Immunological studies, II. Intradermal tests and their application in the field for the detection of schistosomiasis japonica, paragonimiasis and clonorchiasis.
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A thymic calf extract (LEUCOTROFINA) was injected twice a day for 20 days to 24 elderly patients, in order to establish its efficacy to improve the lymphocytic "memory" against the antigens commonly used in the skin tests (Candidin, Tuberculin, Varidase, Mumps, Trichophytin) and the DNCB test. As far as the recall antigens were concerned, no remarkable improvement was observed in patients over 75 years, while a significant positive response (from 47% to 84,6%- P less than 0,05) was noticed in patients treated with leucotrophina aged between 65 and 75 years, compared to not treated control group. With DNCB test no difference was noted in both groups. Our data confirmed the interesting role of a thymic extract therapy in elderly patients.
Six horses with chronic obstructive pulmonary disease (COPD) and 8 horses with recurrent urticaria were skin tested with 67 extracts from 58 allergens, including pollens, epidermals, cultivated farm plants, dusts, molds, and insects. Reactions were evaluated 3 times over a 24-hour period immediately after the injections. Results were compared with those obtained from 11 clinically normal horses. All horses had positive skin test reactions. Significant differences was evident between horses with COPD and clinically normal horses for only 3.0% of the possible extract reactions, and between horses with urticaria and clinically normal horses for only 4.5% of the possible extract reactions. Horses with COPD or urticaria had greater total percentage of allergen extract reactions than did clinically normal horses. Positive reactions were observed at all 3 evaluation periods, and late-onset reactions were not always preceded by positive reaction at earlier periods. All horses with COPD or urticaria had at least 1 skin test reaction that exceeded the mean +/- 2 SD, as calculated for each of the 67 extracts for the group of clinically normal horses.
14 patients clinically hypersensitive to vespid sting by history, 6 patients with large local reactions and 10 control subjects were skin tested with serial two- and tenfold dilutions of venom and whole-body extract of yellow jacket, wasp, and white-faced hornet antigens. Radioallergosorbent test determinations with the same antigens were also made. Determination of minimal reactive dose by skin testing distinguished control and hypersensitive patients groups for all three antigens using either venom or whole body extract. Yellow jacket venom skin testing detected 12 of 14 patients considered clinically hypersensitive. This was not the case with the other two venoms, possibly because most of the patients were yellow jacket sensitive, or any of the whole-body extracts. The Radioallergosorbent test was less useful than venom skin testing in detecting patients considered clinically sensitive.
A prospective study was carried out in two groups of individuals: a group 1 (n = 40) included workers from a poultry farm, with potential occupational risk of exposure to Histoplasma capsulatum, etiologic agent of histoplasmosis, and a group 2 (n = 16), persons without occupational risk of exposure to the agent. Histoplasmin skin test was performed in both groups, and three sera were obtained from each individual: 1) before skin test was done, 2) 30 days after, and 3) 180 days after it. In both groups the histoplasmin skin test, even when the test was positive, was not a sufficient antigenic booster to provoke an increase in the H. capsulatum antibody levels capable to be detected by the serologic tests used (ELISA and Double Immunodiffusion). These results contribute to improve the interpretation of ELISA test values in the diagnosis of histoplasmosis.
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A test implant of Zyderm collagen was carried out on 250 patients using the volar forearm site. The behaviour of the implant in the host tissue was followed-up in 6 cases by both direct and electron microscopy. There were 14 positive reactions. Biopsy was carried out in 3 cases, all of which exhibited severe reactions; foreign body granulomata were found in 2 of these, perivascular lymphocytic infiltration in the third. All 3 had a follow-up for 3 months and the biopsy sites healed normally. Trial implants are always advisable with collagen material. In order to avoid the possibility of such delayed hypersensitivity reactions, the test implant should be investigated at 72 hours and kept under observation for 4 weeks prior to carrying out the full corrective procedure. In two cases, reactive adverse reactions at the collagen implant treatment site were observed in spite of negative reaction at the test site. Nevertheless evidence suggests that Zyderm injectable collagen is a suitable material, leading to good cosmetic results; it carries minimal risk and is well tolerated even after a long period of time.
This paper is part of the author's free-teaching theses presented in 1974, in which he has studied 436 persons not carriers of the B.S.A. and other diseases, resident in Campos, Conceição de Macabu and Quissamã (urban and rural zones). Tests were applied in these patients by using standardized antigen of polysaccharide of Paracoccidioides brasiliensis of histoplasmine. The author concluded that there has been existence of the B.S.A.-infection which means what is called "INFEKT". He emphasizes that the epidemiologic researches have important role in the estimation of the incidence of the B.S.A.
