Lymphomatoid granulomatosis in a renal transplant recipient

Lymphomatoid granulomatosis is a multi-system disorder of high mortality and characterised by angiocentric and angiodestructive lymphoreticular proliferative and granulomatous change. A case is described of this disease occurring in a renal transplant patient. The patient underwent a rapid remission of the disease after a course of combined cytotoxic therapy and remains free of disease three years after treatment. This case is the second described renal transplant patient to develop the disease and the first to be successfully treated. It is likely that the disease originated as a consequence of immunosuppression similar to the development of lymphomas in allograft recipients.

[The mixing index in the argon breath holding test for the demonstration of pharmacologically induced airways reactions. A comparison with other methods (author's transl)]

In 42 patients with obstructive airways diseases the behavior of the mixing index (delta argon %/1 during phase III of the argon-volume diagram) was studied after beta2 stimulation or after provocation by acetylcholine. Changes in airways resistance resp. conductance (GAW), FEV1.0 and residual volume (RV) were also determined for comparison. In an inhomogeneous subgroup with obstructive airways disease of various aetiology the mixing index (MI) and FEV1.0 indicated changes in the airways system with about equal frequency. Distinct discrepancies between the two tests, observed in a few cases, suggest that the two methods register different pathophysiological reactions. These differences could be confirmed statistically in a more homogeneous subgroup with extrinsic bronchial asthma. A correlation could be established between MI and RV on the one hand and between FEV1.0 or GAW and RV on the other hand. The results indicate that the mixing index as a test of distribution of ventilation reflects mainly the reactions of the small airways. Its use offers the possibility of a more differentiated pharmacodynamic evaluation.

A data processing system for a group of three clinical chemistry laboratories. 1. Hardware and organisation

A real time data processing system for a group of three clinical chemistry laboratories (one base and two satellite) has been developed as a successor to one used previously. This paper describes both the inadequacies of the previous worksheet-based system and the advantages of the new system, including flexibility, fast response and comprehensiveness, incorporating urgent routine and long delay (that is, endocrine) requests, and the use of a parallel flow work scheme.

A data processing system for a group of three clinical chemistry laboratories. 2. File structure and operation

In the preceding article the hardware and organisation of a new data processing system were described. This paper deals with the file structure and operation, the use of management information, the economical use of disc-file space and hardware, and the transferability of the system.

Injuries in soccer

The injury profile of a professional soccer team from the 1976 to 1977 season is compiled in this report. Injuries are spread across all of the playing positions, with midfielders and forwards being most prone to injury. During the entire season of this report, 60 injuries were encountered, 35 during game situations and 25 in practice. The most common injuries noted were foot and ankle sprains, but muscle strains were also frequent. Most injuries were of a minor variety. Seventeen injuries resulted in missed games while 46 injuries resulted in no games being missed. Only one player had an injury which did not allow him to return to play during the season. Although little is written in the American literature concerning soccer injuries, it does appear that the injury potential is much less when compared with that of football. The rapid increase in interest in this sport will require physicians and trainers to become familiar with its specific needs in order to render adequate care and participate in injury prevention programs.

The determination of antithrombin III. Comparison of six methods. Effect of oral contraceptive therapy

At III levels measured with six methods in 36 people: 10 healthy controls, 10 women taking a progestagen Lynestrenol and 16 women taking a combined oestrogen-progestagen contraceptive pill. The reproducibility and the sensitivity of these methods as well as the correlation between methods were studied. The Hensen and Loeliger technique had a poor reproducibility and the results obtained with the Howie technique were not in good correlation with those obtained with other methods, especially in the group taking oral contraceptives. The two amidolytic methods using chromogenic substrates were found to be very accurate for antithrombin III activity determination. The rocket immunoelectrophoresis was more accurate and more practical than the radial immunodiffusion. With all methods--except the one of Howie--the 10 women taking progestagen Lynestrenol and the 16 taking combined oestrogen-progestagen had a low AT III and differed significantly from the 10 normals tested. No difference was observed between women taking progestagen only or an oestrogen-progestagen combination.

The activation of plasma factor XIII with the snake venom enzymes ancrod and batroxobin marajoensis

The snake venom enzymes Ancrod and Batroxobin marajoensis are able to activate human plasma factor XIII as shown by the formation of the gamma-dimers. The concentration of gamma-dimers increases with the concentration of the activating enzymes. Factor XIII activated by Ancrod or Batroxobin marajoensis is, however, unable to catalyse the incorporation of the amine dansyl-cadaverine into casein. The partially activated factor XIII is therefore not demonstrable by means of the artificial test system. This factor XIII loses little activity and remains activable by thrombin.

Interaction study between phenprocoumon and flurbiprofen

The effects of flurbiprofen on various coagulation and haemostasis parameters were studied in 19 patients adequately anticoagulated on a fixed dose of phenprocoumon. Laboratory controls were performed 5 times at weekly intervals. Flurbiprofen 50 mg 3-times daily was given for 2 weeks after an initial control period of 2 weeks. The last control followed 1 week after cessation of flurbiprofen. All changes observed during the administration of flurbiprofen were quantitatively moderate; some reached statistical significance. The prothrombin time (%) Factor II and Factor X values fell; Factor II values remained unchanged. Factor IX values fell only in the first week on flurbiprofen and reached control values thereafter. Phenprocoumon concentration remained constant throughout. There was no change in spontaneous platelet aggregation. Although there was a slight, statistically significant increase in the Ivy bleeding time, it remained within the normal range. These findings suggest that the interference of flurbiprofen with oral anticoagulation is minimal and probably of no clinical relevance.

Implementation of a British computer system for laboratory data handling

This paper describes the development and implementation of a small real-time British computer system for the handling of patient and test result data in the chemical pathology laboratories of the King's Health District (Teaching). Work destined for subsequent reporting by the computer system is entered by continuous on-line teletype. Test result data from multichannel analyzers are input using an on-line trace reader. Cumulative reports are printed both by line printer at the central laboratory and by on-line teletypes at two peripheral hospital laboratories. In a working day over 4000 new items of data are generated and 300-500 reports printed. The use of a trace reader as an inputing device and the method of employing a high capacity disk to give both speed of operation and limited archive facility are discussed.