Showing papers by "Jewish Hospital published in 1976"

Objective clinical and laboratory studies of immediate hypersensitivity reactions to foods in asthmatic children.

Abstract: Clinical and laboratory observations were made with 38 children afflicted with chronic severe asthma (reversible obstructive airway disease) in which hypersensitivity to food was incriminated in the histories. Symptoms were evoked in double-blind food challenges in only 11/38 children and 14/70 challenges, and were characteristic of immediate-type hypersensitivity and were chiefly gastrointestinal, even though asthma was the common presenting complaint. There were no delayed reactions. Peanut was responsible for 8 reactions, egg for 5, and cow's milk for 1. The feature that most successfully identified those having positive reactions in challenges was a significant wheal reaction in a skin test by puncture technique using a verified extract of 1:20 W/V concentration. No subject with clinically significant, symptomatic hypersensitivity to food had a negative puncture test, and puncture tests were positive in only 10/56 instances of negative reactions in food challenges. Laboratory observations included release of histamine and enzymes from leukocytes and the levels of neutrophil enzymes in serum before and after food provocation tests. While these determinations were of interest with respect to the immunochemical basis of reactions to foods, they did not prove useful for practical clinical diagnosis. The outstanding laboratory findings was the occurrence of "spontaneous" release of 25% to 100% of the histamine from leukocytes in all cases proved clinically hypersensitive by food challenges, which suggests that this may be an indicator of immediate-type hypersensitivity to food. From the findings in the study, a general approach to food hypersensitivity was developed in which the immunologic components coupled with quantitative concentration-response relationships serve to render comprehensible the distinction between asymptomatic (immunologic) hypersensitivity and symptomatic (clinical) hypersensitivity.

High spontaneous release of histamine in vitro from leukocytes of persons hypersensitive to food.

Abstract: In vitro studies of antigenic release of histamine from peripheral leukocytes (basophils) have been done in more than 600 allergic children. Ordinarily only about 5% to 10% of the histamine content of leukocytes will leak out or be released "spontaneously" during incubation of suspensions in vitro, without the addition of antigen. A small percentage of children were found to have leukocytes that released 25% to 100% of the histamine content spontaneously during incubation. The significance of this was not apparent until recently, when studies were concentrated on children suspected of hypersensitivity reactions to foods, among whom a much greater prevalence of spontaneous histamine release from leukocytes was encountered. Of children proved by a double-blind food challenge to react with manifestations of immediate hypersensitivity, 100% had leukocytes that consistently released over 25% (usually between 50% and 100%) of the histamine content spontaneously without the addition of antigen. Such high spontaneous histamine release appears to be characteristic of persons with clinical evidence of hypersensitivity to food.

Antihistamines: Pharmacology and Clinical Use

Abstract: Antihistamines are a diverse group of drugs which possess the ability to inhibit various histaminic actions. By and large, they bear a certain structural resemblance to histamine, and act principally to prevent histamine-receptor interaction through competition with histamine for histamine receptors. Consequently, they are helpful therapeutically in preventing, rather than reversing, histaminic actions. Individual antihistaminic drugs act to inhibit histaminic action at one or another histamine receptor (H1 or H2-receptor), but not at both receptors. The large number of antihistaminics which have been available for many years and employed chiefly as ‘antiallergic’ drugs are classified as H1-receptor inhibitors; they are most effective therapeutically in inhibiting manifestations of histamine-induced wheat and erythema formation and pruritus. H2-receptor inhibitors, agents which are able to inhibit histamine-induced gastric acid secretion, have been developed more recently. Antihistaminics in general and H1-receptor inhibitors in particular, exert a wide variety of pharmacological activities. Their use is frequently accompanied by undesirable side-effects, notably CNS depression, dryness of mucous membranes, and gastrointestinal effects. Used judiciously and in proper dosage, antihistaminic drugs are helpful in the control of allergic disorders, allergic rhinitis and urticaria in particular; newly developed H2-receptor inhibitors show therapeutic promise in the treatment of peptic ulceration.

