Search PubMed⌕ Search

Biomedical subjects

A Catanzaro

Publications and source records attributed to A Catanzaro.

At least 73 records · Page 4Linked to original sources
PubMed1986

The effect of complement depletion on immunologically mediated middle ear effusion and inflammation.

Immunologic injury during immune response to antigen in the middle ear cavity has been suggested to be a contributing factor in otitis media with effusion (OME). One of the mechanisms proposed involves the generation of immune complexes, with subsequent injury mediated by complement fixation. To evaluate the potential role of complement in OME, an animal model of immune-mediated middle ear effusion and inflammation was used. Antigenic challenge of the middle ear of normal, sensitized guinea pigs results in OME. This response was compared with that observed in guinea pigs whose sera were decomplemented by treatment with cobra venom factor. As compared to controls, decomplemented animals exhibited less effusion [130 (+/- 35) vs 83 (+/- 60) microliter, P less than 0.05] and inflammation in the middle ear following antigenic challenge. These results suggest that complement could play a role in the pathogenesis of OME. However, the fact that animals with severely depleted serum complement still displayed a moderate amount of effusion and inflammation indicates that other mechanisms are also involved in our model of immune-mediated OME.

Animals↗
PubMed1985

Multiple puncture skin test and mantoux test in Southeast Asian refugees.

Skin test reactions to PPD applied by Mantoux techniques were compared with reactions to tuberculin tine test (PPD-tine); tuberculin, old tine test (OT tine); Aplitest; and Mono-Vacc, tuberculin, old (Mono-Vacc) in newly arrived refugees from Cambodia and Laos. The reaction to Mantoux test was accepted as the "true reading" and compared to the reaction size to one of the multiple puncture tests (MPT). A 2 X 2 table was constructed and sensitivity, specificity, false negative, and false positive rates computed over a broad range of cut-off points for MPT. The MPTs were very sensitive (100 percent to 78 percent) but lacked specificity (78 percent to 18 percent) when a cut-off of 1 mm was used. Predictably, as the cut-off is moved to larger reactions, sensitivity decreases and specificity increases. The relationship between the two is emphasized in a receiver-operator characteristics analysis. The MPTs are not intended for diagnostic use. Reaction to the MPT should be interpreted with the same careful consideration that clinicians use to interpret reactions to the Mantoux test.

Asia, Southeastern↗
PubMed1984

Neutrophil chemotactic activity generation by alveolar macrophages after bleomycin injury.

Saline lavage was performed on rat lungs after the intratracheal injection of saline or bleomycin. An increase (p less than 0.025) in total cells recovered, an increase (p less than 0.001) in neutrophils, and an increase (p less than 0.001) in albumin concentration were noted in lavage fluid recovered from rats subsequent to bleomycin injury. At 5, 10, 15, and 20 days after injury, macrophages recovered from bleomycin-treated rats generated increased (p less than 0.05) amounts of neutrophil chemotactic activity in vitro compared with macrophages recovered from saline-treated rats. The chemotactic activity was attributable to a factor or factors of low molecular weight and hydrophobic in nature, characteristics similar to previously described alveolar macrophage-derived neutrophil chemotactic factors. The generation of neutrophil chemotactic activity was suppressed (p less than 0.025) by hydrocortisone and 5,8,11,14-eicosatetraynoic acid (ETYA), suggesting that the neutrophil chemotactic activity generation is dependent upon the lipoxygenase pathway of arachidonic acid metabolism.

5,8,11,14-Eicosatetraynoic Acid↗
PubMed1983

Treatment of coccidioidomycosis with ketoconazole: an evaluation utilizing a new scoring system.