RAST and skin tests were compared for five venoms in a group of 60 patients with histories of stinging insect allergy. Twelve patients were skin test negative to all venoms and also RAST negative. The 48 skin test positive patients gave an 88% correlation of RAST and skin test with 92% of the skin test positive patients RAST positive and 82% of the RAST positive patients skin test positive. If patients strongly positive to honey bee showing positive RAST to vespids with negative skin test were not counted, then 91% of the RAST positive patients were skin positive. The term "false" should not be used in relating RAST to skin test results without supporting challenge evidence.
In a single-blind study of 23 patients with respiratory allergic disorders, we studied the effect of different antiallergic drugs on intradermal (ID) skin test response. After discontinuing the medication prescribed to patients, ID skin tests were done to determine the baseline values. The subjects were then randomly assigned different doses of different drugs orally, including theophylline (200 mg), salbutamol (4 mg), ephedrine (24 mg), and prednisolone (10 mg). Only epinephrine (1:1000) was injected subcutaneously (0.5 ml). ID skin tests were repeated 2 hours after the administration of the medicines that were taken orally. In the case of epinephrine, the tests were repeated 30 minutes after the injection. No significant differences could be observed in ID skin tests before and after the medication, irrespective of the test allergens.
The diphtheria antitoxin titres determined in human sera by the intradermal titration method have been compared with the titres obtained by a range of ELISA assays. A direct ELISA based on highly purified diphtheria toxoid correlated poorly with the in vivo method but an assay based on capture of toxoid by a non-neutralizing monoclonal antibody produced results that correlated very well. The performance of assays involving partial blockade of antigen and non-neutralizing monoclonal antibodies was intermediate.
Sensitisation to non tuberculous mycobacteria (NTM) may provoke a non specific tuberculin reaction and can cause problems in the interpretation of tuberculin tests in subjects who have not been vaccinated with BCG. The practice of testing for antigens to NTM (sensitins) should be useful for pointing to the right diagnosis. Our study was carried out on 24 asymptomatic children aged between 11 months and 8 years 9 months; these children were considered to be sensitive to NTM based on comparative cutaneous tests (reactions to sensitins > or = 5 mm and > or = 3 mm vs tuberculin) and were selected from a group of 53 children who had either initially achieved a positive tuberculin reaction or who had undergone conversion on subsequent prevaccination testing. The tests were carried out with tuberculin RT 23, tuberculin Merieux and sensitins from M. avium and M. intracellulare. They had been repeated two to four months later in cases of a response to one of the different reactants. At the first examination the tuberculin reactions were most often weak, the Merieux tuberculin induced a stronger response than the RT23 tuberculin. A dominant response for one or both sensitins was present in 18 cases. The tuberculin reactions became weaker whilst the sensitins remained relatively stable. The difference became significant in the six remaining cases. Although tests for tuberculin and sensitins have some diagnostic value which is necessarily imprecise, comparative analysis of the cutaneous reactions to the different antigens may contribute to avoid an erroneous interpretation for tuberculin allergy in asymptomatic young children without any risk factors for tuberculous infection. It is important to identify those subjects having non specific tuberculin reactivity induced by sensitisation to NTM in order to avoid non justified chemoprophylaxis and also to be able to vaccinate these children with BCG.
56 healthy rabbits were inoculated with the active Cysticercus each into lateral ventricle of the brain, the white substance of the brain and into Spatium subarachnoideale. Rabbits were killed after 32 weeks p.i. Then their brains were macro- ev. microscopically investigated. The positive seroreactions (ringpreciptitation reaction and the latex-test) were observed at the beginning of the second week after infection. Curve of the titers was revealed two tops: first one between 6-7 weeks, second one 16-22 weeks after infection. All rabbits except one reacted positive on the application of the Cysticercus antigen. The control group consisted of the 8 rabbits revealed negative serological and immunological reactions. Three groups of the cerebral cysticercosis, dependent on the localization of the cysticerci in the brains, were observed: oedema form, hydrocephalous form and tumor form. These forms as well as the symptoms are similar to the human cerebral cysticercosis.
To compare two different sources of bird-antigens (intestinal extracts versus serum dilutions) we performed intracutaneous tests in 79 birdkeepers (34 pigeon-, 20 hen- and 25 budgerigar-keepers) and in nonexposed control persons. The bird-exposed persons were divided into 3 groups: 1. Seropositive patients with extrinsic allergic alveolitis (EAA), 2. seropositive persons without any signs of EAA (sensitized asymptomatics), and 3. exposed seronegative healthy persons. The results of the investigation demonstrate that the early skin-reaction (20 minutes after antigen-application) is nonspecific and do not have any diagnostic value. Most of patients with EAA (65.7%) and 29.6% of sensitized asymptomatics developed a positive 6-hour-(Arthus-) reaction with intestinal extracts, whereas in control groups we have not seen any Arthus reaction. Consequently, we recommend the use of intestinal extracts in the diagnostic procedure of EAA.