Differential Diagnosis Of Type Research Articles

Pancreatic cancer, pancreatogenic diabetes, type 2 diabetes mellitus

Pancreatic cancer (PC) is the fourth leading cause of death among all types of cancer. PC is very aggressive with a low 5-year overall survival rate. The highest prevalence of diabetes mellitus (DM), significantly exceeding the average population, is registered among patients with prostate cancer Recommendations for systemic screening of patients with diabetes for the detection of PC are not standardized. The purpose of this review is to present an analysis of current literature data on pathogenetic relationships between DM and PC and prospects for PC screening. Research data indicate that there is a bidirectional relationship between DM and PC, in which DM can act either as a risk factor for PC or as a marker of paraneoplastic syndrome of PC. In the differential diagnosis of type 2 diabetes, pancreatogenic diabetes and diabetes associated with PC, a set of clinical signs can be used. Patients with DM who have additional signs/symptoms of increased risk can be considered as a group subject to mandatory screening. Numerous studies of various proteomic, metabolomic, genetic and transcriptomic biomarkers PC have been published. The search for an easy-to-use clinically useful and cost-effective PC marker is still ongoing.

Akut solunum yetmezliğinde optik sinir kılıf çapının prognostik önemi

Purpose: The primary aim of this study was to determine the role of the optic nerve sheath diameter (ONSD) measured using ultrasonography in the differentiation of hypoxemic respiratory failure and hypercarbic respiratory failure. The secondary aim was to determine the value of ONSD in predicting the clinical outcome in hypercarbic patients.
 Materials and Methods: Non-traumatic adult patients presenting with dyspnea were included in this study. Arterial blood gas and concurrent ONSD measurements were obtained from all patients included in the study during presentation and at the second hour of treatment. The patients were divided into two groups - hypoxic and hypercarbic respiratory failure. An equivalent number of healthy volunteers were enrolled as the control group. 
 Result: Mean ONSD values were 3.8±0.2 mm in the 24 patients with type 1 respiratory failure, 5.2 ± 0.5 mm in the 25 patients with type 2 respiratory failure, and 3.9±0.3 mm in the healthy controls. The ONSD of the hypercarbic patients was statistically significantly greater than that of the hypoxic patients and healthy volunteers. The ONSD of the hypercarbic patients was 5.2±0.5mm at baseline and 4.4±0.6 mm after treatment, the difference being statistically significant. However, the difference in ONSD was not statistically significant in predicting hospitalization and mortality. 
 Conclusion: Sonographically measured ONSD may be an effective parameter in the differential diagnosis of type 1 and 2 respiratory failure. ONSD values changed significantly with treatment in patients with type 2 respiratory failure.

Differential Diagnosis of Type 1 and Type 2 Papillary Renal Cell Carcinoma Based on Enhanced CT Radiomics Nomogram.

ObjectivesTo construct a contrast-enhanced CT-based radiomics nomogram that combines clinical factors and a radiomics signature to distinguish papillary renal cell carcinoma (pRCC) type 1 from pRCC type 2 tumours.MethodsA total of 131 patients with 60 in pRCC type 1 and 71 in pRCC type 2 were enrolled and divided into training set (n=91) and testing set (n=40). Patient demographics and enhanced CT imaging characteristics were evaluated to set up a clinical factors model. A radiomics signature was constructed and radiomics score (Rad-score) was calculated by extracting radiomics features from contrast-enhanced CT images in corticomedullary phase (CMP) and nephrographic phase (NP). A radiomics nomogram was then built by incorporating the Rad-score and significant clinical factors according to multivariate logistic regression analysis. The diagnostic performance of the clinical factors model, radiomics signature and radiomics nomogram was evaluated on both the training and testing sets.ResultsThree validated features were extracted from the CT images and used to construct the radiomics signature. Boundary blurring as an independent risk factor for tumours was used to build clinical factors model. The AUC value of the radiomics nomogram, which was based on the selected clinical factors and Rad-score, were 0.855 and 0.831 in the training and testing sets, respectively. The decision curves of the radiomics nomogram and radiomics signature in the training set indicated an overall net benefit over the clinical factors model.ConclusionRadiomics nomogram combining clinical factors and radiomics signature is a non-invasive prediction method with a good prediction for pRCC type 1 tumours and type 2 tumours preoperatively and has some significance in guiding clinicians selecting subsequent treatment plans.

