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PubMed1990

[A study of microdensitometric evaluation of opacity of maxillary sinuses in patients with nasal allergy].

The opacity of the maxillary sinuses on X-ray film in Waters' view in patients with nasal allergy was evaluated by a microdensitometer. The patients with nasal allergy were diagnosed with the positive results of the following; 1) eosinophilia in nasal secretion, 2) nasal provocation test, 3) intradermal skin test or radioallergosorbent test (RAST). The ratio of density of the maxillary sinuses and orbits was determined by a microdensitometer, and the ratio of the average degree of the opacity of the maxillary sinus to that of the ipsilateral orbit was designated as the M/O ratio. The normal range of the M/O ratio was set over the mean value -2 standard deviations in the normal group. The results are followings. 1) The abnormal shadows in the maxillary sinuses were found out to be 36.9% in patients with nasal allergy. 2) Patients under 15 years old had significantly higher incidence of abnormal shadows, especially in the bilateral sinuses compared with patients over 15 years old. 3) Polyps in the maxillary sinus were recognized in 5.0% of all the sinuses. 4) There were no significant differences for the incidence of abnormal shadow among the patients with nasal allergy caused by different antigens.

Absorptiometry, Photon↗
PubMed1997

Bovine tuberculosis in the Lake Victoria zone of Tanzania and its possible consequences for human health in the HIV/AIDS era.

A total of 8190 cattle from 42 well-managed herds in the Lake Victoria zone of Tanzania were tested for bovine tuberculosis by a single comparative intradermal test (SCITT) using avian and bovine purified protein derivative (PPD) antigens. The prevalence of bovine tuberculosis in this area was found to be 0.2%. There was significant variation (p < 0.001) among the herds tested in the four regions in this zone (Kagera, Mara, Mwanza and Shinyanga). The highest prevalence (2.12%) was in a herd of 566 cattle which had recently arrived in Kagera region from Dar-es-Salaam. None of the 915 cattle tested in Shinyanga or of the 254 resident cattle in the Kagera region were positive by SCITT. This area, and particularly the Kagera region, has the highest human morbidity and mortality due to the acquired immunodeficiency syndrome in Tanzania. Therefore, the presence of bovine tuberculosis in cattle necessitates further investigations on the role of animal-derived tuberculosis in human health.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Diagnosis of nonimmediate reactions to beta-lactam antibiotics.

Nonimmediate manifestations (i.e. occurring more than 1 h after drug administration), particularly maculopapular and urticarial eruptions, are common during beta-lactam treatment. The mechanisms involved in most nonimmediate reactions seem to be heterogeneous and are not yet completely understood. However, clinical and immunohistological studies, as well as analysis of drug-specific T-cell clones obtained from the circulating blood and the skin, suggest that a type-IV (cell-mediated) pathogenic mechanism may be involved in some nonimmediate reactions such as maculopapular or bullous rashes and acute generalized exanthematous pustulosis. In the diagnostic work-up, the patient's history is fundamental; patch testing is useful, together with delayed-reading intradermal testing. The latter appears to be somewhat more sensitive than patch testing, but also less specific. In case of negative allergologic tests, consideration should be given to provocation tests, and the careful administration of the suspect agents. With regard to in vitro tests, the lymphocyte transformation test may contribute to the identification of the responsible drug. Under the aegis of the European Academy of Allergology and Clinical Immunology (EAACI) interest group on drug hypersensitivity and the European Network for Drug Allergy (ENDA), in this review we describe the general guidelines for evaluating subjects with nonimmediate reactions to beta-lactams.

Adult↗
PubMed1978

Specific immunity to human papilloma virus (HPV) in patients with genital warts.

A study of human papilloma virus (HPV) specific cellular and humoral immunity in 30 patients with genital warts is reported. By in vivo testing with purified, inactivated plantar wart virus, a cell-mediated immunity to HPV was determined in 60% of patients. Circulating antibodies, evaluated by immunofluorescence testing, were rare, but these increased after an intradermal test had been carried out, especially in patients with a positive skin test, suggesting a booster effect. No significant difference was found between this group of patients and those having skin warts. Our results showed a specific immune response to HPV in most patients, confirming the role of the viral agent in the induction of genital warts.

