Showing papers by "Jewish Hospital published in 1979"
TL;DR: The nasal and respiratory symptoms observed after oral challenge to aspirin (ASA), tartrazine, and other nonsteroidal anti-inflammatory substances are best described as idiosyncratic reactions as mentioned in this paper.
Abstract: The nasal and respiratory symptoms observed after oral challenge to aspirin (ASA), tartrazine, and other nonsteroidal anti-inflammatory substances are best described as idiosyncratic reactions. A positive response to oral challenge, defined as a 20% fall in forced expiratory volume in 1 sec (FEV1) from baseline for up to 4 hr, occurred in 44 of 230 patients with ASA, 11 of 277 with tartrazine, 2 of 93 with sodium salicylate, and 2 of 69 with acetaminophen. No one had a positive response to tartrazine, sodium salicylate, or acetaminophen who was not also positive to ASA. The dose of ASA causing a positive response was less than 5 grains in 95% of the patients. Of 50 patients with a suspicious history studied in detail, 96% of those with ASA idiosyncrasy had sinusitis and 71% had nasal polyps. Methacholine challenges and random circulating and sputum eosinophils did not differentiate patients with a negative challenge from those with a positive challenge. However, patients with a positive history and positive challenge had significantly more random nasal eosinophils than those with negative aspirin challenges. The term "aspirin triad" has outlived its usefulness since ASA idiosyncrasy can exist in patients lacking certain components of the triad. ASA idiosyncrasy is unsuspected in many patients and possibly overdiagnosed in others.
208 citations
TL;DR: It is suggested that ketogenic diet and anticonvulsant drug therapy have additive deleterious effects on bone mass and that these effects are partially reversible by vitamin D treatment.
Abstract: Vitamin D and mineral metabolism status was examined in five children maintained chronically on combined ketogenic diet-anticonvulsant drug therapy (KG), and the results compared to those obtained in 18 patients treated with anticonvulsant drugs alone (AD) and 15 normal controls. KG patients exhibited biochemical findings of vitamin D deficiency osteomalacia: decreased serum 25-hydroxyvitamin D (25OHD) and calcium concentrations, elevated serum alkaline phosphatase and parathyroid hormone concentrations, decreased urinary calcium and increased urinary hydroxyproline excretion, and decreased bone mass. Although the KG and AD groups demonstrated similar reductions in serum 25OHD concentration, the KG patients exhibited a significantly greater reduction in bone mass. In response to vitamin D supplementation (5000 IU/day), mean bone mass in the KG group increased by 8.1±0.9% (P<0.001) over a 12-month period. These results suggest that ketogenic diet and anticonvulsant drug therapy have additive deleterious effects on bone mass and that these effects are partially reversible by vitamin D treatment.
82 citations
TL;DR: Results of treatment of all patients with acute lymphocytic leukemia in adults have improved markedly during the last decade but lag behind those observed in children for reasons as yet unexplained.
61 citations
TL;DR: Cytogenetic studies have been done on a group of childhood patients over a period of 3 1/2 years in which Giemsa trypsin banding was applied to all specimens and no correlation could be found between the disease subgroup and the karyotypic aberration in patients with anomalies involving a common chromosome.
Abstract: Cytogenetic studies have been done on a group of childhood patients over a period of 3 1/2 years in which time Giemsa trypsin banding was applied to all specimens. Fifteen of the 107 patients (14%) were diagnosed as having acute nonlymphoblastic leukemia (ANLL). Twelve of the 15 had chromosomal abnormalities. The most common was an involvement of the No. 7 chromosome which occurred in five patients. Three patients had trisomy 19. No correlation could be found between the disease subgroup and the karyotypic aberration in patients with anomalies involving a common chromosome.
59 citations
TL;DR: Nine premature infants developed radiographic and biochemical rickets at a mean ±SD of 12.6±2.8 weeks of age, and serum 25-hydroxyvitamin D concentrations were all low, with a mean of 0.9%.