Клінічні та лабораторні критерії цукрового діабету 2-го типу в дітей

Метою даного огляду літератури є аналіз даних літератури щодо клінічних та лабораторних критеріїв цукрового діабету (ЦД) 2-го типу в дітей. Проведений огляд наукової літератури за ключовими словами «цукровий діабет», «цукровий діабет 2-го типу», «клініка», «лабораторні критерії», «фактори ризику» з використанням як пошукової системи PubMed. З огляду на дослідження, що проведені за останні 10 років, проаналізовані тези 213 статей. Критерій для відбору статей для дослідження був заснований на їх тісній актуальності з темою. Більш детально вивчено результати дослідження, що висвітлені у 21 статті. ЦД 2-го типу — багатофакторне захворювання зі спадковою схильністю. Більшість пацієнтів із ЦД 2-го типу вказують на наявність такого захворювання в найближчих родичів; за наявності ЦД 2-го типу в одного з батьків ймовірність його розвитку в нащадка впродовж життя становить 40 %. Здебільшого виражені клінічні прояви відсутні, і діагноз встановлюється при рутинному визначенні рівня глікемії. Захворювання зазвичай стартує у віці понад 10 років, при цьому в переважної більшості пацієнтів відзначаються ожиріння та інші компоненти метаболічного синдрому. Критерії діагностики ЦД 2-го типу запропоновані International Society for Pediatric and Adolescent Diabetes (ISPAD). З метою диференціальної діагностики між ЦД 1-го і 2-го типу в дебюті захворювання визначається рівень у крові інсуліну і С-пептиду як натще, так і під час проведення перорального глюкозотолерантного тесту.

Impairment of carbohydrate metabolism in children and adolescents with obesity

Obesity is one of the socially significant diseases of our time and is a generally recognized risk factor for the development of carbohydrate metabolism disorders, including type 2 diabetes mellitus (DM), the prevalence of which in the pediatric population is rapidly increasing.Aim of the study. To demonstrate the most frequent types of carbohydrate metabolism disorders in children and adolescents with obesity.Materials and methods. 123 obese patients under 18 years old were examined and the structure of obesity complications was analyzed.Results. Carbohydrate metabolism disorders were identified in 24 patients (19%): impaired fasting glycemia (IFG) (8 girls, 6 boys (11%)), type 2 DM (6 girls, 3 boys (7%)), and type 1 DM (1 boy (1%)). Descriptions of 4 clinical cases are given: 1) patient, 17 years old, with constitutional-exogenous obesity of 3rd degree, arterial hypertension (AH), dyslipidemia and nonalcoholic fatty liver disease (NAFLD) and a history of transient IFG; 2) patient, 16 years old, with morbid obesity, NAFLD, AH, polycystic ovarian syndrome (PCOS), type 2 DM, compensated on metformin therapy; 3) patient, 17 years old, with constitutional-exogenous obesity of the 3rd degree, AH, dyslipidemia, NAFLD, type 2 DM (on insulin pump therapy), complicated by diabetic nephropathy and diabetic polyneuropathy; 4) patient, 12 years old, with type 1 DM, manifested against the background of obesity.Conclusion. When screening for obesity complications in children and adolescents, carbohydrate metabolism disorders may be detected in one in five patients. Prediabetes in childhood can be transient. When a child with obesity is identified, differential diagnosis of type 1 and type 2 DM should be made. It is necessary to teach patients with type 2 DM the skills of self-monitoring on a par with patients with type 1 DM and motivate them to control glycemia regularly at home.

