Perioperative cefamandole prophylaxis against infections.

Seven hundred and seventeen patients were included in a prospective randomized double-blind trial comparing the efficacy of five doses of cefamandole (group I, 335 patients) with that of a single preoperative dose (group II, 382 patients) for prophylaxis against sepsis in patients who had an operation using either a Moore prosthesis, Ender or Küntscher nails, a bone plate, or another internal-fixation device. Patients who had an open fracture or total joint replacement were not included in the study. The two groups were similar in terms of mean age, sex ratio, duration of preoperative hospital stay, underlying risk factors, and type of surgical procedure.

IgA nephropathy: association of a history of macroscopic hematuria episodes with increased production of polymeric IgA.

From the clinical point of view patients with IgA nephropathy present two main symptoms. Some patients have episodes of macroscopic hematuria, either isolated or recurrent, while others present only asymptomatic urinary abnormalities. Although these differences could be due to age-related, geographical or other unknown reasons, in this paper we studied whether patients with these two clinical manifestations differ in some IgA immunological aspects, described occasionally as abnormal in this disease.

Immunological abnormalities in the tonsils of patients with IgA nephropathy: inversion in the ratio of IgA: IgG bearing lymphocytes and increased polymeric IgA synthesis.

In the last few years the mucosal origin of the IgA deposited in the kidneys of patients with IgA nephropathy has been examined by several investigators. We have previously presented evidence that polymeric IgA may have a predominant role in the pathogenesis of IgA nephropathy. Taking into account that these patients often present with macroscopic haematuria following respiratory tract infections we have studied the possible existence of immunological abnormalities in the tonsils of patients with IgA nephropathy.

Immunological studies in a familial IgA nephropathy.

The hypothesis that abnormalities of immune function might occur in healthy first degree relatives of two patients with a familial IgA nephropathy was tested. After 7 days of culture, pokeweed mitogen stimulated peripheral blood mononuclear cells from the two affected members with IgA nephropathy (father and older son), as well as two other healthy sons, produced significantly more polymeric IgA than the controls. The fact that only the two patients with IgA nephropathy presented high serum levels of polymeric IgA favours the idea that a defect in the clearance of this immunoglobulin might be an important step in the appearance of this nephropathy.

T-cell dysfunctions in IgA nephropathy: specific abnormalities in the regulation of IgA synthesis.

This work was undertaken to determine the cellular abnormalities that could explain the high levels of serum IgA frequently found in patients with IgA nephropathy. Seventeen control subjects and twenty-seven patients who had received no therapy were studied. After in vitro pokeweed mitogen (PWM) stimulation, significantly higher amounts of IgA were produced by peripheral blood mononuclear cells (PBM) of patients when compared with those of the control group (560 +/- 97 vs 231 +/- 57 ng/ml, P less than 0.

Increased rates of polymeric IgA synthesis by circulating lymphoid cells in IgA mesangial glomerulonephritis.

Recently we have described the existence of high levels of polymeric IgA, partially as immune complexes, in the serum and kidney from patients with IgA mesangial glomerulonephritis. As these patients often have macroscopic haematuria, following upper respiratory tract infections, our working hypothesis in this paper was that circulating lymphocytes from secretory tissues after viral stimulus could produce in these patients a large amount of polymeric IgA. To test it, peripheral blood lymphocytes (PBL) from patients and controls were cultured for seven days in the presence or absence of pokeweed mitogen (PWM).