52 citations
TL;DR: During acute immune complex disease in the rabbit, immune deposits could be detected in the choroid plexus, as well as the kidney, in a majority of the animals sacrificed from 9 to 14 days after the injection of bovine serum albumin (BSA).
51 citations
TL;DR: It is proposed that, in vivo, ribosomal contributions to the accuracy of protein synthesis include both specificity in tRNA selection at the A site and the coding capacity of the P site, as these sites are defined by in vitro criteria.
49 citations
TL;DR: It is concluded that the addition of peptidic material, which may act as an adjuvant, to endotoxins is required to make them useful for immunotherapy of the weakly immunogenic line-10 tumor.
Abstract: The transplantable line-10 hepatocellular carcinoma of guinea-pigs has been used as a model for the study of immunotherapy of malignant tumors. Cure rates of up to 100% have been obtained with ReGl-CM from 0 antigen-deficient (Re) mutant strains of Enterobacteriaceae, provided they were combined with mycobacterial trehalose dimycolate (cord factor, P3). Whereas highly endotoxic LPS extracts from all wild-type strains so far tested have failed to cause tumor regression, acid hydrolysis of such LPS samples led to residual fractions (RESI) that cross-reacted serologically with ReGl-CM samples (Chang and Nowotny, 1975) and provided cure rates up to 100%. RESI from Serratia marcescens was essentially nonpyrogenic and 100 times less lethal for chick embryos than potent endotoxins. Antigenic material associated with endotoxic extracts appears to be cryptic or sterically hindered from being effective in wild-type LPS but is exposed in ReGl and RESI samples. Reduction of the aminoacid content of ReGl-CM by microparticulate silica gel chromatography or by treatment with Triton X-100 significantly lowered the ability to bring about tumor regression without affecting endotoxicity. Antitumor activity could be restored by the addition of synthetic N-acetyl-muramyl-l-seryl-d-isoglutamine (MDP) or a nontoxic lipoid side fraction recovered during the isolation of ReGl-CM, which contained a small amount of peptidic substances. It is concluded that the addition of peptidic material, which may act as an adjuvant, to endotoxins is required to make them useful for immunotherapy of the weakly immunogenic line-10 tumor. Chemical procedures known to ‘detoxify’ endotoxins while retaining adjuvanticity, such as succinylation and phthalylation, resulted in complete loss of endotoxicity and tumor-regressive potency of ReGl-CM. Transesterification with sodium methoxide led to a water-soluble phase, which cured 50% of tumor-bearing animals even though lethality and pyrogenicity were reduced by 100 times and 50 times, respectively. Thus there was no direct correlation between endotoxic potency and tumor-regressive activity. In addition, our findings indicate that a low level of toxicity may be required to obtain optimal levels of tumoricidal action.
49 citations
TL;DR: This chapter discusses serological identification of atypical mycobacteria, which consists of species- or type-specific antigens on the surface of the smooth colony-forming bacteria.
Abstract: Publisher Summary This chapter discusses serological identification of atypical mycobacteria. Mycobacterium tuberculosis and Mycobacterium bovis form only rough colonies and cannot be identified by the seroagglutination test. Serological techniques have also been used as tools for identification. The most discriminating and useful test is the seroagglutination test. This test is applicable only to smooth colony-forming mycobacteria. The majority of the atypical mycobacteria are of this colony form. The seroagglutination test is based on the presence of species- or type-specific antigens on the surface of the smooth colony-forming bacteria. Cultures that kill the animals in several weeks are considered Mycobacterium avium ( M. avium ), whereas non-pathogenic cultures are designated Mycobacterium intracellulare ( M. intracellulare ). A serological study of M. avium and M. intracellulare revealed that the avian strains belonged almost exclusively two types: 1 and 2. Type 2 predominates. Later, a type 3 was discovered in England, which is found frequently on the European continent.
