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Biomedical subjects

P Lieberman

Publications and source records attributed to P Lieberman.

At least 19 recordsLinked to original sources
PubMed1979

Complement activation following intravenous contrast material administration.

Untoward reactions to iodinated contrast material (ICM) continue to be a significant medical problem. Complement components were assayed in patients having reactions to evaluate the possibility of complement activation in these reactions. Reactor group samples were drawn from patients during the contrast reactions and then 2 weeks later to provide the equivalent of preinjection baseline samples, Control patient values were determined from blood samples drawn from patients before and 20 minutes after ICM injections without reaction. There were consistent falls in total hemolytic complement (CH50) as well as C3, C4, and C5 in both the control group and the reactor group. These falls in the complement reached statistical significance only for CH50 in the reactor group. The results indicate that complement activation occurs after ICM injection. This activation can occur independent of clinical reactions; however, falls in total hemolytic complement and low hemolytic complement titers prior to ICM infusion may be related to the presence of anaphylactoid symptoms.

Adolescent↗
PubMed1979

IgE mediated hypersensitivity to pancreatic extract (PE) in parents of cystic fibrosis (CF) children.

On exposure to pancreatic extract (PE), four parents of cystic fibrosis (CF) children developed immediate hypersensitivity-like symptoms: i.e. rhinoconjunctivitis, asthma, and/or anaphylaxis. IgE to PE was demonstrated in the subjects by skin testing, leucocyte histamine release and radioallergosorbent test (RAST). No serum precipitating antibodies were found. Bronchial challenge caused an immediate asthmatic response. No delayed asthmatic response or hypersensitivity pneumonitis-like reaction occurred. The responsible antigen for PE induced asthma is unknown; trypsin failed to inhibit PE-RAST and is therefore not responsible in these subjects. Caution should be exercised in using PE for skin testing and bronchial challenge in subjects with suspected hypersensitivity to PE. Certain measures were found useful in preventing the occurrence of symptoms in the four subjects.

Adult↗
PubMed1979

Recurrent idiopathic anaphylaxis.

Eighteen patients with recurrent episodes of life-threatening anaphylaxis of unknown cause were studied. Each patient had repeated detailed histories taken and had repeated physical examinations, hypersensitivity skin tests to foods, and complete blood cell counts. In addition, each patient underwent stringent dietary manipulation. Seventeen of the 18 patients underwent a series of studies. Three patients were hospitalized for study. Results of all tests were essentially normal except for an elevated plasma histamine level during attacks in two patients. Episodes could not be prevented with antihistamine therapy. Attacks were treated successfully by instructing the patients in the self-administration of epinephrine. It thus appears that recurrent episodes of anaphylaxis due to nonimmunologic histamine release of anaphylaxis due to nonimmunologic histamine release can occur without discernible cause and can be lifethreatening.

Adult↗
PubMed1978

Anaphylactoid reactions to iodinated contrast material.

A review of the literature involving anaphylactoid reactions to iodinated contrast material (ICM) suggests that the reactions are nonantibody-mediated but that a complex activation of inflammatory mediators occurs. Histamine release and/or complement activation has been demonstrated in both in vitro and in vivo experimental systems. It appears that pretreatment of selected cases (those patients previously exhibiting an anaphylactoid reaction) is effective in reducing the frequency and severity of subsequent reactions when readministration is necessary.

Adrenal Cortex Hormones↗
PubMed1978

Radiographic contrast media studies in high-risk patients.

Patients with prior anaphylactoid reactions (AR) to radiographic contrast media (RCM) are at increased risk for another reaction upon repeat exposure to RCM. One hundred one patients, who had prior AR to RCM, who gave informed consent, and who had an essential need for a repeat RCM study, were pretreated with prednisone, 50 mg orally every 6 hours for 3 doses ending one hour prior to RCM study, and diphenhydramine, 50 mg intramuscularly, one hour prior to RCM study. The repeat RCM study was then carried out using standard procedures with resuscitation equipment readily available. Ninety-six patients had no reaction. Five of the 101 (4.95%) developed AR. These AR consisted only of mild urticaria or pruritus. No significant or life-threatening reactions occurred. Pretreatment decreases the risk in this population of patients and is recommended as standard prophylaxis for patients requiring RCM who have had a previous AR.

