The New England journal of medicine
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To characterize lung sounds objectively, we examined, by means of time-amplitude plots, selected tape recordings of auscultatory phenomena considered by six observers to be typical of those in a standard classification. Normal lung sounds could not consistently be visually distinguished from adventitious sounds at conventional chart recorder speeds of 100 mm per second or less, but the differentiation was easily achieved when the time scale of the plots was raised to 800 mm per second. ⋯ When continuous sounds (rhonchi or wheezes) were heard, the deflections were usually more than 250 msec. Time-expanded wave form analysis provides reproducible visual displays that allow documentation of the differentiating features of lung sounds and enhances the diagnostic utility of the sounds.
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Sjögren's syndrome is associated with a serologically defined histocompatibility antigen of the HLA-B locus, HLA-B8. Another closely linked locus, HLA-D, determines lymphocyte-defined cell-surface antigens. In laboratory animals such antigens are closely linked to immune response genes. ⋯ We found the primary association of association of Sjögren's syndrome to be with HLA-Dw3, which we observed in 84 percent of patients with Sjögren's syndrome in the absence of rheumatoid arthritis as compared to 24 percent in controls (P less than 0.00001). The frequency of HLA-B8 and HLA-Dw3 in patients with both Sjögren's syndrome and rheumatoid arthritis did not differ from that in controls. Patients with Sjögren's syndrome and rheumatoid arthritis comprise genetically distinct groups.