Adolescent↗
PubMed1990

[Allergic and serologic diagnosis of paratuberculosis in cattle].

The use of allergenodiagnosis in cattle herds where paratuberculosis is to be eradicated depends on the allergenogenic properties of the causative agent of this disease. An evaluation of the reliability of an intradermal allergic test performed to diagnose paratuberculosis in cattle in the given area revealed that this method is important especially if the result of this test is explicitly negative. A cultivation proof of the causative agent of paratuberculosis is of greatest importance among bacteriological methods for infection diagnosis. The agreement of the bacteriological and serological examination which reached 80% in young cattle pointed out the high specificity of an indirect haemagglutination test. In cows, unlike calves and heifers, the specificity of diagnostic tests was considerably lower. It is recommended to use an elimination method mainly in young cattle: regular examinations of calves from their age of three months will help to form a group of heifers free of infection, observing the basic infection controlling measures and providing conventient diet.

Animals↗
PubMed1994

Serum sickness-like illness associated with rifampicin.

We describe a patient with human immunodeficiency virus infection who developed the main clinical features of a serum sickness reaction while receiving treatment with daily therapeutic doses of tuberculostatic drugs. A decrease in complement titers as well as a detection of significant levels of circulating immune complexes were observed. A positive skin test result was observed six hours after an intradermal test with rifampicin. No immunoglobulin or complement deposition was observed by direct immunofluorescence of a punch biopsy specimen from the cutaneous lesion.

Adult↗
PubMed1997

[Chronic eosinophilic pneumonia associated with allergy to candida and with changes in bronchoalveolar lavage fluid].

A 61-year-old woman was admitted to the hospital with the chief complaints of fever, coughing, and shortness of breath. A chest X-ray film revealed infiltrates in both upper lung fields. A specimen was obtained by transbronchial lung biopsy and chronic eosinophilic pneumonia was diagnosed. The patient' s condition improved after the start of corticosteroid therapy. A relapse occurred, and corticosteroid therapy was again successful. Because an environmental provocation test was positive, allergological examinations were done. An intradermal test for sensitivity to candida was positive, as was a test for precipitation of antibodies to candida. In addition, an inhalation provocation test with candida antigen was positive. Therefore, allergy to candida was believed to have caused this patient's symptoms. Bronchoalveolar lavage was done three times. Eosinophils predominated in the first sample, but lymphocytes predominated in the last two. This raises the possibility that chronic eosinophilic pneumonia and bronchiolitis obliterans organizing pneumonia might change into each other.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Interferon-gamma or granulocyte-macrophage colony-stimulating factor administered as adjuvants with a vaccine of irradiated autologous tumor cells from short-term cell line cultures: a randomized phase 2 trial of the cancer biotherapy research group.

The objective was to study the effects of patient-specific vaccine immunotherapy administered with either interferon-gamma (IFNgamma) or granulocyte-macrophage colony stimulating factor (GM-CSF) in patients with metastatic cancer. Short-term cell lines were established from cancer tissue resected from patients with metastatic cancer for use as autologous tumor cell vaccines. Successful cultures were expanded to 1 to 2 x 108 cells, irradiated, and cryopreserved in aliquots of 106 cells for intradermal testing of delayed tumor hypersensitivity and 107 cells for subcutaneous vaccinations. The study design was that of a randomized phase 2 trial. Patients were stratified by tumor type and by whether they had measurable disease at the time vaccination was to commence, and then randomized to receive either 100 MIU IFNgamma subcutaneously or 500 microg GM-CSF subcutaneously at the time of each tumor cell vaccination. Following a baseline test of delayed-type hypersensitivity (DTH) to an intradermal injection of 106 irradiated autologous tumor cells, patients received 3 weekly subcutaneous injections of 107 cells, had a repeat DTH test at week 4, then received monthly vaccinations for 5 months. A positive DTH test was defined as at least 10 mm of induration; survival was determined from the first DTH test. There were 98 patients enrolled with a median follow-up of over 4 years. The most prevalent diagnoses were melanoma (51), renal cell carcinoma (18), and soft-tissue sarcoma (14). There were 49 patients (26 men, 23 women, average age 50.4 years) randomized to IFNgamma and 49 (28 men, 21 women, average age 54.1 years) to GM-CSF. The average numbers of vaccine and adjuvant injections were 6.3 and 5.9, respectively. For the patients who received IFNgamma, the objective response rate was 0 of 21; for patients who received GM-CSF the response rate was 1 of 26. Only eight patients (four from each arm) had a positive baseline DTH reaction to autologous tumor. The tumor DTH test converted from negative to positive in 13 of 45 of the IFNgamma group and 11 of 43 of the GM-CSF group. With 29 patients deceased in the IFNgamma arm and 31 in the GM-CSF arm, the 2-year and 5-year survival rates were 45% and 29% for the IFNgamma arm and 41% and 23% for the GM-CSF arm (NSD). Both adjuvants were well tolerated and results were similar in both arms of the study. Both adjuvants were associated with a 25% to 30% rate of DTH conversion and a 25% 5-year survival rate. Immune recognition of autologous tumor can be induced with this approach.