PHA‐Induced Activation of Suppressor Cells in Normal Human Peripheral Blood Lymphocytes

Abstract: Normal human peripheral blood and tonsil lymphocytes can be stimulated to proliferate by phytohemagglutinin (PHA). When cells cultured with this mitogen for 3 days were transferred fo fresh autologous lymphocytes in fresh medium with PHA, the mitogen response of the fresh lymphocytes was suppressed. The suppression required the presence of viable cells, in that culture supernatants alone were not inhibitory and cell extracts showed only marginal inhibition. Approximately equivalent numbers of previously stimulated cells were required to produce optimal suppression of the PHA response of fresh cells. Cells irradiated after PHA stimulation were as effective as nonirradiated cells in causing suppression. PHA-stimulated cells also inhibited concanavalin A-induced proliferation and a mixed lymphocyte reaction. However, PHA-stimulated cells only partially inhibited the response to pokeweed mitogen. The suppressive effects were fully retained by a nylon-wool-enriched T-cell fraction but not by a B-cell-enriched fraction.

Regression of tumors by an endotoxin combined with trehalose mycolates of differing structure

Abstract: A transplantable hepatocarcinoma of guinea pigs has been used as a model for study of immunotherapy of malignant tumors. Cures of established neoplasms have been effected with viable bacillus Calmette-Guerin (BCG); and certain microbial fractions, when presented in association with oil droplets in saline emulsion, have also caused regression of the tumors. P3, a mycobacterial glycolipid (trehalose dimycolate) related to cord factor, although itself inactive, has conferred antitumor properties on several otherwise ineffective materials, including bacterial endotoxins. In the present work, original P3 (isolated from Mycobacterium tuberculosis strain Aoyama B) and several fractions obtained similarly from different sources have been compared for ability to potentiate a particular endotoxin from a O antigen-deficient (Re) mutant of Salmonella typhimurium. All were trehalose mycolates, and all were about equally effective, despite differences in mycolic acid composition. Most significantly, one of the active glycolipids was from the fast-growing nonpathogen, Mycobacterium phlei, and two were monomycolates of trehalose.

Radioimmunoassay for colchicine in plasma and urine.

Abstract: A radioimmunoassay for the measurement of colchicine (in quantities as small as 0.05 nanogram) in plasma and urine was developed with the use of an antibody from immunized rabbits. After the intravenous injection of 2 milligrams of colchicine in seven subjects, the calculated zero-time concentration in the plasma was 2.9 +/- 1.5 micrograms per deciliter, and the mean half-time in the plasma was 58 +/- 20 minutes. Declining, but measurable, amounts of colchicine could be detected in urine up to day 9 after the drug was administered.

Personality profiles in asthma

Abstract: One hundred and fifty-five hospitalized asthma patients were administered the Minnesota Multiphasic Personality Inventory (MMPI) in order to evaluate the existence of common personality characteristics. When the full sample was divided into subgroups according to age, sex, and duration of the illness, it was found that patterns emerged that appeared largely explicable by these variables rather than the asthma per se. The single most frequent pattern observed across these subgroups was a V-shaped configuration of a "neurotic triad" (scales 1, 2, and 3). This pattern is not unique to asthma, but is also characteristic of other chronic illness populations and seems to represent a defensive stance in coping with the problems of chronic illness. The findings speak against any stereotypic asthmatic personality. It appears more profitable to investigate individual personality patterns associated with coping styles and their relationship to the illness via behaviors that either maintain or delimit the effects of chronic asthma.

Tritiated thymidine labeling index of benign and malignant human breast epithelium.

Abstract: 38 specimens of benign breast tissue from young women and 92 primary breast carcinomas were evaluated for tritiated thymidine ([3H]TdR) labeling index (TLI) by in vitro pulse labeling. The TLI on nonneoplastic, terminal breast ducts was significantly higher during the latter half than during the first half of the menstrual cycle (P less than 0.001), and a geometric mean TLI of 1.5 during the latter half of the cycle is consistent with approximately 47% turnover of these cells during the menstrual cycle. Ducts of fibroadenomas showed similar menstrual variation TLI. The range of TLI observed in the carcinomas was 0.04-18.6, arithmetic mean 3.7, geometric mean 2.1. The TLI of carcinomas was not significantly correlated with size of the tumor, but tended to be higher in women less than 50 yr old than in women older than 50 yr (P less than 0.05), and in the presence of two or more metastatic axillary lymph nodes than when fewer than two nodes were involved (P less than 0.02).

