Covalent modification of protein by drugs may disrupt self-tolerance, leading to lymphocyte activation. Until now, determination of the threshold required for this process has not been possible. Therefore, we performed quantitative mass spectrometric analyses to define the epitopes formed in tolerant and hypersensitive patients taking the β-lactam antibiotic piperacillin and the threshold required for T cell activation. A hydrolyzed piperacillin hapten was detected on four lysine residues of human serum albumin (HSA) isolated from tolerant patients. The level of modified Lys541 ranged from 2.6 to 4.8%. Analysis of plasma from hypersensitive patients revealed the same pattern and levels of modification 1–10 d after the commencement of therapy. Piperacillin-responsive skin-homing CD4+ clones expressing an array of Vβ receptors were activated in a dose-, time-, and processing-dependent manner; analysis of incubation medium revealed that 2.6% of Lys541 in HSA was modified when T cells were activated. Piperacillin–HSA conjugates that had levels and epitopes identical to those detected in patients were shown to selectively stimulate additional CD4+ clones, which expressed a more restricted Vβ repertoire. To conclude, the levels of piperacillin–HSA modification that activated T cells are equivalent to the ones formed in hypersensitive and tolerant patients, which indicates that threshold levels of drug Ag are formed in all patients. Thus, the propensity to develop hypersensitivity is dependent on other factors, such as the presence of T cells within an individual’s repertoire that can be activated with the β-lactam hapten and/or an imbalance in immune regulation.
Acting on the Holy Qur’an by contemplating its meanings, stopping at its commands and prohibitions, and everything in it that guides us to truth and mercy. The Holy Qur’an includes it for various purposes in one verse, and there is no doubt that this is part of the perfection of this great book, and one of the sciences of the fundamentalists is the indication of the context, and it is a great science of high rank, and it is one of the most important things that lead to the correct understanding of the miraculous and decisive book of God Almighty, and one of the best meanings of the Qur’an It was not from the context of the verses, and from here it can be said that the indication of the context is one of the origins of deriving lega
... Show MoreThe information revolution، the new language has become one for all the peoples of the world through handling and exchange and to participate in all key areas (economic، cultural and scientific) and Accounting episode of this revolution has turned most of the traditional systems (manual) in companies to automated systems، this transformation in the regulations summoned from the auditors that develops their traditional examination automated systems so had to provide tools for auditing help auditors to keep abreast of developments and as a result there is no evidence checksum Local Private audited automated systems came search to provide evidence helps auditors for guidance as part of COBIT، which provides audit procedures Detailed inf
... Show MoreThe research aims to learn spatial disparities tracts of agricultural crops in the
province of Maysan and their relationship (the salinity of the soil and the degree of chemical
interaction (PH)) The research is divided into an introduction and three Investigation eat first
section spatial disparities agricultural crops (cereals, vegetables, legumes and forage). The
comparison between the years of production in the province where the province has seen
varied spatial by hand and taking second section degrees of soil salinity and its impact on
agriculture, as well as the chemical reaction (PH) and its impact on agriculture The third
section has been used three technical techniques first linkage and the second simple an
Abstract
Performance evaluation is of great importance in all countries of the world, because it has a prominent and effective role in determining the efficiency and effectiveness of the optimal use of available resources, which are rare and important in achieving the desired objectives. With the continued growth of public spending and the limited resources, the State seeks to achieve its objectives through its units with minimal expenditure or deficit, rationality and wastefulness in the spending. In many countries, particularly developing countries, reforms are made in the public sector to achieve that goal through the adoption of IPSAS, which is reflected in the developmen
... Show MoreIndustrial product is one of the things of daily use and direct interaction with the user, so the ranges of its association to the user, took a varied and multiple aspects. The user today sees the products as things have specifications related directly to the psychology of the user, so he can reflects his values, principles and ideas on the composition of the total structure of the product, making them a means by which manifested the internal entity's of the user took an external materiality. And then counting the products being things excite positive feelings among different user was a natural result given the complexity of the relationship between the user and the industrial product. So pleasure is one important effects that result fro
... Show MoreContemporary arts have achieved, in accordance with the transition of concepts, a new logic in presentation and expression in general, and specifically in the field of ceramic art. The shift towards the logic of rejection and subversion of prevailing methods, which have been almost a constant foundation for a long period, has directly influenced the direction of visual arts in the contemporary world.
The growth and cultural transformations that the world has witnessed after the two World Wars have produced cognitive shifts based on strategies that diverge from the dominant culture. These approaches vary according to existential needs, as the language of art has become conceptual and a medium for contemporary culture with its rapid an
Background: Drug resistant epilepsy is defined as failure of adequate trials of two tolerated, appropriately chosen and used antiepileptic drug schedules to achieve sustained seizure freedom. Up to 30% of patients referred to clinics with a diagnosis of pharmaco-resistant epilepsy may have been misdiagnosed, and many can be helped by optimizing their treatment.Pseudoresistance, in which seizures persist because the underlying disorder has not been adequately or appropriately treated, must be ruled out or corrected before drug treatment can be considered to have failed.
Objectives: The objectives of this study were to determine the causes of drug failure in patients with epilepsy and to differenti
... Show Moreتشهد بیئة الأعمال المعاصرة جملة من التغیرات والتطورات التكنولوجیة وتزایداً في حدةالمنافسة، وأتساع الفجوة بین العاملین والإدارة ، وقدرة الإدارة على التمییز بین الموظفین، والمشاركة فيإتخاذ القرارات، الامر الذي یلقي على عاتق شركة التأمین إجراء التغییر التنظیمي لتحقیق تطور فيالخدمات التأمینیة التي تقدمها للجمهور من تنوع التغطیات التأمینیة )الوثائق( والسرعة في تسویةالتعویضات وغیرها من الانشطة التي تمارسه
... Show MoreThe aim of this study is to design a proposed model for a document to insure the mistakes of the medical profession in estimating the compensation for medical errors. The medical profession is an honest profession aimed primarily at serving human and human beings. In this case, the doctor may be subject to error and error , And the research has adopted the descriptive approach and the research reached several conclusions, the most prominent of which is no one to bear the responsibility of medical error, although the responsibility shared and the doctor contributes to them, doctors do not deal with patients according to their educational level and cultural and there are some doctors do not inform patients The absence of a document to insu
... Show More