Adjuvants, Immunologic↗
PubMed1996

Reactivity of tixocortol pivalate-positive patients in intradermal and oral provocation tests.

Pivalone/tixocortol pivalate commonly yields positive reactions in the patch test series. The clinical relevance of these positive reactions was investigated in more detail. In the standard patch test series 5.6% (73 of 1306) of the patients were positive to corticosteroids, 5.2% to 0.1% tixocortol pivalate in ethanol (Pivalone nasal spray diluted 1:10) and 2.3% to 1% hydrocortisone butyrate in ethanol. Some of the patients were tested in parallel with Pivalone and 1% tixocortol pivalate in petrolatum. The former test reagent yielded some false-positive reactions, whereas with the latter, some allergic responses were missed. Intradermal tests with the succinate esters of hydrocortisone, methylprednisolone and prednisolone were performed with 52 patients positive to Pivalone. Of these 76.9% (40 of 52) were positive in the intradermal tests; 38 to hydrocortisone, 35 to methylprednisolone and 30 to prednisolone. Twelve patients who had been positive in the intradermal tests were challenged orally with corticosteroids and they all showed positive reactions to hydrocortisone, methylprednisolone or prednisolone. The patients developed localized reactions at the sites of previous eczema or positive skin tests or diffuse erythema or exanthema. The oral doses of hydrocortisone eliciting positive delayed skin reactions ranged from 20 to 200 mg. Reactivity to tixocortol pivalate is closely related to sensitivity to hydrocortisone, methylprednisolone and prednisolone, but high oral doses of these corticosteroids may be required to produce allergic symptoms.

Administration, Cutaneous↗
PubMed1993

Evaluation of intradermal mould antigen testing in the diagnosis of equine chronic obstructive pulmonary disease.

Intradermal end-point titres for commercial aqueous extracts of Micropolyspora faeni, Thermoactinomyces vulgaris and Aspergillus fumigatus were determined in control and chronic obstructive pulmonary disease (COPD) affected horses. The intradermal end-point titres of control and COPD-affected horses were not significantly different and values for individual horses for M. faeni, A. fumigatus and T. vulgaris were not correlated with the pulmonary dysfunction or with the bronchoalveolar lavage fluid neutrophilia which had been induced by previous inhalation challenges with these antigens and by 'natural (hay and straw) challenges'. These findings suggest divergence of the dermal and pulmonary reactivities to M. faeni, A. fumigatus and T. vulgaris in the horse and indicate that intradermal mould antigen testing is of limited value in the investigation of equine COPD.

Animals↗
PubMed2002

Allergen vaccination with a liposome-encapsulated extract of Dermatophagoides pteronyssinus: a randomized, double-blind, placebo-controlled trial in asthmatic patients.

