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Biomedical subjects

P Lieberman

Publications and source records attributed to P Lieberman.

At least 109 records · Page 6Linked to original sources

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↗

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↗

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↗

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↗

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↗

Controlled study of the cytotoxic food test.

The cytotoxic food test was not found to be an accurate method for diagnosing atopic reactions to foods. Claims that the test correlated with other untoward reactions to foods (eg, headache, diarrhea, fatigue) could not be corroborated. The test itself is time-consuming, dependent on subjective interpretation, and inconsistent in results when repetitive runs are performed on the same patient.

Adolescent↗

Kaposi's sarcoma of genitourinary tract.

Kaposi's sarcoma of the external genitalia is rare. Four cases with the initial lesion on the glans penis and 13 cases with secondary involvement of the external genitalia are presented. A high association between Kaposi's sarcoma and malignant lymphoma is noted. The natural history is one of multiple recurrences in the immediate vicinity of the primary site or at distant locations at varying time intervals. Wide margin electron beam irradiation is the recommended treatment. A variety of chemotherapeutic agents also have produced favorable responses; yet prognosis for cure is poor because of the generalized nature of the disease--the course of which is nevertheless often prolonged.

Aged↗

Allergic response to glucagon injection as a result of insulin contamination.

A 25-year-old obese woman with adult onset diabetes, with known insulin allergy, was evaluated for her insulin response to glucagon. Intravenous injection of glucagon produced severe generlaized allergic reaction. Skin tests with various insulin and glucagon preparations showed allergic reaction to be most pronounced with beef regular single peak and single component insulin, pork regular single peak, beef lente single peak, and neutral regular (beef-pork) single peak insulin. Allergic reactions to numerous glucagon preparations were found to be directly proportional to the amount of insulin contamination in those preparations. Purification of one glucagon lot by column chromatography verified the presence of proinsulin and insulin contaminants in the preparation.

Adult↗

Non-Hodgkin's lymphoma in children: results of treatment with LSA2-L2 protocol.

The results obtained with very intensive treatment in previously untreated patients early in the disease are encouraging, and we hope will change the philosophy of most investigators that even in far advanced disease such as those with marrow metastases or multiple primary sites, one can still obtain complete regression at all tumour sites within 1 to 1 1/2 months from onset of therapy by combined treatment with multiple chemotherapeutic agents and radiation therapy to one or more sites.

Adolescent↗