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Biomedical subjects

M Kiss

Publications and source records attributed to M Kiss.

At least 37 records · Page 2Linked to original sources

[Food allergy in patients with chronic urticaria].

Basic food allergens (bread, milk and egg) were investigated in patients with idiopathic chronic urticaria. In 29 of 43 patients, sensitivity could be shown against one or more antigens. The results suggest not only the anaphylactic IgE-mediated reaction in same patients, but also an antibody or cell-mediated mechanisms in the development of the disease. Besides the Prick test, therefore, testing of other circulating antibodies by means of the ELISA technique and the leukocyte migration test is recommended to establish the causative agents in patients with chronic urticaria.

Adolescent↗

Implementing national standards for cancer pain management: program model and evaluation.

The purpose of this quasi-experimental (pre and posttest) study was to test a model pain management program (PMP) to implement the American Pain Society (APS) quality assurance standards for the management of acute and chronic cancer pain using a continuous quality improvement (CQI) approach to improve professionals' knowledge and skills, patient satisfaction, and to identify areas needing improvement. The sample consisted of 1210 nurse responses and 698 interviews of patients with pain during hospitalization at a major urban cancer center. The PMP provided a structure (standards), educational opportunities, and training in CQI methods. Outcome measures included a patient evaluation questionnaire and concerns checklist; nurse knowledge, attitude and barriers questionnaire; and focus groups to identify areas needing improvement. Significant improvements were found in patients' satisfaction, nurses' knowledge and attitude scores, and reductions in nurses' perceptions of barriers. Focus groups revealed the need for improved communication among disciplines about pain and better assessment of patients unable to self-report. The program met its goal of implementing the APS standards, educating nurses, and identifying "system" problems, and improving overall patient satisfaction.

Evaluation Studies as Topic↗

Identification of different circulating autoantibodies in patients with bullous pemphigoid and pemphigus vulgaris by means of immunoblotting.

Immunoblotting studies with salt-split human epidermis were performed on sera from 15 patients with pemphigus vulgaris and 20 patients with bullous pemphigoid by using peroxidase-labelled antihuman IgG and IgA. Eleven sera of pemphigus vulgaris antigen. Most of the sera gave additional specific bands at 210 and 80 kD, with lower intensity. The sera of 4 patients, 3 of them were in clinical remission, did not yield specific bands. Seventeen sera of the 20 bullous pemphigoid patients yielded a 220-230 kD protein band against the major bullous pemphigoid antigen and 4 of them gave another specific band at 160-180 kD. Five sera produced multiple bands (220, 130, 100 and 75 kD). IgA antibodies against the major bullous pemphigoid antigen were demonstrated in 2 cases with IgA deposits along their basement membrane, as revealed by direct immunofluorescence. The immunoblot patterns correlated only weakly with the clinical findings in bullous pemphigoid. There was a considerable diversity in both clinical findings and immunoblot patterns.

Aged↗

Detection of bullous pemphigoid antibodies by means of synthetic peptides as antigenic epitopes.

In an earlier study, the circulating autoantibodies in patients with bullous pemphigoid (BP) were demonstrated in higher frequencies by means of an immunoblot technique then via indirect immunofluorescence. In the present work with the help of Peptide Structure software, two matched antigenic epitopes were chosen and synthesized. The sera of 34 patients with BP were investigated in parallel by an immunoblot technique using a human epidermal extract, and by an ELISA technique with synthetic peptides. The sera of 16 healthy persons and 10 patients with other bullous diseases served as controls. Among the 34 patients with BP, 23 sera proved positive for at least one synthetic peptide. Positive reactions with the major BP antigen (230 kD) were found in 22 patients by immunoblot technique and in 16 patients by the ELISA technique with the synthetic peptide, whereas with the minor BP antigen (180 kD), positive reactions were found in 9 patients by the immunoblot technique and 18 patients by the ELISA technique using the synthetic antigenic epitope of the minor BP antigen. All control sera were negative for both antigens in ELISA investigations. In 3 patients with pemphigus vulgaris, characteristic bands against pemphigus vulgaris antigen were identified by means of the immunoblot technique, but all other cases were negative. It is suggested that the development of this technique may lead to an opportunity for the rapid and simple diagnosis of BP.