BACKGROUND: Liposomes are potent immunologic adjuvants and have been proposed as allergen carriers in allergy vaccination. OBJECTIVE: We sought to investigate the efficacy and safety of vaccination with Dermatophagoides pteronyssinus encapsulated in liposomes. METHODS: We conducted a double-blind, placebo-controlled study. Fifty-five asthmatic patients sensitized to mites were randomly assigned vaccination with D pteronyssinus extract encapsulated in liposomes or empty liposomes for a period of 12 months. The principal parameters were symptom and medication-consumption scores. The percentage of healthy days (ie, days without medication and with absent or mild symptoms) was calculated. Immediate and late skin test results, allergen bronchial challenge test results, and allergen-specific serum immunoglobulin levels were evaluated before and after treatment. RESULTS: All clinical scores were markedly lower in the active group than in the placebo group after vaccination. Nearly half (45.8%) of the patients actively treated reduced their symptom and medication scores by at least 60% versus only 12% of patients receiving placebo treatment (P =.0388). The percentage of healthy days in the active group rose from 10.5% before treatment to 64.5% afterward (P =.0008). Reduction in organ sensitivity was demonstrated by skin prick test responses (P <.01), late-phase response after intradermal testing (P =.009), and bronchial challenge test results (P =.026) in the active group. Serum levels of specific IgG increased throughout the treatment, whereas specific IgE levels showed only an initial transient increase. No change in these parameters was observed in the placebo group. Vaccination was well tolerated, and no subcutaneous nodules appeared. CONCLUSION: Vaccination with D pteronyssinus encapsulated in liposomes is an effective and safe treatment for allergy-induced asthma.

Adolescent↗
PubMed1993

A practical method for the production of Brucella skin test antigen.

Skin test antigens for the diagnosis of brucellosis were produced from the rough Brucella abortus strain 45/20. The production of two products termed Brucellin B and Brucellin W are described. The method described for the production of Brucellin W is recommended as an improved practical method of Brucellin production. The Brucellin products described were equal in sensitivity to that of a commercially available product, Brucellergen, which is used in New Zealand. Brucellin B was extensively tested in non-infected cattle and its specificity was equal to that of Brucellergen. Recommendations for the standardisation of skin test reagents for the diagnosis of brucellosis are made. Intradermal testing for brucellosis in cattle should be used only for the identification of infected herds and not as an individual animal test.

Journal Article↗
PubMed1996

Entomophthoramycosis: therapeutic success by using amphotericin B and terbinafine.

A 12-year-old girl had been presenting a woody infiltration and erythema in the frontal region and on the entire left half of the face, leading to deformity of the nose and buccal fissure, and adenomegaly in a posterior cervical chain, for the last 18 months. Sinusitis was diagnosed and treated with antibiotics, and submitted to ethmoid sinusotomy, with no improvement. Several laboratory tests were made to find the correct diagnosis. An intradermal test for delayed hypersensitivity showed a positive reaction (5 mm) with necrosis for metabolic antigens for Conidiobolus. An oral mucosa biopsy showed a dense lymphohistiocytic infiltrate and focal points of necrosis. Gomori staining for fungi revealed countless wide, nonseptate hyphae. Amphotericin B was prescribed during 35 days, with no improvement. Terbinafine given orally was started in association with amphotericin B. Reduction of the lesions was observed 2 months later. No side effects were seen during 4 months of treatment.

Amphotericin B↗
PubMed1990

Development of a simple, rapid in vitro cellular assay for bovine tuberculosis based on the production of gamma interferon.

Whereas in vitro assays of antibody responses to infectious agents are commonly used for routine diagnostic purposes, diagnostic tests for cellular responsiveness are confined to in vivo intradermal tests. This paper describes a simple and rapid in vitro cellular assay for bovine tuberculosis. The assay system is based on the detection of gamma interferon (gamma IFN), which is released in response to specific antigen. This assay can be carried out with whole blood samples thus avoiding the time-consuming task of isolating lymphocytes. A simple bioassay has been developed to quantitate the amount of gamma IFN produced, but this will eventually be replaced with an enzyme-linked immunoassay using monoclonal antibodies specific for bovine gamma IFN. The application of this system to bovine tuberculosis and other infectious diseases may provide a convenient in vitro cellular assay for routine diagnostic purposes.

Animals↗
PubMed1968

A review of serological tests for the diagnosis of hydatid disease.

