[Soft ulcer: problems in diagnosis and therapy].
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Adult↗
Biomedical subjects
R Jarisch
Publications and source records attributed to R Jarisch.
[The leukocyte migration inhibition test (LMIT) in recurrent herpes simplex labialis. Comparison of the results of treatment with BCG and Levamisole (author's transl)].
Forty six patients suffering from recurrent herpes simplex labialis (HSLR) have been treated by either BCG or Levamisole. Therapy was equally successful in both groups: 10 patients remained free of symptoms during the observation period, 11 patients improved clearly and 2 patients did not respond to the therapy. Sensitization of lymphocytes toward herpes simplex virus antigen (HVS-AG) was determined in vitro by means of the leukocyte migration inhibition test (LMIT); test were performed before therapy and in certain intervals after the end of it. While lymphocytes of 10 control persons could be stimulated by HSV-AG, those of patients suffering from HSLR did not react to this antigen before onset of any therapy. Clinical success of therapy correlated well with the in vitro results of the LMIT: after therapy, the lymphocytes of symptom-free and improved patients also reacted in vitro to the antigen added.
Adolescent↗
[Results of hyposensitization in children (author's transl)].
The results of specific hyposensitization in 160 children (121 boys) were evaluated using a questionnaire. In 54% complete remission or clear-cut improvement without additional need for medication was achieved. In a further 34% improvement was demonstrated when compared to the pretreatment period. The main initial complaints were allergic rhinitis or allergic asthma. Treatment was pursued for at least 3 months and for a maximum of 3 years. There were no differences in the success rate as regards sex and offending allergen.
Adolescent↗
[Capabilities and limitations of in-vitro allergy diagnostics (on the model of bee-venom allergy and on Neurodermatitis in relation to IgE-T-lymphocyte interaction)].
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Bees↗
IgE antibodies to bee venom, phospholipase A, melittin and wasp venom.
Specific IgE antibodies against bee venom, phospholipase A, melittin and wasp venom have been examined in fifty patients with an unusually severe reaction after bee or wasp sting. Two thirds of the bee venom-sensitive patients also have detectable IgE antibodies to wasp venom. More than 50% of the wasp venom-sensitive patients are also allergic to bee venom. Phospholipase A and melittin IgE antibodies were found, respectively, in two thirds and one third of the bee venom-sensitive cases. Specific IgE antibody determinations by the Radioallergosorbent test play an essential role in the diagnostic work. After a reaction to hymenoptera stings both bee and wasp venom tests are necessary due to the high incidence of a false or incomplete identification of the stinging insect. Melittin, known for its potent pharmacological activity and possibly responsible for most of the side effects in bee venom immunotherapy, can probably not be excluded from therapeutic venom preparations since IgE antibodies to the melittin preparation were detected in one third of the cases.
Bee Venoms↗
[Immunotherapy of allergic disease. Studies on 460 patients].
The results and side effects of immunotherapy in atopic dermatitis, bronchial asthma and/or allergic rhinitis are evaluated in 460 patients. The findings are listed in terms of diagnosis, age, sex and preparations as well as duration and number of incorporated allergens of immunotherapy-vaccine. In 82% a good result was reported, while in 18% no improvement could be seen. The results increase gradually from atopic dermatitis to bronchial asthma and allergic rhinitis, although the differences fail to be significant statistically. Males respond better than females. However, in bronchial asthma only, the differences are significant (p less than 0.01). According to the preparations used (Bencard, Novo-Helisen, Allpyral), no differences could be seen. The percentage of side effects is higher than 50%, but is mainly restricted to local swelling, tiredness and itching. Again no significant differences could be seen between the vaccines used.
Adolescent↗
[Standard epicutaneous testing: 5-year results and their effects on future examinations].
1385 patients were subjected to patch tests in the last years. The most important contact allergens in these seris were found to be rubber, nickel, chromate. Compositions of patch tests series varies with regard to the individual substances included: allergens with low sensitizing potency (methol, resorcin, methylsalicylate (!), hexachlorophene, iodochlorhydrooxychinoline) are gradually replaced by others of more recent importance, e.g. mercury (Merfen). Some allergens give better results when tested in higher concentration (balsams of peru, parabens, colophony and wool fat alcohols). Our findings correspond widely with the recommendations of the ICDRG (International Contact Dermatitis Research Group). Therapeutic possibilities are limited; topical application of corticosteroids may be taken as routine regimen. Bufexamac (Parfenac) has been proposed for this purpose, recently. Protective creams (like ion exchange ointments) are of limited use due to the necessity of repeated application.
Adolescent↗
[Allergic rhinitis--does the radioallergosorbent test improve the diagnosis? (author's transl)].
A comparison between the skin test and radioallergosorbent test RAST) in 127 patients with allergic rhinitis reveals no advantage of RAST. This contrasts with the results obtained in other allergic diseases. However, the determination of a single pollen allergen allows the in vitro diagnosis of allergic rhinitis, which, obviously, is due to cross reactivity of pollen allergens. This makes the RAST a useful procedure in routine diagnosis, especially in the case of patients living far away from an allergy centre. In these cases RAST can easily be used as a screening test.
