[Modification of skin tests under the influence of inhaled beclomethasone dipropionate aerosol].
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Biomedical subjects
Publications and source records attributed to D Herman.
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The clinical and pathological characteristics of gallbladder carcinoma were studied in a group of 56 Southwestern American Indian patients. This is the third most common malignant tumor among American Indian females in a population served by the New Mexico Tumor Registry accounting for 8.5% of specific cancer diagnoses by site. Carcinoma of the gallbladder is relatively more common within the Indian population than among Spanish Americans or Anglos living in this area. This is true for both sexes. No significant differences in average age at diagnosis, ratio of female to male patients, signs and symptoms, stage at diagnosis or survival were detected in comparison with studies pertaining to gallbladder carcinoma in non-Indian populations. A squamous cell carcinoma component was unusually common however, and carcinoma in situ or atypical adenomatous hyperplasia of the mucosa was frequently documented adjacent to invasive carcinoma. Although gall stones were present in tumor containing gallbladders in 93% of cases, elective cholecystectomy for cholelithiasis is probably not a practical means of prevention of this tumor in view of the unusual frequency of cholelithiasis in Indian women. Pharmacological conversion of bile to a non-lithogenic form may deserve consideration as prophylaxis against both cholelithiasis and carcinoma of the gallbladder in this population.
The relatively simple and precise technique of direct immunofluorescence on a tissue section enables the study and enumeration of all types of plasma cells including mastocytes (stained with acridine orange) in normal conjunctiva (5 cases), chronic non-allergic conjunctivitis (5 cases), allergic conjunctivitis of the educt (11 cases) and vernal conjunctivitis (11 cases). There is evidence of elevation of IgE plasma cells in type I allergic conjunctivitis where they are twice as raised as in non-allergic cases in adult forms, and three times more elevated in vernal conjunctivitis. There was no correlation between the number of IgE plasma cells in the tissues and IgE level in sera. Thus in air-borne conjunctival allergies local hypersensitivity seems to be the predominant, even exclusive, feature.
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On the basis of three cases, the authors review the clinical picture of Hoigne's syndrome, characterised by the development of acute manifestations, essentially psycho-sensorial, immediately following the injection of procaine penicillin G (PPG). The syndrome is due to the passage into the circulation of micro-aggregates of PPG and has no immuno-allergic basis. Subsequent treatment with penicillin is not contraindicated.
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The notion of anaphylactic shock under anaesthesia implies sensitization, with a minimum delay of 1 week, on the occasion either of a previous anaesthesia with the responsible product, or with taking a drug with common antigenic determinants. Clinically this is reflected by the rapid and explosive appearance of symptoms which are always comparable: tendency to vascular collapse, respiratory bronchospastic distress, erythematous rash and Quincke's edema, gastrointestinal disorders, etc. These signs and symptoms of anaphylactic shock are closely related to the pharmacological actions of substances liberated during the reaction, of reaginic orgin (histamine, S.R.S.A.). It is reproduced by the direct effects of numerous anaesthetics on the liberation of theses very substances without the intermediary of an immunological mechanism. In consequence, the clinical argument alone is not sufficient to assert the true anaphylactic nature of a shock. Consequently, the elements of the history must be strongly borne in mind: notion ofsensitization during a previous anaesthesia, to the responsible product or to a drug which could have a crossed antigenicity with it.
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A finding commonly obtained in research using the Buss "aggression machine" is a main effect for trail blocks, indicating an escalation in shock intensity over trails. Theoretical explanations for this effect were tested in a modified verbal operant-conditioning situation. In Experiment 1, subjects could administer any of 10 levels of positive reinforcement to a "learner" for correct verbal responses or any of 10 levels of negative reinforcement to a learner for incorrect responses. Half of the subjects were required to begin with weak, half with strong, reinforcements. Results indicated that, regardless of condition, subjects gave more intense reinforcements as the learning trails progressed. Those who administered negative reinforcements devalued the learner relative to those who administered positive reinforcements. In Experiment 2, a role-playing procedure was used in which subjects administered either positive or negative reinforcements to a learner whose performance either did or did not improve over trials. Again, in all experimental groups, subjects administered increasingly intense reinforcements over trials. The results are interpreted as supporting a disinhibition theory of anti- and prosocial behavior.
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