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Biomedical subjects

R C Reichman

Publications and source records attributed to R C Reichman.

At least 73 records · Page 4Linked to original sources
PubMed1988

Detection of infection by human papillomavirus in genital condylomata. A comparison study using immunocytochemistry and in situ nucleic acid hybridization.

One hundred eighty exophytic genital lesions clinically suspicious for infection by human papillomavirus (HPV) were analyzed by hematoxylin and eosin light microscopy, immunocytochemistry for HPV capsid antigen; and in situ nucleic acid hybridization for HPV messenger RNA (mRNA). Of 96 cases morphologically consistent with infection by HPV, 53% were antigen-positive, and 83% were mRNA positive (P less than 0.01). Of 55 cases suggestive but not diagnostic of HPV infection, 13% were antigen-positive and 26% were mRNA positive. Negative results were obtained in all lesions not believed to be indicative of HPV infection by morphologic criteria. In mRNA positive diagnostic cases, two thirds were of HPV type 6 and one third were HPV type 11. Two cases of coinfection with HPV types 6 and 16 were found. The study concludes that in situ hybridization for HPV mRNA is a more sensitive indicator of HPV infection, and in addition, provides HPV type, which may have prognostic significance.

Antigens, Viral↗
PubMed1988

Treatment of condyloma acuminatum with three different interferons administered intralesionally. A double-blind, placebo-controlled trial.

STUDY OBJECTIVE: To determine the efficacy and toxicity of intralesionally administered interferons in the treatment of condyloma acuminatum. DESIGN: Randomized, double-blind, and placebo-controlled study. SETTING: Outpatient clinics at university medical centers. PATIENTS: Seventy-nine patients with biopsy-proved condyloma acuminatum that was refractory to conventional therapy were enrolled in the study. INTERVENTIONS: Alpha-2b, alpha-nl-, and beta-interferons were used. One wart on each patients was injected three times per week for 4 weeks with either 1 x 10(6) units of interferon or placebo. MEASUREMENTS AND MAIN RESULTS: Forty-seven percent of warts injected with interferon resolved completely, compared with 22% of placebo-injected warts (P = 0.009). In addition, more recipients of interferon had a complete resolution of uninjected lesions. No differences in rates of response were noted among the different interferon groups. Approximately one third of interferon-injected warts recurred, compared with none of four placebo-injected warts. Intralesionally administered interferon was nontoxic and well tolerated, although transient pain on injection was observed frequently. CONCLUSIONS: Intralesional administration of each of these three interferons appears to be useful in treating condyloma acuminatum. However, the frequent recurrence of disease and the failure of many lesions to resolve indicate that different regimens, such as longer courses of therapy or different routes of administration, should be evaluated to maximize beneficial effects of interferon for treating this common sexually transmitted disease.

Adult↗
PubMed1987

A Markov model for a clinical episode of recurrent genital herpes.

A time-homogeneous Markov process is proposed for modeling the clinical course of recurrent genital herpes and is used to obtain estimators for various characteristics of the disease episode. The model has a finite, discrete time parameter and discrete state space, with six transient states corresponding to the six stages a herpes lesion may enter. The healed condition is represented as an absorbing state. The number of lesions present at the onset of the clinical episode and the number of lesions appearing during the course of the episode are assumed to have negative binomial distributions. Clinical trial data are used to examine the assumptions of the model and to estimate its parameters. Estimates of clinical variables based on the model are computed and are compared with those calculated directly to assess how well the model represents the biological process of the disease.

Herpes Genitalis↗
PubMed1986

Herpes simplex virus-induced immunespecific interferon production by cryopreserved human peripheral blood mononuclear leukocytes.

Peripheral blood mononuclear leukocytes (PBML) from 21 human donors seropositive for herpes simplex virus (HSV) type 1, and from seven seronegative donors were employed to produce interferon (IFN) in response to stimulation by HSV and phytohemagglutinin (PHA). Cryopreserved PBML produced titers of IFN, including immunespecific IFN, that were not significantly different from titers produced by freshly prepared PBML. In addition, cryopreserved PBML stored under conditions designed to simulate inter-institutional exchange of specimens produced quantities of IFN that did not vary significantly from quantities of IFN produced by cryopreserved cells that were stored under conventional conditions. Production of immunespecific IFN by cryopreserved cells represents an example of a measurement of cell-mediated immunity that is analogous in reliability and flexibility to currently available measurements of humoral immune responses.