Mistaken Identity: Missed Diagnosis of Type 1 Diabetes in an Older Adult

Type 1 diabetes can occur at any age from infancy to elderhood. Patients with hyperglycemia onset at older ages are presumed to have type 2 diabetes, but the misdiagnosis of type 2 diabetes as type 1 diabetes in adults has serious consequences. Medical error in this domain leads to significant patient harm that could be avoided with the correct diagnostic testing. Here, we discuss the case of a 58-year-old man who presented with diabetic ketoacidosis (DKA) at age 51 but was given the diagnosis of type 2 diabetes. During two subsequent admissions for DKA, he suffered severe complications. After his third episode of DKA, antibodies and C-peptide were checked, prompting a change in diagnosis to T1DM. Following a correct diagnosis of T1DM, diabetes education and appropriate treatment, the patient remained free of DKA and had improved glucose control. Under-diagnosis of type 1 diabetes can lead to recurrence of life-threatening episodes of DKA. Anti-GAD antibody and C-peptide testing are under-utilized in the differential diagnosis of type 1 versus type 2 diabetes in adults. This case demonstrates the consequences of the mis-diagnosis of type 1 diabetes as type 2 diabetes. The correct diagnosis is necessary to prevent hospital readmissions, morbidity, mortality and medical errors.

Clinical and morphological characteristics of type 1 and 2 autoimmune pancreatitis

Rationale: In the recent years, an increased interest to autoimmune pancreatitis (AIP) has been seen, related to growing diagnostic potential. In its turn, this leads to an increase in numbers of diagnosed AIP cases. At present, two types of AIP have been described with diverse clinical manifestation and morphology of the pancreas. However, the reproducibility of the differential diagnosis between AIP type 1 and 2 is low even among pancreatic pathologists.Aim: To identify criteria for the morphologic diagnosis of AIP type 1 and 2.Materials and methods: A morphological study of biopsy and surgical specimens from 26 patients with AIP was performed. There were 22 cases of AIP type 1 and 4 cases of AIP type 2. In addition to hematoxylin eosin staining of the specimens, immunohistochemistry was used with counting of CD138+ absolute numbers, determination of IgG+ and IgG4+ cells in the inflammatory infiltrates, as well as the ratios of IgG4+/IgG+ and IgG4+/CD138+ cells.Results: AIP type 1 was characterized by storiform fibrosis of the pancreatic tissue (81.8% cases), involving the parapancreatic fat tissue, by moderateto-severe lymphoplasmocytic infiltration and signs of obliterative/non-obliterative phlebitis. Type 2 AIP was characterized by severe fibrosis with predominantly periductal (centrilobular) fibrosis and mild chronic inflammatory infiltration of the pancreas, while there was no extension of fibrosis and inflammatory infiltration to the parapancreatic tissues in any case. The mean number of CD138+ cell in AIP type 1 was 101.2 ± 27.9 per 1 high-power field (HPF), and in AIP type 2, it was 42.8 ± 20.9 per 1 HPF. The mean absolute number of IgG+ cells in AIP type 1 was 99.6 ± 25.7 per 1 HPF, whereas in AIP type 2, 42.1 ± 20.8 per 1 HPF. In AIP type 1, the mean number of IgG4+ plasmatic cells in the infiltrates was 74.5 ± 27.2 per 1 HPF, whereas in AIP type 2, it was 3.4 ± 2.7 per 1 HPF. The IgG4+/IgG+ ratio was 75 ± 12.6% vs. 8.4 ± 6.2%, and the IgG4+/CD138+ ratio was 72.4 ± 12.3% vs. 8.3 ± 5.9% in AIP type 1 and type 2, respectively.Conclusion: For the differential diagnosis of type 1 and 2 AIP, it is necessary to take into consideration not only typical histological abnormalities, but also the numbers of CD138+, IgG+ and IgG4+ cells within the inflammatory infiltrate, as well as the IgG4+/IgG+ and IgG4+/CD138+ ratios.

No additional value of conventional and high-sensitivity cardiac troponin over clinical scoring systems in the differential diagnosis of type 1 vs. type 2 myocardial infarction.