The evaluation of the response of patients with coccidioidomycosis to any therapeutic modality is a major challenge. A numerical scoring system was devised to quantitate separately the severity of disease on clinical presentation, the findings on chest film, bone scan, gallium scan, serology and skin test with coccidioidin and spherulin. The scoring system was used to evaluate the response to treatment with ketoconazole of seven patients with infiltrate pulmonary coccidioidomycosis; 20 patients with chronic cavitary coccidioidomycosis; and 40 patients with disseminated coccidioidomycosis. Dissemination included the soft tissue in 15, bone in 15, synovium in 11 and skin in 18. In all categories clinical severity scores improved dramatically. Radiographic scores showed similar improvement in cases of infiltrative pulmonary coccidioidomycosis but showed no change in cavitary coccidioidomycosis. Serology scores improved significantly (-2 or more) in one of seven infiltrative pulmonary cases, three of twenty chronic cavitary cases and twenty-three of forty disseminated cases. Among those with adequate mycology followup, cultures converted to negative in two of three infiltrative pulmonary coccidioidomycosis; seven of fourteen chronic cavitary coccidioidomycosis; and sixteen of twenty-two with disseminated disease. Unfortunately, when ketoconazole was discontinued or interrupted, symptoms recurred in four of twenty (20 percent) with chronic cavitary and ten of forty (25 percent) of disseminated cases. The disease in two patients progressed while on ketonconazole. One of those developed meningitis.

Antifungal Agents↗
PubMed1983

Detection of serum antibodies in coccidioidomycosis by solid-phase radioimmunoassay.

A radioimmunoassay (RIA) was developed to measure antibody in coccidioidomycosis with improved quantitation. Sera from 41 patients with active coccidioidomycosis had a mean +/- SD value of 0.6 +/- 0.49 mg/ml. Twelve healthy controls and 23 patients with noncoccidioidal diseases had a mean level of 0.06 +/- 0.12. Complement fixation (CF) and RIA titers were also compared with the clinical course in 19 patients with active coccidioidomycosis (seven had pulmonary disease; 12 had disseminated disease). The RIA was most useful in pulmonary cases. Pulmonary patients who experienced an improvement in symptoms more often experienced a drop in RIA titer (all of four patients) than CF titer (two of four). Similarly, pulmonary patients who demonstrated radiographic improvements experienced a drop in RIA titer (four of five) more often than a drop in CF titer (three of five). In patients with disseminated disease, there was agreement between the two assays and the clinical symptom score.

Antibodies, Fungal↗
PubMed1983

A guinea pig model to study effects of persistent intrabronchial antigenic stimulation and inflammation.

Chronic antigenic stimulation and inflammation of the bronchial tree occurs in several diseases involving microbial airway colonization. We developed a guinea pig model to study the effects of persistent intrabronchial antigenic stimulation with keyhole limpet hemocyanin (KLH). Sepharose beads 200 to 300 micron in diameter conjugated with 300 micrograms KLH were injected via a tracheostomy catheter, causing them to lodge in the bronchial tree. When lung sections from these animals and animals given uncoupled sepharose beads were examined histologically, it became apparent that in this model the persistent antigenic stimulus is accompanied by local inflammation caused by an irritant effect of the beads. To determine how the intrabronchial antigen was distributed locally and systemically, 125I labeled KLH-coupled beads were administered. Radioactivity remained predominantly in the lung, where 13 +/- 5% of the administered dose was still detectable by Day 30. Autoradiographs of Day 30 lung sections demonstrated that the radioactivity was concentrated on the individual beads, indicating that it largely represented KLH persisting in the bronchial tree. Minute amounts of radioactivity were detected systemically and in the regional lymph nodes (LN). A radioimmune assay of serum collected on Day 1 demonstrated that some of the circulating radioactivity represented antigenic KLH. When anti-KLH antibody-forming cells (AFC) were measured in lung homogenate, regional LN, blood, and spleen cell preparations after KLH-coupled bead administration, they were initially detected only in the spleen. Significant concentrations appeared in the lung homogenate, regional LN, and spleen by Day 10 and thereafter through Day 20.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1982

Health status of refugees from Vietnam, Laos, and Cambodia.

