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Biomedical subjects

B Schwartz

Publications and source records attributed to B Schwartz.

At least 271 records · Page 15Linked to original sources

Immunotherapy with partially purified and standardized tree pollen extracts. III. Specific IgE response to the major allergens of alder, birch and hazel pollen during immunotherapy.

Patients allergic to pollen from alder, birch and hazel were hyposensitized during a 3-year period with either birch pollen extract alone (n = 24) or a mixture of one or more of alder, birch and hazel pollen extracts (n = 27). The effect of the treatment was evaluated by RAST and tandem crossed-radioimmunoelectrophoresis (tandem-CRIE). The patient' specific IgE response to the major allergens of alder (Aln g I), birch (Bet v I) and hazel (Cor a I and Cor a II), as measured by tandem-CRIE, and the total specific IgE response, measured by RAST, decreased significantly (Pc less than 0.05) during immunotherapy, irrespective of the extract used during the treatment. There was no significant difference (Pc less than 0.05) between the two treatment groups. The results obtained indicate either that birch pollen extract alone is adequate in the treatment of the studied patient group or the patients had been sensitized towards birch pollen alone.

Clinical Trials as Topic↗

High-dose local steroid treatment in bronchopulmonary aspergillosis. A pilot study.

Two patients with allergic bronchopulmonary aspergillosis (ABPA) have been treated with a high dose (1600 micrograms daily) of inhaled corticosteroid for 18 months. A beneficial effect with regard to asthmatic symptoms was observed in both patients. During the first 14 months of the observation period no significant changes were observed in lung function parameters. Bronchial histamine challenge showed decreased hyperreactivity. IgE decreased in both patients, while specific IgE and IgG remained the same. After 14 months of treatment one of the patients developed severe, acute exacerbation of the ABPA and was treated with high-dose prednisolone and local steroid. The patient is now fully recovered and has continued on local steroid therapy. The other patient had no episodes of exacerbation and remains stable on this treatment.

Administration, Topical↗

Sensitization of children in the Stockholm area to house dust mites.

Atopic sensitization of children in the Stockholm area to house dust mites (HDM) was investigated in a case-control study. Sixty children with and 60 without positive skin prick tests for HDM were matched for age and sex. HDM-sensitized children had previously more often lived in other areas known to be mite infested than the control children. Sensitization to mites was related to dampness in the homes, but no significant relationship was found to the type of residence, frequent visits to a summer house in the archipelago or parental smoking. Dust samples from mattresses of the children with the strongest positive reactions to mites in skin prick tests and the respective controls were subjected to an enzyme immunoassay, to measure the content of the major allergens of the Dermatophagoides (D.) species D. pterinyssinus, D. farinae and D. microceras. Mattress dust samples from the beds of HDM-sensitized children contained significantly higher HDM antigen concentrations than those from the beds of controls. Private houses contained significantly more HDM antigens than flats and 10 of 11 homes in which a dampness problem was recognized contained mite antigens. It is postulated that mite infestation is increasing in the area, energy-saving measures creating improved conditions for HDM survival.

Adolescent↗

Differential distribution of protein kinases along the crypt-to-lumen regions of rat colonic epithelium.

The activity of cAMP-dependent and cAMP-independent protein kinases, a class of enzymes involved in the regulation of cell proliferation was measured in rat colonic epithelium. Sequential cell populations harvested by a stepwise scraping technique from colonic crypt regions were identified by histology and incorporation of [3H]-thymidine into DNA. cAMP-independent phosphorylation of casein, in the presence of [gamma-32P]ATP, was markedly suppressed by quercetin, a bioflavonoid known to inhibit G-type casein kinase, protein kinase-C and tyrosine protein kinase. Conversely, the cyclic nucleotide regulatable form requiring histone as substrate was responsive to the action of the heat stable protein kinase inhibitor. The protein kinase species were characterised and partially purified by DEAE-cellulose chromatography. The activity of cAMP-dependent protein kinase in colonic cytosols (pmol 32P/min/mg protein, means (SE)) increased from 129.4 (15.9) in superficial cell populations to 238.5 (31.4) in lower crypt cell fractions (p less than 0.01). Colonic cAMP-independent protein kinase activity increased from 87.3 (15.6) in surface cell preparations to 178.1 (30.0) in lower crypt cell populations (p less than 0.02). A comparable activity gradient was observed in membrane fractions. The activity gradient persisted when the results were expressed as a function of cellular DNA. These findings indicate that protein kinases display a defined topological segregation along the colonic crypt regions and that during migration to the lumen colonic cells attenuate enzyme signals supposedly related to tissue growth.