Adult↗

Human herpesvirus 8 in classic Kaposi sarcoma.

Recent studies suggest the role of a new human herpesvirus (HHV8) in the pathogenesis of different forms of Kaposi sarcoma (KS). In the present work we investigated the presence of HHV8 sequences in KS tumour tissues from patient with classic KS. Since clear evidences point to the role of immune suppression in the development of AIDS-associated KS or patients receiving immunosuppressive therapy, immunological investigations were also performed. We could show a highly consequent association of HHV8 sequences with classic KS in the large series of patients supporting our previous findings that this virus might be in some way involved in the pathogenesis of this tumour. In addition immunological examination of the patients revealed a mild decrease in the CD4 positive cell number, a significantly reduced CD4/CD8 ratio, a diminished PHA reactivity and leukocyte migration factor production of lymphocytes. The changes observed in the present study are similar, but much less pronounced than those may be observed in HIV infection.

Aged↗

Alpha-melanocyte stimulating hormone induces collagenase/matrix metalloproteinase-1 in human dermal fibroblasts.

Recent reports have suggested that alpha-melanocyte stimulating hormone (alpha-MSH) plays an important role in untraviolet (UV) irradiation mediated skin changes including pigmentation, inflammation and connective tissue damage. alpha-MSH synthesis has been found to be induced in human keratinocytes following UV irradiation. In order to test the hypothesis whether UV induced alpha-MSH - via a paracrine loop - regulates the synthesis and the activity of collagenase/MMP-1, we studied the effects of alpha-MSH on the expression of MMP-1 and its tissue inhibitor of matrix metalloproteinases (TIMP-1). Confluent human dermal fibroblast cultures from foreskin biopsies of healthy human donors were treated with 10(-5)M, 10(-8)M and 10(-11)M alpha-MSH for 30 min. As determined by Northern blot analysis 10(-5)M and 10(-8)M alpha-MSH dose- and time-dependently induced steady state levels of MMP-1 mRNA up to 9-fold compared to untreated controls. TIMP-1 mRNA steady state levels were also slightly induced, however, the increased MMP-1/TIMP-1 ratio when normalized to beta-actin reflected an unbalanced synthesis. MMP-1 protein expression was studied with an immunofluorescence technique using a monoclonal antibody against MMP-1. After alpha-MSH treatment an increased number of fibroblasts revealed an intense perinuclear staining pattern compared to the less intense staining of control fibroblasts. The overall collagenolytic activity of supernatants from alpha-MSH treated fibroblasts was increased by 35%. Our data support the view that UV induced alpha-MSH - by the stimulation of collagenase/MMP-1 - may contribute to the loss of interstitial collagen related to cutaneous photoaging.

Cell Extracts↗

[Effectiveness of immunoblotting in the diagnosis of blistering skin diseases].

Results obtained with the immunoblot technique and indirect immunofluorescence on the specific circulating autoantibodies in 20 patients with bullous pemphigoid and in 15 patients with pemphigus vulgaris were compared. In 17 of the 20 patients with bullous pemphigoid, autoantibodies against the 230 kD major antigen could be demonstrated, and in 9 of these 17 patients more specific autoantibodies against "salt-split" epidermis antigen (220, 180, 130, 100 and 75 kD) were shown. Indirect immunofluorescence were positive only on the sera of 5 of the 20 patients with bullous pemphigoid. The sera of 11 of the 15 patients with pemphigus vulgaris yielded autoantibodies against specific antigen (130 and 85 kD protein). To summarize the results, the immunoblot technique is an excellent method to demonstrate circulating autoantibodies in patients with autoimmune bullous skin diseases and its sensitivity is better than that of the indirect immunofluorescence, procedure. Moreover, it gives a possibility to differentiate among different clinical types.

Aged↗

The lymphocyte transformation test with sulphadiminidum and with prealbumin-sulphadiminidum complex in patients with drug allergy.