More than 0.5 million refugees from Southeast Asia have immigrated to the United States. We undertook a prospective evaluation of 709 refugees within two months of their resettlement in San Diego. The sample included 164 Vietnamese, 356 Cambodians, 139 Laotians, and 50 Hmong. The prevalence of abnormalities was high: intestinal parasites, 61%; positive tuberculin test (PPD) results 55%; anemia, 37%; hepatitis B antigenemia, 14%; and abnormal VDRL test results, 12%. Except for hepatitis, significant differences were noted among the Vietnamese, Cambodian, Laotian, and Hmong subjects on each of these health status indicators. The refugee population should not be considered a homogeneous group of Indochinese, particularly by those responsible for their health care.

Adolescent↗
PubMed1982

Nosocomial tuberculosis.

Hospital employees are at risk of contracting tuberculosis from patients. The undiagnosed case with sputum-smear positive for acid-fast bacilli is the usual source case. However, even the smear-negative patient may pose a risk. This was documented by a high rate of skin test conversion in hospital staff exposed to a smear-negative, culture-positive patient in a respiratory intensive care unit. The patient required bronchoscopy, intubation, and assisted ventilation. Of susceptible hospital staff members who were exposed to the index case, 14 of 45 (31%) converted their PPD skin test. Ten of 13 (77%) susceptible hospital staff members present at the time of bronchoscopy converted, compared with 4 of 32 (12.5%) who were not present at bronchoscopy (Fischer's exact test p = 0.0006). Rough calculations suggest that during the bronchoscopy and intubation the index case generated at least 249 infectious units per hour. At the ventilation levels in this area, this resulted in 1 infectious unit of tuberculosis in each 68.9 cubic feet of air. Improved ventilation, high efficiency filters, and ultraviolet irradiation are effective recommended ways to clean the air of infectious particles.

Air Microbiology↗
PubMed1982

Ketoconazole for treatment of disseminated coccidioidomycosis.

Of 29 selected patients with disseminated coccidioidomycosis, 27 were treated for at least 6 months with ketoconazole, 200 to 600 mg/d. Two patients had progression of coccidioidal disease shortly after starting ketoconazole, and one developed meningitis. Seven of eight patients with synovitis had prompt improvement in symptoms, but four either had recurrent synovial thickening without recoverable Coccidioides immitis or could not remain free of symptoms off the drug. The response of osteomyelitis to ketoconazole was hard to assess; three of eight cases clearly improved and none progressed. Abscess or sinus formation clearly improved in eight of patients; five remained free of disease after the drug was discontinued. Skin lesions improved in six of nine; three lesions remain healed off the drug. Ketoconazole is absorbed readily after oral ingestion and has little toxicity. In the dosages used, it seems to suppress but not eradicate C. immitis. The drug may be able to stabilize the infection while cell-mediated immunity is restored.

Adult↗
PubMed1982

Ketoconazole for treatment of chronic pulmonary coccidioidomycosis.

Twenty-one patients with chronic pulmonary coccidioidomycosis were treated with ketoconazole. In 16 patients with chronic cavitary disease, nine improved, four showed no change, and the condition of three deteriorated; three of nine patients had culture conversion. Roentgenograms showed improvement in two patients, no change in 12, and deterioration in two. Serologic improvement was not noted. In five patients with persistent infiltrative disease, the response was more favorable. Radiographic improvement, culture conversion, and serologic improvement were seen in most patients. Ketoconazole-induced side effects were mild and of short duration, ending in the first days of therapy. Ketoconazole seems to be of significant value in infiltrative pulmonary disease, but seems unable, at the doses used, to change finding in the sputum or to change radiographic findings in chronic cavitary disease. Further long-term observation is necessary to evaluate fully the role of this drug in chronic pulmonary coccidioidomycosis.

Adult↗
PubMed1981

Disseminated coccidioidomycosis in children.

