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The Zenith Syndrome by Robert Menzies (2013, Paperback, Large Type)
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Chen Y, Bodles AM. Amyloid precursor protein modulates beta-catenin degradation. J Neuroinflammation ; 4: The epidemiology of the dementias: Curr Opin Psychiatry ; She was treated with PLEX, steroids and cyclophosphamide, the latter for 32 months—a period greatly exceeding usual practice. She improved with treatment and no further relapses have occurred despite continued cigarette smoking. Standard therapy again improved the PH, but she was left dialysis-dependent. Like the case of Liu et al. Taken together, these two cases provide an important lesson that a monophasic illness is not inevitable in anti-GBM disease, and detection of anti-GBM antibodies can be quite variable depending on the assay used.
These observations extend the phenotype of antic-GBM disease. A common feature in these two cases is the continuing exposure to pulmonary irritants and prominent manifestations of PH with relapses. This might explain the repeated bouts of PH in the presence of a low and undetectable by conventional assays levels of possibly low-affinity anti-GBM antibodies. These antibodies might have been detected by WB or bio-sensor-based assays, which were not performed. The continued presence of linear deposits of IgG in the case of Gu et al.
WB or chemiluminescence assays are preferred when the ELISA assays are inextricably negative; however, these assays may be of limited availability.
Evaluation of a new disease-specific endovascular device for type B aortic dissection.
The observation of a response of PH to PLEX, cyclophosphamide and steroid therapy despite the absence of detectable anti-GBM antibodies implies that removal of some substance or replacement of a missing factor was involved. While this may have been low-affinity anti-GBM antibody, other factors might also be involved, such as complement components or cytokines.
But this is pure speculation. In any case, while many questions cannot be answered, these two exceptional cases re-emphasize the broad spectrum of anti-GBM disease and illustrate the limitations of presently available unstandardized assays for anti-GBM antibody. The option of bilateral nephrectomy has been largely abandoned as a maneuver to prevent recurrent anti-GBM disease in renal allografts [ 31 ], but anecdotes of improvement in the activity of native disease and refractory, persistently high anti-GBM antibody levels following bilateral nephrectomy have been reported [ 32 ].
The evidence that the diseased kidneys somehow are involved, in provoking continued autoantibody production resistant to immunosuppressive therapy perhaps by release of altered GBM antigens, is weak and unsubstantiated. Finally, every effort should be made to remove subjects from exposure to pulmonary irritants of any kind in patients with a diagnosis of anti-GBM disease, regardless of the presence or absence of detectable circulating anti-GBM antibodies.
All patients with anti-GBM disease also deserve regular and close follow-up, even for years after the initial episode, even though only a very few will pursue a course revealed by these two highly instructive cases. See related article by Liu et al. Multiple recurrences of anti-glomerular basement membrane disease with variable antibody detection: Clin Kidney J 9: Frequently relapsing anti-glomerular basement membrane antibody disease with changing clinical phenotype and antibody characteristics over time. National Center for Biotechnology Information , U.
Journal List Clin Kidney J v. Published online Jul Author information Article notes Copyright and License information Disclaimer. Correspondence and offprint requests to: Received Jun 28; Accepted Jun For commercial re-use, please contact journals.
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See " Multiple recurrences of anti-glomerular basement membrane disease with variable antibody detection: This article has been cited by other articles in PMC. Abstract Anti-glomerular basement membrane GBM disease usually pursues a self-limited course, at least from the immunological perspective.
Conflict of interest statement None declared. The role of anti-glomerular basement membrane antibody in the pathogenesis of human glomerulonephritis. Perturbations first began to be studied in order to. These radiant sources were formed approximately twelve billion years ago.
Quasar formations take place by collision of galaxies, i. Quasars were foremost identified as red shift sources. It was launched in and is one of the great observatories of NASA. Hubble was created with a need to capture high-resolution images of universe. It is capable of taking high-resolution images with negligible background light. Though the HST launched in , the idea of maki. Heliopause is the outer edge of the heliosphere which acts as the surface of the bubble that surrounds our solar system.
The Heliopause is that part of the solar system which is exposed to particles and ions of deep space.
Heliopause is the boundary of the heliosphere which is the spherical region around the Sun. It is filled with solar magnetic fields and solar wind that consists.
Solar panels are those devices which are used to absorb the sun's rays and convert them into electricity or heat. A solar panel is actually a collection of solar or photovoltaic cells, which can be used to generate electricity through photovoltaic effect. These cells are arranged in a grid-like pattern on the surface of solar panels. Thus, it may also be described as a set of. An aurora is a natural phenomenon which is characterised by a display of a natural-coloured green, red, yellow or white light in the sky. ISRO was formed in with a vision to develop and harness space technology in national development, while pursuing planetary exploration and space science research.
A Lagrangian point is a position or location in space where the combined gravitational forces of two large bodies is equal to the centrifugal force that is felt by a third body which is relatively smaller.
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The two large bodies here may be the Earth and Sun or the Earth and Moon. A lagrangian point is also known as a Lagrange point, Liberation point, or L-point. These points are loc. Choose your reason below and click on the Report button. This will alert our moderators to take action. Get instant notifications from Economic Times Allow Not now You can switch off notifications anytime using browser settings. National Entrepreneurship Awards Vodafone Business Services Digilogue - Your guide to digitally transforming your business.