Reviewing the literature on hydatid serology for the period 1958-66, the author concludes that the complement-fixation test is not the most sensitive procedure but may have value for postoperative evaluation. The haemagglutination, bentonite-flocculation and latex-agglutination tests are the procedures of choice at present. The fluorescent-antibody test shows much promise, but requires further evaluation. The intradermal test performed with standardized antigen is useful for diagnosis and epidemiological studies. Reliable serological diagnosis of hydatid disease in animals awaits the use of more specific antigen. Although many related species share common antigens with Echinococcus granulosus, the sensitivity of the diagnostic serological tests is high because of the strongly specific response elicited by the specific antigens used. the need for further standardization of both antigen and test procedure is pointed out.

Agglutination Tests↗
PubMedDate not supplied

[Toxoplasmosis and contact with animals: study of 390 cases].

Three hundred and ninety patients with suspected toxoplasmosis due to their contact with animales--they owned them, or work with them--are studied. The great significance of this way of acquiring the disease is stated. Every patient had a complement fixation test and an intradermal reaction test with toxoplasmine. An 85.2% positiveness to complement fixation, and a 64.1% to intradermal test were found among those patients who informed animal contact; a 70,6% positiveness to complement fixation, and a 56,2% to intradermal reaction was found in the patients who denied having any contact with animals. This showed both the importance of animal contact as well as other forms of transmission. The contacts were also studied, and the animals were classified according to J. Jira, the researcher: maximal, high, minimal and unreceptiveness to toxoplasma. The possibility of acquiring toxoplasmosis from other sources besides the close contact with animals must be taken into consideration.

Animals↗
PubMed1977

An approach to diagnosis and treatment in the migrant allergic population.

An approach to allergy diagnosis and treatment in the migrant population of the United States is derived from a review of selected aspects of pollen aerobiology and the nature and distribution of allergenic plants. Pollen distribution and importance are defined and divided into four relatively homogenous geographic regions of the continental United States. Botanic relationships between pollens are then summarized, especially as they relate to the methodology and results of studies of antigenic relationships between pollens. From this information, 13 mixes of tree pollens, 12 mixes of grass pollens, and 12 mixes of week pollens are proposed which would include the pollens of major and secondary importance found in the four defined geographic regions and which would be appropriate for puncture testing. Further grouping of antigens is described for use in intradermal testing and formulating treatment mixtures. A sample skin test sheet is presented which summarizes this information in a practical format.

Epitopes↗
PubMed1989

Structural correlations with cross-reactivity of beta-lactam antibiotics in delayed type hypersensitivity. Cross-allergenicity in hypersensitivity to cephems with a tetrazolyl group in the C-3 side chain.

Cross-reactivity associated with delayed type hypersensitivity (DTH) arising from cephem antibiotics with a tetrazolyl group in the C-3 side chain was investigated by clinical testing and animal experiments. Clinical cross-reaction testing was performed with the leucocyte migration inhibition test (LMIT) with respect to sixteen patients with hypersensitivity induced by cephems with a tetrazolyl group in the C-3 side chain. The proportion of positive LMIT cross-reactions to cephems with a tetrazolyl group in the C-3 side chain was 78% (25/32), to cephems without a tetrazolyl group, 5% (1/22), and to penams, 0% (0/12). The proportion of positives in tests performed with methyl-tetrazolethiol (MTT) and hydroxyethyl-tetrazolethiol (HTT), which essentially represent the structures of the C-3 side-chains in the allergenic drugs, was 29% (4/14), while the corresponding proportion for 7-aminocephalosporanic acid (7ACA), which represents the skeleton structure of the cephem antibiotics, was 33% (1/3). The animal experiments were performed with guinea pigs, with latamoxef, cefoperazone and MTT as the sensitizing agents and testing for cross-reactivity by means of delayed type intradermal reactions as well as the LMIT. The results of intradermal testing and the LMIT agreed almost completely, thus providing strong support for the clinical results. Latamoxef and cefoperazone displayed the same cross-reactivity, manifesting cross-reactions with MTT, HTT and 7ACA as well as with cephems having a tetrazolyl group in the C-3 side chain. Moreover, DTH induced by MTT displayed cross-reactivity with cephems possessing tetrazolyl groups in the C-3 side chain. The above results indicate that free MTT radicals, as well as the skeleton ring structure represented by 7ACA, are strongly involved in DTH arising from cephem antibiotics with a tetrazolyl group in the C-3 side chain.

Adult↗