ABSTRACT
Decreased binding capacity of the erythrocyte complement receptor (RBC CR1) in systemic lupus erythematosus (SLE) may contribute to abnormal handling of circulating immune complexes in these patients. Decreased numbers of RBC CR1 have been reported in SLE, but, since binding is a function of both receptor number and receptor binding kinetics, we measured kinetic parameters for the interaction of complement (C) containing [3H]DNA:anti-DNA immune complexes (IC) with normal control (NC) and SLE RBC. Experiments were performed at five temperatures ranging from 7-37 degrees C. The parameters measured included: (1) the maximum quantity of DNA:anti-DNA:C which could bind per RBC, S; (2) the association rate constant, ka, for the binding of DNA:anti-DNA:C to RBC; (3) the dissociation rate constant, kd, for the dissociation of bound DNA:anti-DNA:C IC from RBC; (4) the steady-state constant, Kss (ka/kd); and (5) the energies of activation for association, Eaa, and dissociation, Ead. Although the relative amount of bound DNA:anti-DNA:C per RBC was significantly decreased in SLE patients compared to NC (P less than 0.001), the mean values for Kss, ka, kd, Eaa and Ead did not differ significantly between the two groups. These data suggest the following: (1) RBC CR1 binding and dissociation of DNA:anti-DNA:C are consecutive reactions resulting in steady-state concentrations of free and RBC-bound IC; (2) at steady-state times, the ratio of RBC bound to unbound DNA:anti-DNA:C are governed by kinetic factors; (3) since the binding kinetics of SLE and NC RBC are not significantly different, the decreased binding activity described by other investigators can only be due to a decreased number of CR1 per RBC; and (4) values for Eaa and Ead suggest that the rate-determining steps in IC association with and dissociation from RBC involves making and breaking of hydrogen bonds.
Subject(s)
Antigen-Antibody Complex/metabolism , DNA/immunology , Erythrocytes/immunology , Lupus Erythematosus, Systemic/immunology , Antibodies, Antinuclear/metabolism , Humans , In Vitro Techniques , Kinetics , Models, Chemical , Receptors, Complement/metabolism , ThermodynamicsABSTRACT
Splenectomy was performed in patients with Hodgkin's disease in a prospective study at the University Hospital of Umeå 1973-1978. Fifty-nine subjects were included and the laparotomy was made as a part of the pre-treatment investigation. The result of the surgical exploration was compared to other investigations, e.g., lymphangiography or cavography. The operation morbidity was 5% (3/59). The clinical stage was changed in 15/58 (26%). Fourteen upstaged and one downstaged. The macroscopical evaluation was poorly correlated to the histological involvement. It is concluded that if the staging procedure is performed by specialized surgeons the morbidity is low. No adverse effects have yet been observed after splenectomy. The staging laparotomy and splenectomy is considered superior to nonsurgical staging procedures from both treatment and cost benefit point of view.
Subject(s)
Hodgkin Disease/pathology , Laparotomy , Adolescent , Adult , Female , Hodgkin Disease/mortality , Hodgkin Disease/surgery , Humans , Lymph Nodes/pathology , Lymphography , Male , Middle Aged , Postoperative Complications/mortality , Prospective Studies , Splenectomy/adverse effectsABSTRACT
The effect of adjuvant combination chemotherapy when given to non-laparotomized patients in remission after radiotherapy in stage I or II non-Hodgkin's lymphoma was studied in a prospective randomized multicenter study. Locally extended field radiotherapy was given to a target absorbed dose of 40 Gy in 20 fractions. Fifty-five patients who were in complete remission 6 weeks after conclusion of radiotherapy were randomized to either no further therapy or to 9 cycles of CVP (cyclophosphamide + vincristine + prednisolone). The relapse-free survival at 30 months was 41% for patients without and 86% for patients with adjuvant chemotherapy (p = 0.02). The survival was the same for both treatment arms, being 90% at 30 months. Fifteen patients have relapsed, 14 of them with extensions and 1 with a recurrence within the radiation target volume. Analysis of subgroups showed that adjuvant chemotherapy in the present series significantly prolonged the relapse-free survival in diffuse histiocytic lymphoma.
Subject(s)
Cyclophosphamide/administration & dosage , Lymphoma/therapy , Prednisolone/administration & dosage , Vincristine/administration & dosage , Adolescent , Adult , Aged , Clinical Trials as Topic , Drug Therapy, Combination , Female , Humans , Lymphoma, Large B-Cell, Diffuse/therapy , Lymphoma, Non-Hodgkin/therapy , Male , Middle Aged , Remission, SpontaneousABSTRACT
Sideropenic anemia with epithelial lesions (Plummer-Vinson syndrome) was previously very common among women in northern Sweden. The incidence of this condition is decreasing, however, because of better nutrition and improved health care. Plummer-Vinson syndrome as a sequela of previous sideropenic anemia still influences the pattern of hypopharyngeal and oral cancer in northern Sweden where the female/male ratio in these diseases is remarkably high and where cancer in the postcricoid part of the hypopharynx is relatively common. In Sweden as a whole, a decreasing trend in the incidence of hypopharyngeal cancer in women can be demonstrated, which is probably due to diminished prevalence of Plummer-Vinson syndrome.
Subject(s)
Deglutition Disorders/epidemiology , Pharyngeal Neoplasms/epidemiology , Plummer-Vinson Syndrome/epidemiology , Adult , Aged , Female , Humans , Male , Middle Aged , Mouth Neoplasms/epidemiology , Nutritional Physiological Phenomena , Plummer-Vinson Syndrome/complications , Precancerous Conditions/etiology , Smoking , SwedenABSTRACT
Radiation induced brachial plexus lesions were correlated to the dose-time-fraction schedule. Ellis' formula was used and the mathematical treatments were made according to KIRK et coll. (1971). It was found that the frequency of lesions increases very rapidly for small increases of CRE over a certain level.