Isolation of mycobacteria from clinical specimens by use of selective 7H11 medium.

Abstract: 7H11 agar containing carbenicillin, amphotericin B, polymyxin B and trimethoprim lactate (selective 7H11 or S7H11) was used for the selective isolation of mycobacteria from clinical specimens. This medium as previously described contained 100 μ g. carbenicillin per ml. It was found that reducing the concentration of carbenicillin to 50 μ g. per ml. made S7H11 less inhibitory to certain strains of mycobacteria. However, some strains of M. kansaii , M. intracellulare , and M. gordonae still do not grow well on S7H11. Of 3,134 clinical specimens (mostly sputum) received, processed, and plated on 7H11 agar and the S7H11 medium, 508 positive specimens were isolated. Of these, 402 were positive on both types of media, 30 were positive on 7H11 only, 19 were positive on S7H11 only, 52 were contaminated on 7H11 but positive on S7H11, while only 5 were contaminated on S7H11 and positive on the plain medium. Thus, the total positive specimens on 7H11 was 437 and total positive specimens on the selective medium was 473. Used in conjunction with nonselective media, S7H11 agar appears to be a valuable culture medium for use in diagnostic mycobacteriology laboratories.

Antibodies to melanoma cell and BCG antigens in sera from tumour-free individuals and from melanoma patients

Abstract: THE Mycobacterium bovis strain BCG shares antigenic components with several neoplasms, including human malignant melanoma1–5. Other species of bacteria also have antigenic similarities with a guinea pig hepatoma6. Antibodies to mycobacteria and other bacterial antigens are universally present in sera from normal humans7,8. Since there is a broad range of shared or cross-reactive antigens among mycobacteria and unrelated microorganisms9, it is conceivable that an immune response by normal humans to mycobacteria has been induced by exposure to taxonomically unrelated microorganisms ubiquitous in the environment. Cytotoxic reactions by lymphoid cells from normal animals and humans to many kinds of tumour cells have been reported10–15. Antibodies in sera from patients with various neoplasms have often been observed that react with antigens derived from their own tumours or from those of the same histological type16–18.Humoral responses to tumour-associated antigens have also been noted in sera from normal humans, gibbons and mice19–21. We have investigated whether sera from normal, tumour-free humans contain antibodies which can react with melanoma-associated as well as with BCG antigens. If this were the case, perhaps immunological reactions by normal humans to certain tumours are widespread and reflect previous sensitisation by microorganisms.

Amphotericin B plus 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU-NSC no. 409962) in advanced cancer. Phase I and preliminary phase II results.

Abstract: Twenty-one patients with advanced metastatic cancer received am photericin B (AmB) plus BCNU in a Phase I chemotherapy trial. Of 11 patients with measurable metastases from bronchogenic carcinoma, five had partial antitumor responses lasting 1.5 to 12+ months, and one had objective improvement. Only two of six patients with other types of tumors had objective improvement of short duration. No consistent evidence of immunologic stimulation was observed in eight patients studied. These results suggest that amphotericin B may increase the therapeutic ratio of BCNU, and further trials of this new concept in chemotherapy of advanced tumors are in progress. The dose-limiting toxicity was myelosuppression, usually thrombocytopenia. No enhancement of BCNU toxicity by the addition of AmB was observed. The recommended dose for future studies is: AmB, 7.5 mg/m2 on day 1, 15 mg/m2 on day 2, 30 mg/m2 on days 3 and 4; plus BCNU, 250 mg/m2 on day 4. The regimen is repeated every 6 to 8 weeks.