Adult↗
PubMed1986

Radioimmunoassay for detection of the Snow Mountain Agent of viral gastroenteritis.

The Snow Mountain Agent (SMA) is a Norwalk-like viral agent of acute gastroenteritis that has been detected only by immune electron microscopy (IEM). We established a solid phase microtiter radioimmunoassay (RIA) for SMA antigen employing pre-and post-challenge sera from volunteer studies as capture antibodies. SMA was detected in 12 of 67 stool samples from volunteers who were ill after oral challenge with SMA. All samples in which virus particles were detected by IEM were positive by RIA, but the RIA was 10-80 times more sensitive than IEM. To detect serum antibody to SMA, a blocking test was developed, employing diarrheal stool containing SMA as a standard source of antigen. Serum antibody rises were detected in eight out of nine volunteers with experimentally induced illness following challenge with SMA, as well as in three out of three naturally occurring cases. A preliminary sero-epidemiologic survey suggested that infection with SMA was common in the population surveyed. This RIA should permit large scale seroepidemiologic studies of SMA to be carried out, and should also facilitate characterization of this agent.

Adolescent↗
PubMed1986

Intralesional recombinant alpha-2 interferon for the treatment of patients with condyloma acuminatum or verruca plantaris.

We conducted a multicenter double-blind study comparing human recombinant intralesional alpha-2 interferon (IFN) and placebo in 237 patients with the clinical diagnosis of condyloma acuminatum or verruca plantaris. A single wart on each patient was injected with 0.1 mL containing 10(6) IU of IFN, 10(5) IU of IFN, or placebo three times weekly for three weeks, and the response to treatment was followed up for 12 weeks. Among 91 of the 114 patients with condyloma acuminatum who completed the study, complete clearing of the treated wart occurred in 16 (53%) of 30 patients receiving 10(6) IU of IFN compared with six (19%) of 32 receiving 10(5) IU of IFN and four (14%) of 29 receiving placebo. In the group of 100 patients with plantar warts, there was no apparent benefit associated with interferon administration. Seven patients (3%) had treatment discontinued due to adverse reactions. Intralesional alpha-2 IFN is of benefit in the treatment of a single condyloma; its role in the treatment of multiple lesions remains to be clarified. Its role in the treatment of verruca plantaris, where no response was seen, also remains to be clarified.

Adult↗
PubMed1984

Double-blind placebo-controlled trial of oral acyclovir in first-episode genital herpes simplex virus infection.

One hundred nineteen patients with primary and 31 patients with nonprimary first-episode genital herpes were treated for ten days with 200 mg of acyclovir capsules or placebo capsules orally five times daily. Among acyclovir recipients with primary genital herpes, the median duration of viral shedding (two days), time to crusting of all lesions (seven days), time to healing of all lesions (12 days), and duration of local pain (five days) and constitutional symptoms (three days) were shorter than among placebo recipients (9, 10, 16, 7, and 6 days, respectively). Among patients with nonprimary first-episode genital herpes, oral acyclovir shortened the median duration of viral shedding but had no significant effect on the duration of lesions or symptoms. The time to first recurrence and frequency of recurrences were similar in acyclovir- and placebo-treated patients. Oral acyclovir treatment of primary first-episode genital herpes shortens the duration of viral shedding and symptoms and accelerates healing, but it does not appear to influence subsequent genital recurrences.

Acyclovir↗
PubMed1984

Disseminated aspergillosis presenting with endophthalmitis. A case report and a review of the literature.

A patient with idiopathic thrombocytosis developed sudden loss of vision in his left eye secondary to endophthalmitis caused by Aspergillus flavus. He subsequently manifested other symptoms and signs of disseminated infection, and eventually died despite prompt initiation of appropriate parenteral antifungal therapy. A period of profound, iatrogenic neutropenia preceded the development of his terminal infection. Previously reported cases of hematogenously acquired Aspergillus endophthalmitis are reviewed, and approaches to diagnosis and management are discussed. The frequency of eye involvement in cases of disseminated aspergillosis is unknown, but it may be greater than appreciated previously.

Adolescent↗
PubMed1984

Treatment of recurrent genital herpes simplex infections with oral acyclovir. A controlled trial.