Adult↗
PubMed1978

Localized heat urticaria.

The pathophysiology of localized heat urticaria was studied by performing a heat challenge on a patient with this disease. Serum levels of total hemolytic complement, C3, and factor B decreased following heat challenge, whereas levels of C4 and C5 did not. Plasma histamine levels remained unchanged. Electron microscopic studies of affected tissue revealed endothelial cell damage and neutrophilic degranulation in the affected area. Mast cells remained intact. These data imply that activation of the alternative complement pathway is involved in the pathogenesis of localized heat urticaria and that mast cell histamine release does not play a significant role in this disease.

Adult↗
PubMed1978

Pulmonary function following the adult respiratory distress syndrome.

Fifteen patients (range of ages, 18 to 35 years) who survived an acute episole of the adult respiratory distress syndrome caused by mechanical or thermal injuries, sepsis, and shock were studied during 1 to 30 months after recovery. The patients had had no previous pulmonary diseases, and only two had been smokers. All of the patients were asymptomatic, and their chest x-ray films were normal on follow-up examination. Tests of pulmonary function revealed mild abnormalities which consisted of reduction of pulmonary volumes, decreased carbon monoxide diffusing capacity, and a mild increase of alveolar-arterial oxygen pressure gradients in the early stage ofter recovery. Improvement was noted after a few months, but eight patients still had mild reduction of pulmonary volume after one to two years. No correlation could be established between the severity of the adult respiratory distress syndrome, therapy with mechanically assisted ventilation, the duration of exposure to supplemental oxygen, the fractional concentration of oxygen in the inspired gas, and the degree of residual functional defect.

Adolescent↗
PubMed1977

Infantile agammaglobulinemia and immediate hypersensitivity to penicillin G.

A case of X-linked infantile agammaglobulinemia with preserved synthesis of IgE and resultant normal serum levels of IgE is described. The patient had manifestations of atopy and an anaphylactic reaction following the administration of penicillin G. Because he had multiple respiratory tract infections with Gram-positive organisms and did not respond adequately to prophylactic gamma-globulin administration, penicillin therapy was deemed desirable. Therefore, after successful desensitization, therapy with prophylactic ampicillin was started with a resultant decrease in both number and severity of infections.

Adolescent↗
PubMed1977

Studies of urticaria and acute serum sickness with the C1q precipitin test.

The C1q precipitin test was performed in serum samples from five groups of patients: (1) 20 patients with acomplementemic systemic lupus erythematosus glomerulonephritis (SLE), (2) 2 patients with serum sickness due to the administration of horse serum, (3) 2 patients with serum sickness preceding hepatitis B, (4) 50 patients with chronic urticaria, and (5) 30 normal controls. Positive C1q precipitin tests were found in all patients with SLE and the four cases of serum sickness. Positive tests correlated with depressed serum complement (C3 and C4) levels and were found only in the early phase of serum sickness. Urticaria patients uniformly had negative C1q precipitin tests and normal serum complement levels.

Acute Disease↗
PubMed1976

Chronic urticaria and intermittent anaphylaxis. Reactions to lophendylate.

In a case of chronic, severe urticaria and intermittent episodes of anaphylaxis due to an iophendylate injection (Pantopaque) given in the course of myelography, almost complete relief was obtained from the removal of approximately 8 ml of residual iophendylate from the spinal canal. Data obtained from direct skin testing, Prausnitz-Küstner testing, peptide inhibition of Prausnitz-Küstner testing, and IgE levels quantitated before and after removal of iophendylate indicate that these symptoms were mediated via an IgE anti-iophendylate reaction.

Anaphylaxis↗
PubMed1976

Effect of beta adrenergic stimulation and blockade on cutaneous reactivity to histamine.