The distinction of type 1 and type 2 myocardial infarction (MI) is of major clinical importance. Our aim was to evaluate the diagnostic ability of absolute and relative conventional cardiac troponin I (cTnI) and high-sensitivity cardiac troponin T (hs-cTnT) in the distinction between type 1 and type 2 MI in patients presenting at the emergency department with non-ST-segment elevation acute chest pain within the first 12 h. We measured cTnI (Dimension Vista) and hs-cTnT (Cobas e601) concentrations at presentation and after 4 h in 200 patients presenting with suspected acute MI. The final diagnosis, based on standard criteria, was adjudicated by two independent cardiologists. One hundred and twenty-five patients (62.5%)were classified as type 1 MI and 75 (37.5%) were type 2 MI. In a multivariable setting, age (relative risk [RR]=1.43, p=0.040), male gender (RR=2.22, p=0.040), T-wave inversion (RR=8.51, p<0.001), ST-segment depression (RR=8.71, p<0.001) and absolute delta hs-cTnT (RR=2.10, p=0.022) were independently associated with type 1 MI. In a receiver operating characteristic curve analysis, the discriminatory power of absolute delta cTnI and hs-cTnT was significantly higher compared to relative c-TnI and hs-cTnT changes. The additive information provided by cTnI and hs-cTnT over and above the information provided by the "clinical" model was only marginal. The diagnostic information provided by serial measurements of conventional or hs-cTnT is not better than that yielded by a simple clinical scoring model. Absolute changes are more informative than relative troponin changes.

IgG4-Seronegative Autoimmune Pancreatitis and Sclerosing Cholangitis.

IgG4-related disease is a relatively novel clinical entity whose gastrointestinal manifestations include type 1 autoimmune pancreatitis (AIP) and IgG4-associated sclerosing cholangitis. The presence of elevated serum IgG4 is suggestive but not essential for the diagnosis of type 1 AIP and is a pervasive feature of the proposed diagnostic criteria. The differential diagnosis of type 1 AIP includes malignant conditions, emphasizing the importance of a deliberate, comprehensive evaluation. Management of patients with a suggestive clinical presentation, but without serum IgG4 elevation, is difficult. Here we present three cases of IgG4-seronegative AIP and sclerosing cholangitis that responded to empiric steroid therapy and discuss approach considerations. These cases demonstrate the value of meticulous application of existing diagnostic algorithms to achieve a clinical diagnosis and avoid surgical intervention.

Pseudohypoaldosteronism type 1: clinical features and management in infancy

SummaryType 1 pseudohypoaldosteronism (PHA) is a rare heterogeneous group of disorders characterised by resistance to aldosterone action. There is resultant salt wasting in the neonatal period, with hyperkalaemia and metabolic acidosis. Only after results confirm isolated resistance to aldosterone can the diagnosis of type 1 PHA be confidently made. Type 1 PHA can be further classified into i) renal type 1 (autosomal dominant (AD)) and ii) multiple target organ defect/systemic type 1 (autosomal recessive (AR)). The aim of this case series was to characterise the mode of presentation, management and short-term clinical outcomes of patients with PHA type 1. Case notes of newly diagnosed infants presenting with PHA type 1 were reviewed over a 5-year time period. Seven patients were diagnosed with PHA type 1. Initial presentation ranged from 4 to 28 days of age. Six had weight loss as a presenting feature. All subjects had hyperkalaemia, hyponatraemia, with elevated renin and aldosterone levels. Five patients have renal PHA type 1 and two patients have systemic PHA type, of whom one has had genetic testing to confirm the AR gene mutation on the SCNN1A gene. Renal PHA type 1 responds well to salt supplementation, whereas management of patients with systemic PHA type 1 proves more difficult as they are likely to get frequent episodes of electrolyte imbalance requiring urgent correction.Learning points Patients with type 1 PHA are likely to present in the neonatal period with hyponatraemia, hyperkalaemia and metabolic acidosis and can be diagnosed by the significantly elevated plasma renin activity and aldosterone levels.The differential diagnosis of type 1 PHA includes adrenal disorders such as adrenal hypoplasia and congenital adrenal hyperplasia; thus, adrenal function including cortisol levels, 17-hydroxyprogesterone and a urinary steroid profile are required. Secondary (transient) causes of PHA may be due to urinary tract infections or renal anomalies; thus, urine culture and renal ultrasound scan are required respectively.A differentiation between renal and systemic PHA type 1 may be made based on sodium requirements, ease of management of electrolyte imbalance, sweat test results and genetic testing.Management of renal PHA type 1 is with sodium supplementation, and requirements often decrease with age.Systemic PHA type 1 requires aggressive and intensive fluid and electrolyte management. Securing an enteral feeding route and i.v. access are essential to facilitate ongoing therapy.In this area of the UK, the incidence of AD PHA and AR PHA was calculated to be 1:66 000 and 1:166 000 respectively.