46 citations
Roswell Park Cancer Institute1, Mount Sinai Hospital2, Walter Reed Army Medical Center3, Rhode Island Hospital4, NewYork–Presbyterian Hospital5, Wake Forest University6, West Virginia University7, Jewish Hospital8, University of Missouri9, McGill University10, Columbia University11, VCU Medical Center12
TL;DR: A prospective randomized trial by CALGB examined the relative value of four chemotherapy regimens in 537 patients with stage III B and IV Hodgkin's disease, finding that a new combination BOPP had a therapeutic activity equal to MOPP, and was accompanied by less toxicity.
Abstract: A prospective randomized trial by CALGB examined the relative value of four chemotherapy regimens in 537 patients with stage III B and IV Hodgkin's disease. A new combination BOPP, derived by substitution of BCNU for nitrogen mustard in the MOPP regimen, was compared to MOPP and to two 3-drug regimens, derived by removing the procarbazine in BOPP (BOP) or removing the alkylating agent (OPP). The 4-drug programs gave significantly higher frequency of complete remissions (BOPP 67%, MOPP 63%) than the 3-drug regimens (BOP 40%, OPP 42%), and significantly longer duration of remission and survival. BOPP had a therapeutic activity equal to MOPP, and was accompanied by less toxicity. After 6 cycles of induction chemotherapy, responding patients, both CR and PR, were continued on maintenance chemotherapy for 3 years. No significant difference in relapse rate was demonstrated following maintenance treatment with either vinblastine, chlorambucil, or chlorambucil plus monthly vincristine + prednisone doses. Nor could a reinforcement phase late in the maintenance program be shown to influence the relapse rate. The median survival for all patients entered on the 4-drug programs was 5 years, while the median has not yet been reached at 6 years for those patients, who obtained CR.
40 citations
TL;DR: In the following discussion, certain aspects of antigen inhalation challenge with emphasis on clinical usefulness and recent observations regarding methacholine and histamine inhalation challenges which have not been discussed by the other speakers are covered.
Abstract: In the following discussion, we will cover certain aspects of (1) antigen inhalation challenge with emphasis on clinical usefulness and (2) recent observations regarding methacholine and histamine inhalation challenges which have not been discussed by the other speakers at this Workshop. Due to time limitations we will present generalizations and hope that the details of these generalizations will emerge during subsequent sessions.
TL;DR: It is possible to identify five reasons for caution, not in themselves sufficient to prove that cyclic AMP is a second messenger in bone, that cannot yet be assigned with confidence to functionally specific types of bone cells (osteoblasts, osteocytes, osteoclasts).
Abstract: Parathyroid hormone occupies a pivotal position among the many humoral factors that regulate bone remodeling. It is the principal physiological stimulator of bone resorption, and exerts acute inhibitory and chronic stimulatory effects on bone formation as well (see refs. 1, 2, and 3 for reviews). Its mode of action at the cellular level has been subjected to vigorous inquiry. In the decade that has past since Chase, Fedak, and Aurbach [4] first reported the enhancement of adenylate cyclase activity in bone homogenates by parathyroid hormone, cyclic AMP has become an accepted second (intracellular) messenger for its skeletal effects, having satisfied in large part the criteria of Robison, Butcher, and Sutherland [5]. We now know that parathyroid hormone rapidly augments cyclic AMP production in bone cells, and that certain exogenous cyclic AMP analogues and phosphodiesterase inhibitors reproduce its actions (see ref. 6 for review). Other humoral agents that affect remodeling such as prostaglandins of the E series also increase bone cell cyclic AMP levels [.6]. Although these are persuasive arguments, they are not in themselves sufficient to prove that cyclic AMP is a second messenger in bone. It is possible to identify five reasons for caution. First, parathyroid hormone elicits cyclic AMP responses in many nonskeletal tissues, some of which bear no obvious relationship to its physiological missions [7-14]. Second, metabolites of Vitamin D, like prostaglandins E1 and E2, mimic the resorption-stimulating effect of the hormone, but fail to modify skeletal cyclic AMP production [15-20]. Third, the effects of parathyroid hormone on cyclic AMP metabolism cannot yet be assigned with confidence to functionally specific types of bone cells (osteoblasts, osteocytes, osteoclasts). Fourth, studies with exo-
TL;DR: These chronic alcoholic mothers have poor obstetric histories, tend to have poor or no prenatal care and may repeat pregnancies which result in infants with FAS.