Earlier results (the absence or a decreased level of prealbumin [PA] in the serum, a higher proportion of PA-bearing lymphocytes as antigen-binding cells, and the presence of PA in the eluate of lymphocytes in patients with drug allergy) permitted the conclusion that, besides its other relevant functions, PA may also behave as a hapten carrier protein. The lymphocyte transformation test (LTT) involving measurement of 3H-thymidine uptake was therefore carried out with sulphadiminidum (SA) alone, with the PA-SA complex, and with the albumin-SA complex in patients with proven (3 cases) or suspected (63 cases) sensitivity to SA. In all 3 cases with proven drug allergy to SA and in 5 of the 63 suspect cases, the LTT was positive in response to both the drug alone and to the PA-SA complex (The albumin-SA complex gave positivity in only one case). In 5 of the 63 suspect cases, the LTT was positive only in response to the PA-SA complex. It is suggested that the sensitivity of the LTT could be increased if the test could be run with a complex of a protein (hapten carrier?) and a drug.

Drug Eruptions↗

Treatment of cold urticaria.

BACKGROUND: The etiology of cold contact urticaria is unknown and the therapy is therefore usually rather disappointing. METHODS: This study reports therapeutic data on 42 patients with cold urticaria treated with a combination of terbutaline (3 x 5 mg a week, later 3 x 2.5 mg) and aminophylline-containing drugs (3 x 150 mg). RESULTS: Complete remission of the urticarial response was achieved in 37 of the 42 patients. CONCLUSIONS: The therapy was tolerated relatively well and the results are promising.

Adolescent↗

[A new method, based on in situ DNA hybridization, for the detection of papillomavirus in condyloma patients and their partners].

The detection and typing analysis of human papillomavirus (HPV) were carried out by means of BIOHIT in situ HPV DNA hybridization screening and typing kits in condyloma tissues of patients with genital condyloma acuminatum, in cytological smears of their asymptomatic female consorts, and in female patients with vulval condyloma acuminatum. "Low"-risk HPV 6 and HPV 11 were demonstrated most frequently in the condyloma tissues of the male patients. It is noteworthy that all but one female consorts carried similar HPV type(s) in their cervical smears to those of their sexual partners in condyloma tissues. "Medium" and "high"-risk HPV 18, 31 and 33 types (frequently associated with high-grade dysplastic lesions and carcinomas) were demonstrated more frequently in female condylomas than in male. These three HPV types were identified in both tissues in a female patient with condyloma acuminatum and carcinoma epidermoids cornescens.

Adolescent↗

Papillomavirus DNA typing analysis in condyloma acuminatum patients and their consorts.

The present study demonstrated human papillomavirus (HPV) infection by means of an in situ HPV DNA hybridization screening test (BIOHIT) in 8 male patients with genital condyloma acuminatum, their asymptomatic female consorts and 6 female patients with vulval condyloma acuminatum. The investigations revealed that all but one of the female consorts were infected by HPV but did not show any clinical sign of papillomavirus infection. HPV DNA typing analyses with the most common HPVs present in the genital tract (HPV 6, 11, 16, 18, 31 and 33) revealed the same HPV types in the consorts as found in their partners. (HPV 6 and/or 11 were detected in 4 pairs, HPV 18 and 31 in one pair each, and HPV 18/31 and 16/31 double infections in one pair each.) All cytological specimens of female patients with condyloma acuminatum were HPV-infected, the most frequent type being HPV 31. In the one patient with vulval condyloma acuminatum and carcinoma epidermoides cornescens, the "high-risk" HPV 18 was identified in both condyloma and carcinoma tissues.

Adult↗

[Detection of circulating antibodies in the blood and immune complex precipitates of patients with autoimmune diseases (preliminary report)].

