European journal of clinical investigation
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Eur. J. Clin. Invest. · Apr 1994
Association between biosynthesis of nitric oxide and changes in immunological and vascular parameters in patients treated with interleukin-2.
Hypotension is a dose-limiting side effect of interleukin-2 (IL-2) therapy. This may be due to increased biosynthesis of the potent vasodilator nitric oxide (NO) induced by cytokines such as tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma), which are known to be generated during IL-2 therapy. We describe the relationship between NO biosynthesis and changes in immunological and vascular parameters during IL-2 therapy in 13 patients with metastatic cancer. ⋯ As plasma NOx concentrations increased, systolic blood pressure fell, reaching a minimum at day 3 despite a continued rise in NOx concentrations. These changes were accompanied by a continuous increase in pulse rate throughout the infusion period. These findings indicate that induction of NO biosynthesis contributes to hypotension induced during IL-2 therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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Eur. J. Clin. Invest. · Dec 1993
Spontaneous bacterial peritonitis is associated with high levels of interleukin-6 and its secondary mediators in ascitic fluid.
We investigated 37 patients with ascites and liver cirrhosis in order to examine whether on the basis of correlation of cytokines and acute phase proteins of the ascitic fluid, prognosis of spontaneous bacterial peritonitis can be made. Significantly enhanced levels of interleukin-6, as well as acute phase reactants alpha-1-antitrypsin and C-reactive protein were found in the ascitic fluid of patients with spontaneous bacterial peritonitis. ⋯ In addition, interleukin-6, TNF-alpha and neopterin levels were found to correlate significantly with the outcome of the disease. These findings show that acute phase reaction occurs in the ascitic compartment in correlation with the development of spontaneous bacterial peritonitis.
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Eur. J. Clin. Invest. · Jul 1993
Randomized Controlled Trial Clinical TrialRelationship between ventilation and carbon dioxide production in normal subjects with induced changes in anatomical dead space.
The aim of this study was to test the hypothesis that the increased ventilation to carbon dioxide production relationship on exercise associated with chronic cardiac failure may be due in part to changes in respiratory pattern, causing an increase in anatomical dead space ventilation. In order to assess the effect of changes in respiratory pattern on the relationship between ventilation and carbon dioxide production, normal subjects exercised at the same level at three different respiratory rates (normal, 25% slower, 25% faster). ⋯ There were no significant changes in ventilation, carbon dioxide production, or the correlation between ventilation and carbon dioxide production. This finding lends support to the view that changes in respiratory pattern can only be responsible for a very small proportion of the VE/VCO2 slope difference between chronic cardiac failure and normals.
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Eur. J. Clin. Invest. · Nov 1992
Surfactant protein A (SP-A) is decreased in acute parenchymal lung injury associated with polytrauma.
To further investigate if the pulmonary surfactant system is altered in acute parenchymal lung injury of adults following polytrauma we measured SP-A level and phospholipid composition in 150 sequentially obtained lung lavage samples from poly-traumatized patients (n = 19) beginning at the day of trauma and ending 18 days later or when the patient was extubated. Out of the 19 patients studied 10 had severe parenchymal lung injury (ARDS), nine had moderate lung injury. SP-A was measured using a two-monoclonal sandwich ELISA-assay. ⋯ In patients who had moderate lung injury the SP-A level normalized, but in patients who had severe lung injury the SP-A level remained low during the timespan examined. SP-A alterations did not correlate to changes in phospholipid composition as determined in lung lavage samples of individual patients. We conclude that alveolar SP-A concentrations decrease in polytraumatized patients who have acute parenchymal lung injury soon after the trauma occurs.(ABSTRACT TRUNCATED AT 250 WORDS)