TL;DR: Whereas normal human lymphocytes showed little or no capacity to bind exogenously added Beta2m, it was found that phytohaemagglutinin (PHA)-stimulated cells could bind beta2m and this binding occurred optimally 2 days after PHA stimulation.
Abstract: The mechanism by which exogenously added beta2m binds to lymphoid cells has been explored. In the mouse it has been shown that beta2m remains associated with plasma membrane macromolecules following solubilization with NP-40 and that approximately 25-30% of the binding could be accounted for by binding to H-2 antigens. No binding to mouse immunoglobulin or Ia antigens could be detected. The sites for binding of the remainder of the cell-bound beta2m were not determined. Whereas normal human lymphocytes showed little or no capacity to bind exogenously added beta2m, it was found that phytohaemagglutinin (PHA)-stimulated cells could bind beta2m. This binding occurred optimally 2 days after PHA stimulation. Approximately half of the binding could be accounted for by binding to HLA antigens. The possible significance of these findings with respect to cellular interactions involving major histocompatibility complex gene products in the immune response is discussed.
TL;DR: In this paper, the authors found that nonspecific airway hyperreactivity was associated with a positive bronchial inhalation challenge to a specific antigen, as indexed by a methacholine or histamine inhaling challenge and a positive skin test.
Abstract: Bronchial inhalation challenges to histamine, methacholine, and at least one antigen were performed on 183 asthmatic patients who previously had received skin tests to at least 16 different antigens. Individuals with a positive skin test and a positive antigen inhalation challenge to the same antigen had lower thresholds of response to both histamine and methacholine. This pattern was statistically significant for mixed trees, mixed grasses, mixed molds, and house dust but not for mixed ragweed. For those individuals who had a negative antigen inhalation challenge, skin test reactivity (positive or negative) alone was not associated with a different threshold of response to histamine or methacholine. Also, a higher percentage of positive antigen inhalation challenges were seen in the group of individuals with a low threshold of response to both histamine and methacholine than in groups with either a moderate or high threshold of response to these chemical agents. The results imply that at least two factors are associated with a positive bronchial inhalation challenge to a specific antigen: nonspecific airways hyperreactivity, as indexed by a methacholine or histamine inhalation challenge, and a positive skin test.
TL;DR: Specially designed medication monitors could be used to provide the proper amount of compensatory medication when a patient forgets and to reduce the chance that a suicidal patient will impulsively take an overdose.
Abstract: The medication monitor is a dispenser with a time recording system for determining when patients remove medication. It has demonstrated that nurses and physicians can estimate patient compliance with considerable accuracy. It could be used: (1) to assure that only patients actually ingesting medication are used to evaluate new drugs, (2) to study the factors that influence compliance and strategies to improve compliance, (3) to prevent escalation to more toxic drugs or expensive diagnostic procedures when failure to respond is due to poor compliance, (4) to supervise compliance when society has an overriding interest in therapeutic success, and (5) to monitor the effects of air pollution. Specially designed medication monitors could be used to provide the proper amount of compensatory medication when a patient forgets and to reduce the chance that a suicidal patient will impulsively take an overdose.
TL;DR: Two patients with meningitis caused by antibiotic-resistant Escherichia coli and Klebsiella pneumoniae were treated successfully with intravenous cefoxitin plus oral probenecid, and probenecid did not appear to influence greatly the degree of penetration.
