocitos/inmunología , Suramina/farmacología , Animales , Unión Competitiva/inmunología , Citotoxicidad Inmunológica/inmunología , Antígenos H-2/inmunología , Antígenos de Histocompatibilidad Clase II/inmunología , Humanos , Activación de Linfocitos/inmunología , Prueba de Cultivo Mixto de Linfocitos , Ratones , Ratones Endogámicos , Bazo/inmunología , Linfocitos T/inmunologíaRESUMEN
This study reports the histological effects of topical misoprostol, a synthetic PGE1 analog, administered in varying dosages on the resting canine gastric mucosa. Misoprostol did not macroscopically or microscopically damage the mucosa but its presumed permeability effects on the gastric vasculature induced marked edema of the mucosa and submucosa. Consistent features included increased thickness of both layers, dilated interglandular regions of the lamina propria, marked subepithelial edema, reduced depth and width of gastric foveolae, vasodilation of the vascular channels, reduced height of surface epithelial cells, swelling of their basolateral intercellular spaces, and increased amounts of surface adherent mucus. It is speculated that the mucosal edema, in addition to an increased mucus layer, may be important in the mechanism of gastric cytoprotection by increasing the distance of penetration or absorption for a mucosal-damaging agent, diluting its concentration, and disseminating any focal accumulations of red blood cells.
Asunto(s)
Mucosa Gástrica/efectos de los fármacos , Misoprostol/administración & dosificación , Administración Tópica , Animales , Perros , Mucosa Gástrica/patología , Técnicas In Vitro , NecrosisRESUMEN
Lymphoproliferative disorders of granular lymphocytes (LDGLs) represent a family of diseases that are morphologically similar but diverse with regard to immunophenotype, function, and clonality. In this article, we report three informative cases and propose a modification of the current classification of LDGLs. Our first case is an example of natural killer cell LDGLs (CD2+, CD3-, CD16+, CD57+/-). Based on a review of the literature, we suggest that natural killer cell LDGLs can be divided into two subgroups (types 1 and 2) according to the expression of CD57. Reduced expression of CD57 may distinguish between patients with a poorer prognosis. The remaining two cases illustrate examples of T-cell LDGLs (CD2+, CD3+, CD8+, CD57+) that differ mainly in their expression of CD16. The CD16+ T-cell LDGLs (type 1) usually show a clonal rearrangement of the T-cell receptor-beta chain gene, whereas CD16- T-cell LDGLs (type 2) may show a germline configuration, suggesting a reactive rather than a neoplastic process. Pathologists should differentiate LDGLs from other chronic lymphoproliferative diseases, since most cases evolve slowly and aggressive cytoreductive therapy is usually unwarranted.
Asunto(s)
Antígenos CD/análisis , Trastornos Linfoproliferativos/inmunología , Adulto , Antígenos de Diferenciación/análisis , Antígenos de Diferenciación de Linfocitos T/análisis , Complejo CD3 , Antígenos CD57 , ADN/metabolismo , Humanos , Inmunofenotipificación , Células Asesinas Naturales/inmunología , Trastornos Linfoproliferativos/clasificación , Trastornos Linfoproliferativos/genética , Trastornos Linfoproliferativos/patología , Masculino , Persona de Mediana Edad , Receptores de Antígenos de Linfocitos T/análisis , Receptores de Antígenos de Linfocitos T/inmunología , Receptores Fc/análisis , Receptores de IgG , Linfocitos T/inmunologíaRESUMEN
Poiseuille's law describes the relationship between pressure and the flow of a gas or liquid of known viscosity through a conduit of known length and radius. In clinical bronchoscopy, resistance varies directly with changes in viscosity of the inspired gas and the length of the bronchoscope. According to Poiseuille's law, resistance varies inversely to the fourth power of the radius of the bronchoscope. Flow-pressure curves were generated for commonly used pediatric Storz-Hopkins bronchoscopes with and without telescopes and the resistance of each system was calculated. Extremely high resistance is encountered with the 2.5 x 20 cm bronchoscope with telescope in place, a fact that most pediatric endoscopists are well aware of. However, comparable resistance is encountered when the 3.5 x 30 cm bronchoscope is used with the telescope in place, a fact not well appreciated by most clinicians.
Asunto(s)
Broncoscopios , Resistencia de las Vías Respiratorias , Niño , Diseño de Equipo , Humanos , Ensayo de Materiales , Presión , Ventilación Pulmonar , Reología , Propiedades de SuperficieRESUMEN
Procedures for obtaining thresholds of discomfort from young children are almost nonexistent. This is likely due to the problems encountered in finding a task that they can easily perform. The purpose of this project was to design and test a procedure appropriate to the cognitive and language abilities of 4- to 5-yr-old hearing-impaired children. Data obtained from normally hearing subjects indicate that the procedure can be used with children whose mental ages are at or above 5 yr.