Clinical features and differential diagnosis of type 2 diabetes mellitus in children

This review was designed to evaluate prevalence, specific clinical features, and differential diagnosis of type 2 diabetes mellitus (DM2) in childrenand adolescents. Special emphasis is laid on the importance of immunological and molecular-genetic studies for the verification of diagnosis and activecase detection in h groups.

Diagnosis and current treatments for primary iron overload

Primary iron overload encompasses a variety of genetic iron overload syndromes, dominated in frequency by HFE-related, or Type 1 hemochromatosis, for which French diagnostic and therapeutic guidelines have been recently proposed. Differential diagnosis of Type 1 hemochromatosis can be made from both clinical data and genetic studies. Venesection therapy and family screening remain the basis for the curative and preventive management of most genetic iron overload diseases.

Differential diagnosis of type 1 diabetes: which genetic syndromes need to be considered?

Recently it has become apparent that not all diabetes presenting in childhood is type 1. Increasingly type 2 diabetes, secondary diabetes, maturity onset diabetes of the young, and rare syndromic forms of diabetes such as Wolfram syndrome and Alstrom syndrome have been identified in children. Although individually rare, collectively they make up about 5% of children seen in diabetes clinics. The importance of these syndromes for children lies in the recognition of treatable complications, and for their parents, the possibility of genetic counselling. The scientific importance is enormous as they are experiments of nature that reveal basic mechanisms of insulin and glucose metabolism. We are now able to offer mutation analysis to correlate the clinical pattern to the genotype, and seek novel therapeutic approaches based on the developing knowledge of gene and protein functions. This review focuses on monogenic syndromes of diabetes, particularly where significant advances have been made in our understanding recently. Neonatal diabetes is a specialist field in its own right and is not included, except to discuss Kir6.2 diabetes which may develop in infancy. This review is written for the paediatric diabetes specialist and aims to provide information on the clinical features, natural history, genetics and management of children with diabetes as part of a syndrome. Finally there is information on useful investigations to aid diagnosis.

Cognitive Functioning and Aging in Women

SUMMARY Deficits in cognitive function may impact one's ability to attend to stimuli, think clearly, reason, and remember. Impaired cognitive function is a common complaint among older women presenting for treatment in both mental health and medical care settings, and differential diagnosis of type and extent of cognitive impairment is important for appropriate treatment planning and prognosis. Although overall gender differences in prevalence of cognitive dysfunction are minimal, it is important when treating older women to take into account unique challenges they face in the aging process that impact the cause, type and extent of cognitive complaints with which they present in clinical settings. The current paper provides an overview to guide accurate diagnosis, particularly in women, of different types of cognitive impairment under the broad category of dementias, including Alzheimer's, Lewy Body Disease, Vascular Dementia, and due to general medical conditions such as coronary artery bypass surgery, head injury, menopause, hypothyroidism, breast cancer treatment, Fibromyalgia, and chronic fatigue. In addition, emotional factors such as depression in older female patients complicate differential diagnosis of cognitive impairment and must be addressed. Given the multiplicity of causes of cognitive difficulties for women across the life span, careful assessment is crucial; the current paper reviews assessment strategies to prepare an integrated, biopsychosocial strategy for identifying particular cognitive deficits and related psychological and medical problems. In addition, prognostic indicators and treatment planning are discussed to help the practitioner organize an empathic, reasoned and multifaceted treatment approach to maximize recovery, minimize deterioration, and manage symptoms for older women in the context of their social support system and living environment.

MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess

MR Arthrography in the Differential Diagnosis of Type II Superior Labral Anteroposterior Lesion and Sublabral Recess

Postnatal management for prenatally diagnosed choledochal cysts

Purpose The aim of this study was to determine an appropriate postnatal management plan for prenatally diagnosed congenital biliary dilatation (CBD). Methods Between 1962 and 2002, 5 (5.9 %) of 85 patients had CBD diagnosed prenatally and were examined clinically. Of these 5 patients, 2 (group A) underwent delayed primary definitive surgery after percutaneous transhepatic cholangiodrainage (PTCD), 1 (group B) underwent early definitive surgery in the neonatal period, and 2 (group C) underwent delayed primary definitive surgery without PTCD in early infancy (within 6 months after birth). The clinical data, operative findings, intra- and postoperative complications, and follow-up were evaluated in these 3 groups. Results There were no postoperative complications, such as catheter-related complications, in group A. However, there was adhesion around the choledochal cyst, and the operation was therefore difficult in group A. The diameter of the anastomosis in the hepaticojejunostomy was small, and the cyst wall was thin in group B. Consequently, anastomotic leakage of the hepaticojejunostomy occurred in group B. Neither operative nor postoperative complications such as anastomotic leakage or stenosis occurred in group C. Slight fibrosis of Glisson’s sheath was seen in 2 patients of groups A and C. No liver cirrhosis was seen in any group. Conclusions The authors propose that asymptomatic patients should undergo elective definitive surgery by 6 months of age. For symptomatic patients, especially when a differential diagnosis of type I cystic biliary atresia is doubtful, early definitive surgery is needed before 2 months of age. PTCD appears to be indicated only under certain circumstances, and delayed primary definitive surgery should be performed as early as possible thereafter.

Type‐I cryoglobulinemia‐like histopathologic changes in tick bites: a useful clue for tissue diagnosis in the absence of tick parts

The histopathologic findings of localized reactions to tick bites may present as diagnostic dilemmas, especially if there is no history of a tick bite, or if the tick's mouthparts are not present in the biopsied skin. Skin biopsies of patients with a clinical history of a tick bite were selected and reviewed with the aim of detecting a common histopathologic denominator which could serve as a useful clue to the diagnosis, especially when the tick's mouthparts are absent. Hematoxylin and eosin-stained slides of 15 skin biopsies of tick bites were retrieved from three dermatopathology and pathology laboratories. Where additional paraffin-embedded tissue was available, additional sections were also stained with periodic acid-Schiff (PAS) and phosphotungstic acid-hematoxylin (PTAH). In every case in which adequate tissue was available (13/ 15 biopsies), the capillaries and postcapillary venules of the superficial and deep vascular plexi adjacent to the attachment's site were filled with thrombi. Fibrin thrombi were seen in association with other more numerous thrombi characterized by homogeneous eosinophilic hyaline material similar to the cryoprecipitate present in type I (monoclonal) cryoglobulinemia. All thrombi were positive for PAS and PTAH; however, the latter staining was minimally present in the hyaline thrombi. In most cases, the site of the tick bite showed ulceration, with an underlying wedge-shaped superficial and deep perivascular and occasionally interstitial mixed lymphohistiocytic infiltrate. In addition, there were eosinophils, numerous neutrophils and extravasated erythrocytes. Other findings included suppurative necrosis (7/15) cases, giant-cell reaction (one case), fat necrosis (one case) and eccrine gland necrosis (one case). Vascular eosinophilic hyaline thrombi were found to be a frequent histologic manifestation of a tick bite. This finding may be related to the secretory products of the tick's saliva during inoculation. We believe that a tick bite should be suspected when focal intravascular hyaline occlusion is observed, and that it should be included in the differential diagnosis of type I (monoclonal) cryoglobulinemia, even if there is no history of a tick bite or if tick parts are not present in the skin biopsy specimen.