Chronic pulmonary disease in a child with the ehlers-danlos syndrome

Abstract: The presence of chronic pulmonary disease is an uncommon finding in the Ehlers-Danlos syndrome. The patient discussed herein presented with severe irreversible obstructive pulmonary disease characterized by marked hyperinflation, an increase in static lung compliance, and tracheal dilatation. A largely normal lung biopsy ruled out chronic pulmonary emphysema. Despite the similarity of this patient to those with the Mounier-Kuhn syndrome, the degree of tracheobronchial enlargement was not as great as is usually seen in this disorder although these anatomic changes may develop with time. The findings in this case demonstrate that any site within the tracheobronchial tree may be involved in the Ehlers-Danlos syndrome and further emphasize the need to determine the degree of reversibility of obstructive lung disease in children.

Awareness during electromyographic biofeedback: of signal or process?

Abstract: During relaxation training, awareness of trial-to-trial changes in frontalis-muscle tension levels was assessed with and without auditory electromyographic (EMG) biofeedback. Immediately after each 128-sec training trial, the subject was required to guess whether muscle tension indexed by EMG activity increased ("Up") or decreased ("Down") relative to the immediately preceding trial. The probability of correct guessing, P(c), improved as the absolute difference in EMG increased between trials only when biofeedback was presented. For subjects not receiving biofeedback, P(c) remained low even when the absolute difference between trials was large. Subjects in each condition employed a strategy to guess "Down" more often consistent with the expectation that they were being trained to relax. The "Down" set strategy was shown to be separable from the informational basis of P(c) provided by biofeedback. This procedure can be employed to evaluate central assumptions of biofeedback relating to posttraining awareness of changes in muscle tension and the relationship between awareness and control of muscle tension.

Anabolic Reactions Involving Sialic Acids

Abstract: The sialic acids are a family of ubiquitous aminosugars found in some bacteria and invertebrates, and in all vertebrate tissues. They are normally found as nonreducing termini of complex heteropolymers such as glycoproteins, glycopeptide hormones, and glycolipids. The chemistry and structural features of these compounds are described in Chapter 1 of this volume.

Adriamycin, 1,3-bis (2-chloroethyl)-1-nitrosourea (BCNU-NSC 409462), and cyclophosphamide in refractory adenocarcinoma of the breast and other tumors.

Abstract: Eighty-two patients with metastatic tumor received a therapeutic regimen consisting of BCNU, 100 mg/m2, and cyclophosphamide, 400 mg/m2, both intravenously on day 1, followed by adriamycin, 40 mg/m2, on day 2. Treatment was repeated every 4 weeks. Of 14 evaluable patients with adenocarcinoma of the breast, all resistant to previous chemotherapy and 12 resistant to a five-drug combination chemotherapy program, 12 had objective responses of which seven were good partial responses. Osseous, visceral, and cutaneous metastases responded equally well. Overall, 53% of 68 evaluable patients had objective responses, and 32% had complete or good partial responses. The most encouraging results were in patients with carcinoma of the head and neck, ovarian carcinoma, and multiple myeloma refractory to standard therapy. Significant responses were observed in previously untreated patients with epidermoid carcinoma of the lung, carcinoma of the prostate, and carcinoma of undermined primary. Remissions lasted a median of 5 months. Myelosuppression was moderate in degree and was maximal 2 weeks after treatment. Cumulative thrombocytopenia was apparent but not dose limiting with repeated courses.

Rainbow trout leukocyte culture: a simplified method.

Abstract: The addition of 10% fetal bovine serum to Leibovitz’s L-15 culture medium resulted in marked growth of peripheral blood leukocytes from rainbow trout,Salmo gairdneri Culture medium without serum or with 20% homologous serum did not induce substantial growth In contrast to what has been reported by others, oxygenation of the culture medium was found not to be required for excellent cell growth

The total eosinophil count in asthmatic children

Abstract: The diurnal variation in total eosinophil count (TEC) in asthmatic children not on medications or on thophylline-containing bronchodilators orally every 6 hr is similar to that reported in normal subjects, with a decrease in TEC in the morning and an increase in the evening. Asthmatic children taking prednisone in 8:00 A.M. on alternate days have diurnal variations in TEC on the "day off" prednisone similar to those on normal children. On the "day on" prednisone, administered either on a daily or alternate-day basis, TECs approach zero 4 to 8 hr after prednisone is taken. The TEC then increases in the evening as it does in children not taking prednisone.