Allergens↗
[Kaposi's sarcoma. Pharyngo-laryngeal manifestation, treatment (author's transl)].
Kaposi's sarcoma involvement of the ENT region develops normally years after the onset in the skin. Reports on Kaposi's sarcoma in the ENT literature are therefore very rare. Until now by no kind of treatment including X-ray irradiation satisfactory results could be obtained. The recently introduced longterm-treatment with vinblastine sulfate is very effective reducing the size and extension of the tumorous infiltrations. In the ENT-region the plate, the pharynx, the larynx and the trachea are most frequently involved. We report on a patient with extensive pharyngeal and laryngeal involvement who had to be tracheotomized. While still on treatment with vinblastine-sulfate the decanulement was possible, the patient could resume his profession as bassoonist. This successful treatment regimen has not been mentioned in the ENT-literature previously.
Humans↗
[Bee-venom allergy].
The allergy to bee venom is dangerous and life threatening. Skin tests and immunotherapy should be done with bee venom extracts. The RAST proves to be helpful if blood taking is done within a short period after stinging. In the meantime immunotherapy should be given lifelong and total and specific IgE antibodies controlled. In addition we believe that the determination of IgG-blocking antibodies is important.
Adolescent↗
[Degenerative eczema of the hand versus chronic contact eczema: evaluation using the nitrazine-yellow test].
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Chronic Disease↗
[Allergy diagnosis in childhood (author's transl)].
The determination of total IgE with the PRIST as well as its relevance to paediatric diseases is discussed. An allergic basis to bronchial asthma is detected by RAST in 80% of affected children, which contrasts with only 50% positive results found in adults. The most important allergens are grass pollens, house dust, house dust mite, cat hair, guinea-pig hair and moulds. The existence of pscyhosomatic factors as the sole cause of asthma is questioned. Furthermore, hyposensitization treatment is discussed and emphasis laid on the importance of suppressor-T-cells.
Adolescent↗
[Therapy of recurrent herpes simplex and its surveillance by MIF determination: with levamisole, BCG, urushiol and herpes antigen vaccine (author's transl)].
Thirty patients with recurrent herpes simplex and 6 controls were included in our study. Before initiation of treatment, during therapy with Levamisole, BCG, poison ivy and herpes antigen vaccine and, thereafter, MIF-determinations were performed. The latter test proved to be a useful parameter in evaluating the sensitivity against herpes infection, (and subsequent recurrent manifestations), and effect of therapy. Treatment with Levamisole, BCG and herpes antigen vaccine was successful. MIF-inhibition values paralleled the therapeutic effect in the Levamisole- and herpes antigen vaccine treated group, not however, in the BCG-treated patients
Antigens, Viral↗
[Glutarladehyde-pollen-tyrosine hyposensitization. Course control of therapy using RIST and RAST].
The efficiency of the glutaraldehyd-pollen-tyrosin vaccine was controled by determination of total IgE and IgE antibodies against grass-pollens every two weeks. In addition the clinical state was checked. Patients who suffered from an allergy to grass-pollens only were free of symptoms after therapy. To proof this, a test is necessary since the case history is unreliable in 10% of persons.
Antibodies↗
[Determination of IgE using PRIST].
In 160 allergic patients the total IgE level was determined by PRIST, a paper sandwich technic, and compared with the corresponding RAST values. Judging the IgE levels in positive RAST as pathologic and in negative RAST as normal we found IgE levels up to 20 U/ml as normal and IgE levels higher than 100 U/ml as pathologic. When used alone the PRIST gives a reliability of 73% as a screening test in allergic patients.
Evaluation Studies as Topic↗
[Improvement of the patch-test reading through contact thermography].
The evaluation by contact-thermography (with heat sensitive cholesterinester crystals) of patch tests for contact dermatitis is an important aid to detect weak positive or false negative reactions. In addition, it facilitates the interpretation of patch tests in dark skin persons. The number of diagnosed cases of contact dermatitis can be increased by about 10% without increasing the expenditure of time on the part of the patient or the physician.
Dermatitis, Contact↗
[BCG-septicemia and mucocutaneous candidiasis due to familial combined immunodeficiency (authors transl)].
The history of a patient with mucocutaneous candidiasis and BCG-septicemia is reported. Combined immunodeficiency has been diagnosed as the underlying cause. A sister of the patient died at seven months of age under similar circumstances. The importance of the immunological diagnosis in severe bacterial and mycotic infection during early infancy has been emphasized. In such cases vaccinations with life vaccine are strongly contraindicated.
Autopsy↗
[Diagnostic possibilities using RAST. Correlation with three various skin extracts].
The correlation between RAST and three different commercial extracts referred to allergen and commercial gives a review of the reliability of skin tests (up to 25% false results). The question whether both RAST-discs for house dust and house dust mite have to be used is discussed. The common allergens of house dust mites and the rarer allergens of cats and guinea-pigs are emphasized.
Allergens↗