Animals↗

Antigenic analysis of household dust samples.

Household dust samples from the homes of 106 allergy clinic patients in Baltimore were analyzed for specific allergen content. Dust mite antigen content was determined by enzyme-linked immunosorbent assays (ELISA) specific for the major allergens of Dermatophagoides pteronyssinus, D. farinae, and D. microceras. Cat and dog antigen content were determined by ELISA using antisera for Fel d 1 (formerly cat allergen 1) and dog allergens 3 and 13, respectively. Mold content was assessed by culture with microscopic identification. Dust mite antigen was detected in 99% of homes (D. farinae, 95%; D. pteronyssinus, 88%; D. microceras, 31%), with total antigen content ranging from 50 ng/g dust (the lower limit of detection) to 30,170 ng/g (median, 1,123 ng/g). Animal allergens were found in 100% of samples (cat: range, 2 to 130,000 ng Fel d 1/g; median, 90 ng/g; dog: range, 112.5 to 585,000 IU/g; median, 2,719.5 IU/g). Although there were highly significant differences in antigen content (p less than 0.001) between homes with and without a particular pet in residence, many homes without pets contained pet allergens at high concentrations. Molds were also detected in 100% of homes (range, 4 to 761 colonies/30 mg dust; median, 72 colonies/30 mg). No correlation was demonstrated between antigen content and skin test results, a history of asthma, symptoms on allergen exposure, or the age of the home (except for molds) for any of the allergens detected. We conclude that dust mite allergens, cat and dog allergens, and molds are virtually ubiquitous in Baltimore homes and that our ability to predict the presence and relative quantities of these allergens on clinical grounds is very limited.

Adolescent↗

Measurement of optic nerve head pallor with a video-ophthalmograph and with computerized boundary analysis.

Optic disc pallor was recorded in 53 eyes of 53 patients by means of global analysis with a video-ophthalmograph (Rodenstock Disk Analyzer) and computerized boundary analysis. The coefficients of correlation between the values obtained with the Rodenstock Disk Analyzer and those obtained with boundary analysis were r = 0.24 (p = 0.08) at the 0.29 cutoff level, r = 0.39 (p = 0.004) at the 0.39 level and r = 0.46 (p = 0.0005) at the 0.50 level. Although the correlation was significant, the correlation coefficients were not high. The Rodenstock Disk Analyzer uses global analysis, which does not take into account the spatial relationship of the pallor on the disc, whereas boundary analysis is sensitive to spatial relationship, which may account for the poor correlation.

Adolescent↗

Optic disk cupping and pallor measurements of patients with a disk hemorrhage.

We evaluated whether the rate of occurrence of glaucomatous disk damage in eyes with an optic disk hemorrhage differed from the rate of occurrence in control eyes. We compared 24 patients with a disk hemorrhage to 24 control patients, who had been matched for diagnosis, disk appearance, and visual fields. Cup volume and cup-to-disk area ratio of the optic disk were measured using the stereophotogrammetric technique, and area of pallor was measured using computerized image analysis. We found that diabetes increased the probability that a patient would have a disk hemorrhage, and that a hemorrhage was associated with progression of glaucomatous disk changes in half of the cases during the mean 3.1-year follow-up period. However, the mean rate of glaucomatous disk damage in patients with a hemorrhage was not different from matched control patients. A disk hemorrhage is a sign of later disk damage, but it does not alter the rate of glaucomatous disk progression.

Eye Hemorrhage↗

Decrease of ocular pressure with oral metyrapone. A double-masked crossover trial.

To examine the effect of a decrease in plasma cortisol level on intraocular pressure, 14 subjects with elevated ocular pressure were given oral metyrapone tartrate (an inhibitor of adrenal cortisol biosynthesis) and a placebo in a double-masked, two-period, crossover trial. Ocular pressure and the adrenal response were monitored over a seven-hour period. The decrease in ocular pressure after metyrapone administration was significantly greater than that after placebo. The 14 subjects could be designated as responders or nonresponders by decline of ocular pressure after metyrapone administration compared with response after placebo. The responders could be further differentiated from the nonresponders by a smaller decrease in ocular pressure over time in response to the placebo and by a smaller decrease over time of plasma cortisol level in response to metyrapone. These results provide further evidence that plasma glucocorticoids may play a role in the regulation of ocular pressure.

Administration, Oral↗

Increased plasma free cortisol in ocular hypertension and open angle glaucoma.