Abstract: Two patients with meningitis caused by antibiotic-resistant Escherichia coli and Klebsiella pneumoniae were treated successfully with intravenous cefoxitin plus oral probenecid. A total of 25 patients with central nervous system disorders that required a diagnostic spinal tap were also given cefoxitin, with or without probenecid, for determination of the degree of penetration into cerebrospinal fluid. In patients with uninflamed meninges, little or no cefoxitin entered after a single dose of 4-6 g. After three doses of 4 g each over a 6-8-hr period, penetration was considerable (average, 7% of the simultaneous serum level). In patients with inflamed meninges, a similar concentration was achieved rapidly after a single 2-g dose. After a day of therapy, cerebrospinal fluid levels equivalent to 30%-70% of the simultaneous serum levels were found; as the inflammation subsided, cerebrospinal fluid levels fell to around 15% of those in serum. Probenecid did not appear to influence greatly the degree of penetration.
TL;DR: Adult rainbow trout (RBT) were found to respond well to murine T-independent antigen but not to T-dependent antigens, and it was observed that while large numbers of plaque-forming cells appeared in the spleen and anterior kidney, none were found in the thymus.
TL;DR: Serum and hepatic 25-hydroxyvitamin D levels are decreased in female trout with elevations in protein bound calcium and phosphate and the 25OHD3 binding capacity of hypercalcemic spawning trout is significantly less than that of male fish.
TL;DR: In this paper, the authors describe the synthesis of 6 pseudo cord factors (Ψ CF), analogs of the natural trehalose-6,6′-dimycolate, but based instead upon the dicarboxylic acid (TDA) that is obtained from Trehalose by Pt-catalyzed oxidation From TDA, several bis-amides (mirror amide) and a diester (‘mirror’ Ψ CF) of intermediate to high molecular weight were prepared
TL;DR: The 2 patients who did not have a Ph1 chromosome survived 13 and 30 months, respectively, considerably less time than the 4+ year survival in most of those with Ph1 positive CML.
Abstract: In a 3 1/2 year cytogenetic study of 107 leukemia patients diagnosed in childhood and adloescence, 8 presented with chronic myelogenous leukemia (CML). Seven of the 8 had chromosomal abnormalities. Six had the Ph1 chromosome; 5 had the usual 9;22 translocation. Two patients had involvement with chromosome 15; one had a 9;15 translocation in Ph1 positive cells during remission while a second had a 1;15 translocation during blastic crisis. The 2 patients who did not have a Ph1 chromosome survived 13 and 30 months, respectively, considerably less time than the 4+ year survival in most of those with Ph1 positive CML.
TL;DR: The results of this study point out some of the difficulties in trying to extrapolate in vitro findings to in vivo correlates since neither fenoterol nor therapeutic doses of theophylline interfere with immediate skin test reactivity.
Abstract: Fenoterol, a selective β 2 -adrenergic agent, and aminophylline in the "therapeutic range" were compared with placebo for their inhibitory effect on skin test reactivity to allergens and histamine. Cardiovascular parameters were also assessed. A new, inexpensive micrometer adaptor to a tuberculin syringe was used to deliver allergens and histamine more accurately. No inhibition of skin test reactivity to antigens or histamine was found after a loading dose or after 1 wk of round-the-clock therapy with these bronchodilators. Although there was increased heart rate after 1 and 2 hr with fenoterol, there was no patient preference for one bronchodilator over the other. The results of this study point out some of the difficulties in trying to extrapolate in vitro findings to in vivo correlates since neither fenoterol nor therapeutic doses of theophylline interfere with immediate skin test reactivity.
TL;DR: A patient with an unusual myeloproliferative disorder, characterized by hepatosplenomegaly, myelofibrosis, ringed sideroblasts, and conversion to acute myeloblastic leukemia developed cardiac tamponade secondary to pericardial extramedullary hematopoiesis.
Abstract: A patient with an unusual myeloproliferative disorder, characterized by hepatosplenomegaly, myelofibrosis, ringed sideroblasts, and conversion to acute myeloblastic leukemia developed cardiac tamponade secondary to pericardia extramedullary hematopoiesis. Diagnostic criteria are discussed. Irradiation and systemic chemotherapy were successful in controlling the effusion.
TL;DR: In this article, patient-coping styles, indexed by panic-fear symptomatology, were found to be associated with specific patterns of requesting as-needed (PRN) medications and treatments.