Simple Precipitation-based Method for the Screening of Type III Hyperlipoproteinemia

Familial type III hyperlipoproteinemia (HLP) is characterized by the accumulation of cholesterol-rich remnants (β-VLDL). The differential diagnosis of type III HLP is clinically important because patients with type III HLP develop premature coronary artery disease (CAD) and peripheral atherosclerosis and because type III HLP responds well to dietary treatment and fibric acid derivatives(1)(2). Pathogenetically, type III HLP is related to dysfunctional isoforms of apolipoprotein (apo) E. At the APOE gene locus, three common alleles exist, designated e2, e3, and e4 (3)(4)(5). apoE2 is defective in its binding to lipoprotein receptors(6)(7). Because of the impaired catabolism of chylomicron and VLDL remnants, individuals homozygous for apoE2 reveal detectable amounts of β-VLDL in their plasma. β-VLDLs are atypical lipoproteins with a density <1.006 kg/L and β-mobility on agarose gel electrophoresis. Compared with normal VLDL, β-VLDLs are cholesterol-enriched; compared with normal LDL, they are relatively enriched in triglycerides. More than 90% of patients with type III HLP are homozygous for apoE2, but only ∼1 in 20 individuals carrying the E2/2 phenotype finally develops type III HLP (8). Those homozygous carriers of apoE2 having small amounts of β-VLDL in their plasma not sufficient to produce overt hyperlipidemia have been classified as suffering from normolipidemic dysbetalipoproteinemia. The term type III HLP, in contrast, is applied to hyperlipemic individuals only. Clinical characteristics such as palmar, tendon, and/or tubero-eruptive xanthomas do not occur in all individuals with type III HLP. To establish biochemically the diagnosis of type III HLP, the following criteria have been applied in this study: (a) presence of increased cholesterol and triglycerides at 2500 mg/L or more, (b) an increased ratio of VLDL-cholesterol (VLDL-C) to VLDL-triglycerides (VLDL-TG; >0.4), and (c) an increased ratio of VLDL-C to total triglycerides (>0.3) (9)(10)(11). …

In vitro histamine release from leukocytes in penicillin allergies.

The definite diagnosis of Type I allergy against penicillin is very important. The in vivo tests used for this purpose may have some disadvantages for the patient. Among the in vitro tests used for the evidence and differential diagnosis of Type I allergy against penicillin, the determination of histamine release from leukocytes and the detection of IgE by the RAST test are the most promising. We have used the test of histamine release from leukocyte in this study of 18 cases, nine of whom had Type I hypersensitivity reactions to penicillin and comprised the study group, the rest were control cases. The per cent of histamine release in the control group was "zero" while in the study group it ranged from 3.9 to 51.7 per cent. The results indicate that the method used in this study is a sensitive and reliable method for the diagnosis of Type I penicillin allergies.

A simple sphingomyelinase determination for Niemann‐Pick disease: differential diagnosis of types A, B and C

Journal of NeurochemistryVolume 21, Issue 4 p. 999-1001 A simple sphingomyelinase determination for Niemann-Pick disease: differential diagnosis of types A, B and C K. Harzer, K. Harzer Institut für Hirnforschung der Universität, 74 Tübingen, FRGSearch for more papers by this authorH. U. Benz, H. U. Benz Institut für Hirnforschung der Universität, 74 Tübingen, FRGSearch for more papers by this author K. Harzer, K. Harzer Institut für Hirnforschung der Universität, 74 Tübingen, FRGSearch for more papers by this authorH. U. Benz, H. U. Benz Institut für Hirnforschung der Universität, 74 Tübingen, FRGSearch for more papers by this author First published: October 1973 https://doi.org/10.1111/j.1471-4159.1973.tb07545.xCitations: 22Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume21, Issue4October 1973Pages 999-1001 RelatedInformation