Swiss medical weekly
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The cellular and humoral immunity of patients with pulmonary tuberculosis has been evaluated prospectively in 22 PPD-positive and 10 PPD-negative patients by intradermoreaction (IDR), blast transformation (SL) and MIF production in response to PPD, Candida and varidase, peripheral lymphocyte count, and quantitative evaluation of immunoglobulins. There is a very good correlation between the different tests, and anergy is frequently found in elderly patients. Negative results (IDR, SL, MIF) are significantly observed in the presence of a negative PPD-IDR, lymphopenia (less than 1,000/mm3), impaired blast transformation in response to PHA (less than 21,000 cpm), and a cavitary form of tuberculosis. These findings suggest a defect of cellular immunity in these patients.
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A short review on new types of insulin preparations purified by chromatography is presented. The purity of these new chromatographed insulins, which have almost completely replaced the conventional types of insulin, has been considerably improved. Our own investigations have revealed significantly lower antigenicity of porcine depot preparations compared with beef or mixed beef-pork insulins. ⋯ Mixed beef-pork Lente Insulin purified by single chromatography is also less antigenic than Lente Insulin of conventional purity, but more antigenic than pork insulin (e.g. Monotard). Pork insulin purified by chromatography is indicated in cases of insulin allergy, insulin resistance and lipoatrophy, and also for first insulin treatment in younger and middle-aged diabetics.
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Swiss medical weekly · Jun 1976
[Classification and infectiousness of chronic hepatitis B, defined by the Dane particle in the blood and virus components in the liver].
55 HBAg seropositive patients with chronic hepatitis B selected from a total of 217 liver biopsies were studied for the presence of HBcAg and HBsAg in the liver tissue and of Dane particles in blood by immunofluorescence and electron microscopy. Among 27 patients with non-aggressive chronic inflammation the following constellations were found: a) 19 patients (13 with nonspecific reactive hepatitis, 6 with chronic persistent hepatitis) had isolated HBsAg expression in the tissue (HBs type) and of these only 2 had rare Dane particles; b)4 patients (all with histologically very active chronic persistent hepatitis) with focal HBc- and HBsAg tissue expression (HBc+s type) and detectable Dane particles in blood; c)4 patients (1 with nonspecific reactive, 3 with chronic persistent hepatitis) with generalized HBcAg (and focal HBsAg) expression (HBc type) and multiple Dane particles in blood. Among 22 patients with aggressive inflammation (19 with chronic aggressive, 3 with "hippie"-hepatitis) focal HBcAg tissue expression (HBc+s type) was found in 17 cases and absence of HBcAg in 5 (3 with focal HBsAg, 2 completely negative by immunfluorescence), all 22 associated with Dane particles in blood, however. ⋯ This duality applies mainly to clinically and histologically benign non-aggressive forms of hepatitis presenting with a carrier state or chronic persistent hepatitis. On the basis of these and earlier findings a hypothetical concept of chronic hepatitis is presented which possesses proven diagnostic and prognostic applicability to routine liver biopsies. It is also capable of shedding new light on contradictory findings in the literature and serving as a basis for prospective epidemiologic studies.
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Swiss medical weekly · May 1976
Case Reports[Graft versus host disease, a little known complication of blood transfusion].
A case of fatal graft-versus-host disease (GvHD) following blood transfusions is reported. This relatively rare complication of blood and bloodcomponent replacement therapy may occur in recipients with decreased cellular immunity, which may be due to the underlying disease, chemotherapy or radiation therapy, or a combination of both. GvHD is a result of active proliferation of transfused immunologically competent cells which attack host organs. This complication can be prevented by irradiating transfusions with 1500 rads in vitro.
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Since secondary deep mycoses are frequently seen in internal medicine nowadays, increasing interest has been focused on antimycotic therapy. This report deals with the limited available range of antimycotic substances which can be administered systemically. Since severe adverse effects are often observed with Amphotericin-B, the most effective antifungal agent, the advent of three new systemic antifungal drugs (Clotrimazole, Miconazole, 5-Fluorocytosine) has proven to be a real advance in our therapeutic approach to deep mycoses. To avoid unwanted side-effects, combined therapy with low doses of Amphotericin-B and another antimycotic agent promises to become increasingly important.