Abstract: In a previous study, patient-coping styles, indexed by panic-fear symptomatology, were found to be associated with specific patterns of requesting as-needed (PRN) medications and treatments: Patients who tend to emphasize their symptoms (high panic-fear) requested PRNs frequently, even on days when their pulmonary function levels were essentially normal, while those who tend to minimize their symptoms (low panic-fear) requested PRNs infrequently, even on days when their pulmonary function levels were subnormal. In the present study, we found that patients who requested PRNs frequently spent more days in the hospital than those who requested PRNs only rarely. Intensive medication regimens (i.e., daily corticosteroids or alternate-day corticosteroids supplemented with TAO, cromolyn, or aerosolized steroids) were more often prescribed for patients requesting PRNs frequently than for those requesting PRNs rarely. These differences in patient management were attributable neither to differences in pulmonary function nor directly to differences in panic-fear rating. Thus, patient-coping styles can influence the treatment prescribed, and optimal management requires that individual patient-coping styles be considered in planning a regimen.
TL;DR: This paper discusses three years experience in computer-assisted scheduling of nursing personnel at the Jewish Hospital of St Louis with a computer-based system.
Abstract: This paper discusses three years experience in computer-assisted scheduling of nursing personnel at the Jewish Hospital of St Louis. A computer-based system was developed and implemented to enable ...
TL;DR: Breathing warm humidified air substantially reduced bronchoconstriction induced by body cooling, but not that induced by inhalation of methacholine, which appears to be related to cooling of the airways, which may be compensated by breathing warm humidifiers.
TL;DR: The nuclear cycle among several diverse genetic stocks of Zea mays root meristem cells was compared and it was found that there were no significant differences among the nuclear cycle durations and its component phases.
Abstract: The nuclear cycle among several diverse genetic stocks of Zea mays root meristem cells was compared and it was found that there were no significant differences among the nuclear cycle durations and its component phases. The durations of various periods of their mitotic cycles were studied by autoradiography of cells pulse-labelled with tritiated thymidine (3H-TdR). The total nuclear cycle was 10 to 11.5 hours and mitosis was 0.81 to 1.34 hours at 25°C. The S period is the longest interval (50% of the total time) of the nuclear cycle; of the rest of the cycle, G2 is longer than G1 or mitosis among all stocks. The constancy of the nuclear cycle among several stocks was adduced as evidence for strict genetic control of the cycle. Furthermore, it is demonstrated the DNA synthesis period is not dependent upon the amount of DNA present.
TL;DR: Observations suggest a possible role for parathormone phosphorus and calcium in the motility of neutrophils in patients with primary hyperparathyroidism.
Abstract: Chemotactic and random migrations of neutrophils derived from four patients with primary hyperparathyroidism were found to be defective. These abnormalities improved significantly in parallel with the decrease in serum calcium and parathormone and with the increase in serum phosphorus concentration after surgical removal of the adenoma. These observations suggest a possible role for parathormone phosphorus and calcium in the motility of neutrophils. (J Clin Endocrinol Metab 48: 582, 1979)
TL;DR: Histopathology of temporal bones from children who die with cytomegalic inclusion disease shows viral infected cells in non‐sensory endolabyrinthine epithelium, which could yield information regarding pathogenesis of viral labyrinthitis.
Abstract: The effects of congenital cytomegalovirus infection vary from severe central nervous system destruction to asymptomatic viuria. Yet children with the latter have a high incidence of unsuspected hearing loss. Histopathology of temporal bones from children who die with cytomegalic inclusion disease shows viral infected cells in non-sensory endolabyrinthine epithelium. Experimental mouse cytomegalovirus causes an age related cranial neuronitis and perilabyrinthitis. Immunopathologic localization of different viral antigens in experimental inner ear infections shows differential vulnerability of labyrinthine structures to infections. Adaptation of such techniques to human temporal bone, pathology could yield information regarding pathogenesis of viral labyrinthitis. The development of a human cytomegalovirus vaccine may eliminate the risks of this congenital infection.