Values of plasma free cortisol (not bound to plasma proteins), total plasma cortisol, and percent free cortisol were determined in normal, ocular hypertensive, and open angle glaucomatous subjects. Median total plasma, plasma free, and percent free cortisol levels were higher in ocular hypertensive and glaucomatous individuals. The most significant differences occurred with percent free cortisol values between normal and glaucomatous subjects. There was a significant positive correlation between percent free cortisol and total cortisol levels in normal subjects only. For subjects with glaucoma and hypertension, the percent free cortisol values were independent of the total cortisol values. Multilinear regression analysis also indicated that besides diagnosis and level of total plasma cortisol, male sex, blood sampling late in the day, and increased diastolic blood pressure were the only variables significantly related to increased values of plasma free cortisol and percent free cortisol. Ocular medication for glaucoma and use of beta-blockers were not found to be significant independent variables in the regression models for either plasma free cortisol or percent free cortisol. These observations further suggest that a disorder of the pituitary adrenal axis and/or a binding of plasma cortisol is associated with ocular hypertension and open angle glaucoma.

Adrenergic beta-Antagonists↗

Serum pseudocholinesterase in psychiatric patients.

Serum pseudocholinesterase activity was measured in 123 subjects: 16 agitated depressives, 12 retarded depressives, 7 acute schizophrenics, 14 residual schizophrenics, 16 healthy individuals, 45 surgical patients, and 13 first-degree relatives of 4 agitated depressive patients. The agitated depressive and acute schizophrenic patients had significantly higher pseudocholinesterase serum activity than their retarded inmates. As first-degree relatives of agitated depressive patients showed high levels similar to their ill relatives, a genetic component might play a crucial role. The level of pseudocholinesterase activity in serum of the surgical patients was significantly lower than that of all the psychiatric patients and the controls. The implications of this observation are still obscure.

Acute Disease↗

The prevalence of indoor allergens in the Baltimore area: house dust-mite and animal-dander antigens measured by immunochemical techniques.

Mattress dust samples from 42 homes in Baltimore, Md., were analyzed by ELISA and rocket immunoelectrophoresis (RIE) for major excrement allergens (P1 [equal to Dp 42], Df 6, and Dm 6) of house dust mites, Dermatophagoides pteronyssinus, D. farinae, and D. microceras, by RIE for cat major epithelial allergen (cat Ag 1) and horse major epithelial antigen (horse Ag 11), and by counter-current immunoelectrophoresis (CCIE) for cat and dog antigens. Dp 42 was detected by ELISA in 24 samples (57%) and Df 6 in 39 samples (92%). All samples were negative to Dm 6. Recorded levels varied from 50 ng of allergen per gram of dust (detection limit) to 15,000 ng/gm. A combined content of Dp 42 and Df 6 greater than 700 ng/gm was associated with a positive reaction in RIE. Concentrations of Dp 42 and Df 6 did not correlate (rS = 0.21; p greater than 0.05). Cat and dog antigens were frequently detected by CCIE (77% and 63%, respectively). CCIE titer to cat correlated well with quantitation of cat Ag 1 by RIE (p less than 0.01). Horse antigen was detected in few homes (5%). None of the specific allergen determinations correlated with levels of human serum albumin determined by RIE.

Allergens↗

Increase of pallor and fluorescein-filling defects of the optic disc in the follow-up of ocular hypertensives measured by computerized image analysis.

In 24 ocular hypertensive patients, two optic disc fluorescein angiograms were obtained a mean of 3.9 years apart. Using computerized image analysis, we measured the area of pallor and the fluorescein-filling defect area within the disc and the fluorescein circulation parameters representing the filling rates of optic disc, choroid, and retinal vessels. The results indicated that increase in pallor and fluorescein-filling defect areas, as well as a slowed filling rate of the retinal veins, correlated with glaucomatous progression.

Aged↗

Enhancement of fundus photographs taken through cataracts.

Image-enhancement techniques can aid the clinician in evaluating fundus pictures taken through cataracts. The degradation of the fundus image by cataracts has been described as low-pass filtering. Means to partially overcome this degradation using homomorphic filtering and adaptive enhancement are presented. The clinical value of these enhancement techniques is demonstrated with two cases of progressive glaucoma and cataracts.

Cataract↗

Hematuria induced by urethral catheterization.

The amount of traumatic hematuria induced by urethral catheterization was studied by comparing the pre- and post-catheterization urinalyses of 93 patients presenting to the emergency department with abdominal complaints of an acute nature. Thirty-nine male patients ranging in age from 4 to 91 years and 51 female patients ranging in age from 1 to 70 years were studied. Catheterizations were performed by nurses (54%), resident house-staff (38%), and nurse practitioners (8%). Overall, hematuria was induced in 16 of 93 patients (17.2%) and, when present, never exceeded 3 RBC/hpf.

Adolescent↗