It has been previously demonstrated that iontophoresis of beta adrenergic agents will alter the size of immediate hypersensitivity skin tests. It was unclear whether this alteration was due to an effect on the dermal mast cell (inhibition of histamine release) or on the cutaneous vasculature (inhibition of capillary permeability). For this reason isoproterenol, propranolol, diphenhydramine as a positive control, and saline as a negative control were iontophoresed onto the forearm of 10 atopic and 10 nonatopic adult subjects. In order to bypass histamine release from mast cells the patients were then challenged directly with histamine by the "prick" technique. The size of the resultant wheals was noted. The data obtained allowed the following conclusions: (1) The atopic group responded to histamine with greater wheal size than the nonatopic group. (2) Iontophoresis of diphyenhydramine effectively reduced the magnitude of the histamine wheal in both groups. (3) Isoproterenol decreased the wheal size in both groups. (4) Propranolol increased the wheal size in only the nonatopic group. (5) The successful modulation of the histamine-induced wheal and flare indicated that these drugs, regardless of their effect on the dermal mast cell, exert a measurable effect on the target organ (vasculature).

Adrenergic beta-Agonists↗
PubMed1976

Delayed hypersensitivity skin testing for assessing anergy in the mid-south.

Although skin testing with ubiquitous antigens is widely employed to assess delayed hypersensitivity, little is known about the effect of geographic location on the frequency of skin test reactions to given antigens. To assess skin test reactivity in the mid-South, 82 hospitalized patients and 68 normal controls had skin tests with six antigens: histoplasmin, mumps, tuberculin purified protein derivative (PPD), Candida, Trichophyton, and streptokinase-streptodornase. Ninety-five percent of normal and 79% of hospitalized subjects without immunologically related disease reacted to at least one of the antigens. A high rate of anergy was found in a clinical setting of debilitation and malnutrition. If subjects in poor condition also were excluded, 93% of hospitalized patients reacted to at least one antigen. Rates of reactivity increased with higher concentrations of antigen. To assess anergy in the mid-South, it is recommended that patients be skin tested initially with histoplasmin, mumps, and PPD antigens. If the patient does not react to any of these, streptokinase-streptodornase and Candida albicans (Dermatophytin "O") should be applied.

Antigens↗
PubMed1976

Angiokeratoma corporis diffusum (Fabry disease). A lysosomal disease.

Angiokeratoma corporis diffusum (Fabry disease) is an X-linked recessive disease. We had an opportunity to examine a heterozygous female patient with angiokeratoma and cornea verticillata. The patient's serum alpha-galactosidase activity was reported to be about 50% of normal. Skin lesion biopsy specimens were stained with electron microscopic acid phsophatase (ACP), with proper controls. Acid phosphatase activity was demonstrable within membrane-bound inclusions of cutaneous vascular endothelial cells. This suggested that the accumulation of abnormal glycolipids in the vascular cells occurs in the lysosomes.

Acid Phosphatase↗
PubMed1976

Defective cell-mediated immunity in carcinoma of the prostate.

Cell-mediated immunity was assayed in 18 patients with a histologic diagnosis of carcinoma of the prostate and in 10 control patients with benign prostatic hypertrophy. In vivo cell-mediated response was assayed by intradermal skin testing to a battery of five delayed hypersensitivity antigens. In vitro cell-mediated immunity was studied by lymphocyte transformation using both heterologous and autologous "serums" and nonimmune rosette formation. Lymphocyte transformation studies were carried out using both specific antigens (Dermatophyton and streptokinase-streptodornase) and a nonspecific mitogen (phytohemagglutinin). Nonimmune rosette formation was performed under numerous temperature ranges. A defect in cell-mediated immunity was found in patients with carcinoma of the prostate. Skin tests demonstrated a significantly increased incidence of energy in cancer patients. Mitogen-induced lymphocyte transformation was significantly depressed when autologous serum from patients with carcinoma of the prostate was utilized in the procedure. It is concluded that defect in cell-mediated immunity does exist in patients with carcinoma of the prostate. This defect is expressed in vivo and in vitro and seems to be mediated by a serum factor.

Aged↗