In an effort to define the importance of extrapulmonary coccidioidomycosis in the pediatric age group, we have studied 14 cases and reviewed the literature. The available data suggest that children are as susceptible to dissemination as are adults. Most children with disseminated coccidioidomycosis have evidence, either by history or chest radiographs, of preceding or concurrent pulmonary infection. The most common sites of dissemination are skin, subcutaneous tissue, bone, and meninges. Coccidioides immitis may be detected in tissues or body secretions by microscopic examination or by appropriate culture. Serologic tests are also useful in making the diagnosis and in following the course of the infection. Skin tests are often negative. Infection is progressive in 60% without antifungal therapy. Coccidioidomycosis of bone, skin, or subcutaneous tissue can be managed effectively with combined surgical and antifungal therapy. Meningitis is much more difficult to treat and is fatal in 50% of cases even when treated with amphotericin B.

Adolescent↗
PubMed1981

Adaptive immunity of the tympanic membrane.

In a previous experiment an antiserum was developed in the rabbit from the lamina propria of the tympanic membrane of the guinea pig. In the present study 18 Hartley guinea pigs were used in an in vivo experiment in which the antiserum (RAGTM IgG) served passively to immunize the animals subjected to various forms of trauma to the right tympanic membrane. Two groups (18 animals) immunized with normal rabbit IgG or normal saline served as controls. The left tympanic membrane remained untouched in all groups and served as an internal control. Various forms of trauma (infection, cauterization, section), various times (one to 21 days), and diverse techniques of staining (immunofluorescence, complement, and immunoperoxidase) were studied. The results indicate that the combination of trauma and sensitization in the first group evokes a particular response in the lamina propria of the tympanic membrane in immunized animals (RAGTM IgG). The form of trauma does not influence the results, but time seems to be an important factor. This work addresses several questions concerning the possible role of the combination of trauma and sensitization in conditions that involve the tympanic membrane and middle ear clinically.

Animals↗
PubMed1981

Flexible fiberoptic bronchoscopy for diagnosing pulmonary coccidioidomycosis.

To assess the diagnostic yield of flexible fiberoptic bronchoscopy (FFB), we reviewed records of 30 patients who had (1) cultural and/or histologic evidence of coccidioidomycosis, (2) abnormal chest roentgenograms, and (3) undergone FFB. Each patient underwent a complete examination including sputum collection for smears and culture. As additional diagnostic information was needed, FFB was performed in all patients, followed by percutaneous needle aspiration in 4 patients and thoracotomy in 10. Prebronchoscopy sputum cultures yielded Coccidioides immitis in 6 of 30 patients (20%). Bronchoscopy provided specimens diagnostic of coccidioidomycosis in 16 of 30 patients (53%), and in 10 of 30 (33%), FFB was the first procedure of the examination to produce a diagnostic specimen. The diagnosis was first obtained by needle aspiration in 1 of 30 (3%), by extrathoracic specimens in 3 of 30 (10%), and by thoracotomy in 10 of 30 (33%). All 8 patients with a solitary pulmonary nodule (SPN) had nondiagnostic FFB and comprised the majority of patients not diagnosed until thoracotomy was performed. When patients with a SPN were excluded, 20 of 29 (69%) FFB procedures documented coccidioidal infection. Seven of 22 (32%) prebronchoscopy sputum collections compared with 17 of 29 (59%) FFB procedures produced positive cultures for C. immitis. One of 22 (5%) prebronchoscopy sputum collections, compared with smears and biopsies from 8 of 29 (28%) FFB procedures, produced immediate microscopic evidence of coccidioidomycosis. Coexisting pulmonary pathologic findings in 4 patients were uncovered by FFB. Except in patients with a SPN, FFB is a valuable procedure for documenting pulmonary coccidioidomycosis when sputum specimens are nondiagnostic.

Biopsy, Needle↗