Immunologic studies of a case of myasthenia gravis associated with pemphigus vulgaris after thymomectomy

A case of myasthenia gravis was associated with thymoma and pemphigus vulgaris. The bullous lesions developed after partial thymomectomy, cobalt (60Co) irradiation, and 3 days' extensive sunbathing, although a retrospective study of the patient's sera by quantitative indirect immunofluorescence method indicated that antiepithelial antibody already was positive before the clinical appearance of pemphigus vulgaris. Serial observation of the patient's clinical course and titrations of antiepithelial, antimuscle, and antithymus antibodies suggested a reverse relationship between the severity of myasthenia gravis and titers of antimuscle and anitithymus antibodies, and a parallel relationship between pemphigus vulgaris and antiepithelial antibody. Review of the literature suggests a close relationship between pemphigus vulgaris and myasthenia gravis and thymoma, particularly thymoma injured by medical procedures.     

Immunologic studies of a horse with lymphosarcoma

Immunological, clinical, and pathological investigations were conducted on a horse with lymphosarcoma. The immunological status was investigated by measuring the level of antibodies by single radial immunodiffusion test and the ability of lymphocytes to proliferate in response to mitogens. Multiple immunological abnormalities were noted in this horse. They were; (1) decreased IgM, IgG, and IgA levels in the serum despite hyperproteinemia; (2) increased in-vitro spontaneous lymphoproliferation which reflects augmented mitosis; (3) decreased lymphoproliferative response to T cell stimulants (e.g. Concanavalin-A (Con-A)) suggesting impaired T cell activation; (4) presence of immunosuppressive factors in serum as demonstrated by in-vitro lymphocyte culture systems. Clinical pathology findings revealed an unusual monoclonal alpha peak in the serum and morphologically abnormal lymphocytes distributed throughout the body. Serum fractionated by fast protein liquid chromatography (FPLC) revealed that the immunosuppressive factors were found in this abnormal alpha peak. The immunopathological findings in this horse are discussed.     

Immunologic aspects of allergic and non-allergic asthma

METHODS: The peripheral blood lymphocytes and lung function have been studied in 25 patients: 12 affected by atopic asthma and 13 affected by non atopic asthma. RESULTS: The results obtained indicate that peripheral blood CD3 and CD4 cell as well as HLA-DR marker are higher in the extrinsic asthma group. CONCLUSIONS: These findings confirm that an active inflammatory process exists in the group of non-atopic and functionally more compromised patients.     

Time-sensitive clinical management: a case study of acute asthma care

This paper emerged from a study of change in a major teaching hospital subsequent to the introduction of casemix-based funding--a management tool designed to support the development of industrial practices in hospital management. A clinical unit had been advised to become more financially efficient. The unit staff redefined the task as becoming more clinically effective, as well as more efficient. One of the important themes to emerge was the importance of time. The resultant changes in the provision of care reflected a sophisticated approach to time.     

A disease management case study on asthma

This paper provides an overview of how one pharmacy benefits manager, MedImpact Pharmaceutical Management, Inc. (San Diego, California), approaches its disease management (DM) program for asthma. This group's experience with DM counters the common but fallacious belief that reduction of component costs leads to reduction of total expenditures. In fact, greater expenditures on certain components (in particular, drug therapies and preventive and follow-up visits to physicians) can result in greatly reduced overall expenditures by reducing hospitalizations and emergency department treatments for asthmatic patients. The program addresses four essential components of DM: physician intervention, patient empowerment, health risk management, and pharmaceutical care. For each of these areas, careful statistical analysis, effective education, and integrated management can help improve patient care while reducing overall costs.     

Misdiagnosis of asthma. Two paradigmatic case reports

We present two children, respectively five and six years old, misdiagnosed and treated as asthmatics in allergological centers. After admission to our department, endobronchial inflammatory pseudotumor and lung tuberculosis were diagnosed respectively. While endobronchial pseudotumor is rather rare, lung tuberculosis is a less rare diagnosis that must be considered in patients with a history of persistent and recurrent coughing with or without wheezing, especially when there is no family history of atopical diseases and skin allergic tests are negative, and the social and economic conditions at risk.     

A case management approach to pediatric asthma

Infertility can cause women to lose their sense of power and control, thus diminishing their self-esteem. Terminology, technology, and testing may contribute to this sense of failure. Nurses can intervene by recognizing this negative consequence of infertility and using strategies within the nursing model.     

Immunologic dysfunction in cancer

The interactions between the tumor and its host are complex, and many aspects of the immune system appear to be adversely affected directly or indirectly by the presence of the tumor. Virtually all of the processes involved in immune induction and action have been implicated in the observed deficient response in tumor-bearing patients. Improved understanding and molecular analysis of the mechanisms underlying the escape of tumors from immune surveillance may lead to the development of novel strategies for the prevention of T-cell immunosuppression in cancer patients, the development of novel immunotherapeutic strategies, and potentially prevention of tumor progression or development.     

Immunologic tests in rheumatology

LEARNING OBJECTIVES: Reading this article will familiarize the reader with the application and interpretation of different autoantibody tests used in rheumatology. DATA SOURCES: Recent rheumatologic textbooks, relevant review articles, and seminal articles in English regarding specific tests. RESULTS: An understanding of this review should enable the reader to approach diagnostic testing systematically in a patient with a suspected connective tissue disease. CONCLUSIONS: The proper use and interpretation of appropriate immunologic tests are important in the diagnosis and treatment of patients with connective tissue diseases.     

Single case studies in psychotherapy research.

This article examines the potential role of single case statistical studies in psychotherapy research. Techniques examining averages and trends tend to ignore the fact that not all statistically identical events are qualitatively equivalent and that qualitatively different events may be statistically identical. Single case empirical studies may allow simultaneous quantitative and qualitative explorations that correct for this bias. Intensive single case research allows researchers to choose nonrandom, but theoretically and clinically important, data samples. Such studies also facilitate multidimensional measures–analysis and subtle contextual understanding. This deeper understanding of the single case may then facilitate studies across cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)