Two hundred fifty patients were entered into a multicenter trial to evaluate the efficacy and toxicity of orally administered acyclovir for treatment of recurrent genital herpes. The study consisted of part A, in which patients entered the study within 48 hours of the onset of lesions, and part B, in which patients self-initiated therapy as soon as possible after the onset of a recurrent episode. In both parts, patients received either acyclovir (200 mg) or placebo, five times daily for five days. In both parts, the duration of virus shedding and the time to crusting and healing of lesions were shorter among acyclovir recipients than among placebo recipients. In part B, fewer acyclovir recipients formed new lesions during the study medication period than did placebo recipients. When parts A and B were compared directly, the duration of virus shedding and the times required for crusting and healing of lesions were significantly shorter among acyclovir recipients in part B than among acyclovir recipients in part A. No significant differences in the duration of itching and pain or in the times of subsequent recurrence were noted between acyclovir and placebo groups in either part A or part B. No significant toxic or adverse reactions were seen in acyclovir recipients. Oral acyclovir shortens the duration of virus shedding and the duration of lesions in patients with recurrent genital herpes. These effects are more pronounced when therapy is self-initiated by patients early in the course of a recurrent episode.

Acyclovir↗
PubMed1984

Herpes simplex virus infections.

Infections with herpes simplex virus (HSV) are extremely common. HSV infection may be asymptomatic or may cause any one of a wide variety of disease syndromes. In this review, the physical properties and mode of replication of HSV are briefly described, and an outline of the different clinical manifestations associated with HSV infection is presented. Principles of diagnosis, treatment, and prevention of these infections are also discussed.

Acyclovir↗
PubMed1983

Topically administered acyclovir in the treatment of recurrent herpes simplex genitalis: a controlled trial.

Eighty-eight patients with culture-proven recurrent herpes simplex genitalis were entered into a collaborative, randomized, placebo-controlled, double-blind trial to evaluate the efficacy and toxicity of a topical formulation of acyclovir. Patients entered the study within 48 hr of the onset of lesions, and the study medication was applied six times daily for five days. The duration of virus shedding from lesions present at the time of entry into the study was significantly reduced for men who received acyclovir compared with men who received placebo (P less than 0.05). There were no significant differences between the acyclovir- and placebo-treated groups of either sex in time to crusting of lesions, time required for lesions to heal, time to cessation of pain, or in frequency with which new lesions developed during the course of therapy. Mild, transient burning or pain associated with application of the study medication was a common complaint.

Acyclovir↗
PubMed1983

Serum antibody responses in naturally occurring influenza A virus infection determined by enzyme-linked immunosorbent assay, hemagglutination inhibition, and complement fixation.

Serum antibody responses to influenza A virus infection were examined in 388 normal subjects during a trial of chemoprophylaxis in an outbreak of influenza A in 1980-1981 in which both A/H1N1 and A/H3N2 viruses circulated. Paired serum specimens obtained over a 6-week period were tested for antibodies to both A/H1N1 and A/H3N2 viruses by conventional hemagglutination inhibition, complement fixation, and an enzyme-linked immunosorbent assay (ELISA). Antibody responses detected by ELISA were determined by calculation of the area generated between titration curves of paired sera (area method), as well as by a conventional endpoint dilution method (endpoint method). Forty-two significant antibody rises were detected; 42 by ELISA (area method), 33 by ELISA (endpoint method), 32 by hemagglutination inhibition, and 13 by complement fixation. ELISA (area method) detected rises more frequently than either ELISA (endpoint method) (P less than 0.01), hemagglutination inhibition (P less than 0.005), or complement fixation (P less than 0.001). Another sensitive assay, the microneutralization test, detected significantly fewer rises (33, P less than 0.025) than the ELISA (area method). In the 42 subjects with ELISA (area method) rises, corroborating evidence of influenza A infection by other techniques (virus isolation, microneutralization, hemagglutination inhibition, or complement fixation tests) were available for 39 (93%). ELISA (area method) rises were subtype specific in all serum pairs in which other documentation of subtype-specific infection was available (38 of 38). Thus, ELISA (area method) was the single most sensitive assay for detection of serum antibody rises in this setting and possessed a high degree of subtype specificity.

Antibodies, Viral↗
PubMed1983

Hemophilus influenzae bursitis and meningitis in an adult.

Septic bursitis caused by Hemophilus influenzae, to our knowledge, has not been described previously. We treated a patient who had bursitis and meningitis caused by a nontype B Hemophilus influenzae. The clinical features of septic bursitis are briefly discussed and the importance of bursal aspiration and culture is emphasized.

Bursitis↗