Antibodies against ENA (Extractable Nuclear Antigens), SSA/Ro and SSB/La were investigated in parallel in the serum and the immune complex precipitates of 41 patients with autoimmune disease (10 systemic lupus erythematosus, 23 discoid lupus erythematosus, 3 subacute cutaneous lupus erythematosus, and 5 progressive systemic sclerosis). It was demonstrated that in some cases the autoantibody spectrum of the serum did not coincide with that of the immune complex precipitate. In the majority of patients the protein content of isolated immune complexes was increased and the increase was attributed to IgG solely. In some patients antibodies appeared not only in the serum but also in immune complex, even in 4 patients (2 systemic lupus erythematosus, 1 subacute cutaneous lupus erythematosus, and 1 progressive systemic sclerosis) antibodies were detected only in the immune complex precipitate.

Antigen-Antibody Complex↗

Primary Sjögren's syndrome from the viewpoint of an internal physician.

The characteristics of primary Sjögren's syndrome are described on the basis of the follow-up of 65 patients with extraglandular symptoms at the onset and during the disease. The mean age of the patients at onset was 41.8 years and at the time of definite diagnosis was 45.8 years. Articular (32 cases), lacrimal (30 cases) and salivary (30 cases) manifestations were the most frequent initial symptoms. In only 22 of the 65 patients could Sjögren's syndrome be diagnosed at the onset. In most cases, the articular symptoms observed observed in 56 patients during the course corresponded to true polyarthritis, as verified by joint scintigraphy. Most frequently the wrists and ankles were affected. Chronic atrophic gastritis was found in 35 patients. In the young patients (13 cases), both the antrum and the corpus were affected more frequently than in the controls. In middle-aged patients (21 cases), atrophy of the antrum, and in the elderly (10 cases) atrophy of the corpus was more frequent than in the controls. All three types of chronic atrophic gastritis occurred in the disease. The decreased gastric acid secretion was characteristic of types A and AB gastritis, but the hypergastrinaemia only of type A. It was verified that chronic duodenitis and jejunitis occur in the disease. The pancreatic lesions were mild. Renal involvement was detected in 15 patients, vascular symptoms in 22 and lower-airway changes in 21. The variety of the different symptoms proved that primary Sjögren's syndrome can involve many organs.

Acidosis, Renal Tubular↗

The occurrence of antinuclear, anti-SSA/Ro and anti-SSB/La antibodies in patients with polymorphous light eruption.

Serological features were investigated in 22 patients with polymorphous light eruption. The diagnosis was made from the history and clinical patterns and confirmed by phototesting and histological examinations. In 4 patients with polymorphous light eruption, anti-RNP antibodies were detected in the serum despite the fact that the antinuclear antibody tests were negative in all cases. The serum levels of anti-SSA/Ro antibodies in the patients were mildly but significantly elevated (p less than 0.001) as compared with healthy controls. No difference was found between the patients and controls regarding the serum concentrations of anti-SSB/La antibodies. The conclusion is drawn that it is necessary to examine patients with polymorphous light eruption with regard to a 'late autoimmune course' and it is worthwhile to study the relationship between the photosensitivity and the occurrence of anti-SSA/Ro antibodies.

Adult↗

[Detection of antimitochondrial antibodies by immunodiffusion, ELISA and immunofluorescence methods].

Ouchterlony immunodiffusion and ELISA were used for the detection of antimitochondrial antibodies. The results were compared with those of immunofluorescence measurements. The occurrence of antimitochondrial antibodies was investigated in 20 patients with primary biliary cirrhosis, in 30 with autoimmune disease and in 28 with porphyria cutanea tarda. Sonicated rat liver mitochondria fractions were used as antigens. Among the patients with primary biliary cirrhosis, Ouchterlony immunodiffusion revealed antimitochondrial antibodies in 18 cases, whereas antibodies were not found in the other groups of patients, except for 1 case of systemic lupus erythematodes. ELISA demonstrated that in all 20 patients with primary biliary cirrhosis where immunofluorescence revealed antimitochondrial antibodies, there was an increase in the quantity of antibodies against mitochondrial inner membrane fractions, and in 7 cases even against the outer membrane fractions. These 7 were the most serious cases clinically. These methods allow the differentiation of antimitochondrial antibody subtypes and promote the establishment of the diagnosis.

Antibodies↗