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Biomedical subjects

B Zimmerman

Publications and source records attributed to B Zimmerman.

At least 73 records · Page 4Linked to original sources
PubMed1987

Prevalence of abnormalities found by sinus x-rays in childhood asthma: lack of relation to severity of asthma.

We examined the prevalence of abnormalities found by sinus x-rays in patients with asthma. The overall prevalence of abnormalities found was greater in the patients with asthma, 43 of 138 (31.2%), compared to control patients with dental problems, 0 of 50 (p less than 0.001). However, the percent of patients with abnormalities found by sinus x-rays was the same whether the asthma was mild, requiring minimal medication, or severe, requiring multiple medications. The results provide no support for the hypothesis that sinusitis, as detected by abnormalities found by sinus x-rays, aggravates asthma and promotes increased need for medication to control the asthma.

Allergens↗
PubMed1987

Lymphocyte proliferation to antigen E: demonstration of the restriction of antigen E-specific T cells to ragweed-allergic donors.

Allergic sensitivity to ragweed is common among atopic individuals in North America and can be associated with symptoms of seasonal hay fever and increased airway reactivity in asthma. This sensitivity is mediated by IgE antibody to ragweed antigens that in turn is presumed to be the product of B-lymphocytes regulated by various T cell subsets. Proliferation in vitro by lymphocytes obtained from individuals allergic to ragweed and cultured in the presence of ragweed antigen E (AgE) has been repeatedly described, but a comprehensive study of this proliferation has questioned the specificity of this response. We have examined this question and found that in the first week of culture, the specific lymphocyte proliferation to AgE may be obscured by high background and mitogen-like proliferation. However, by carrying the cells for a longer period of time in culture and providing a second in vitro boost with AgE, specific proliferation could be clearly documented. Lymphocytes from atopic ragweed-allergic donors proliferated at levels 20 to 50 times beyond background in the presence of AgE. Cells from nonragweed-allergic donors (either nonatopic or atopic) did not do so. The AgE-responsive cells could be expanded in culture and demonstrated to be T cells. Moreover, AgE-responsive T cells could only be cloned from AgE-allergic donors and, after expansion and subcloning, demonstrated to respond to AgE but not partially purified dust mite antigen. In contrast, a clone of T cells from a dust mite-sensitive individual proliferated in response to the dust mite antigen but not AgE.

Allergens↗
PubMed1987

Adverse effects of immunization. Is prevention possible?

Vaccination rates must be kept high to prevent epidemics of infectious disease. At the same time, parents must be informed of the rare possibility of serious adverse effects, including seizure and allergic reaction. Every physician who administers vaccine therefore needs to become familiar with the reactions that may occur with each immunologic agent used. The best safeguard against litigation, when and if a serious reaction follows vaccination, is the indication that these considerations were discussed and that an informed choice was made.

Adult↗
PubMed1987

Grading severity and treatment requirements to control symptoms in asthmatic children and their relationship with airway hyperreactivity to methacholine.

Airway hyperreactivity has been proposed to be an important determinant of severity of asthma and medication needs to control symptoms in adults. In this study we tried to determine if this relationship existed in childhood asthma. One hundred and forty-five asthmatic children aged 6 to 19 years with a positive methacholine (MCH) challenge test and a baseline forced expiratory volume in one second (FEV1) of 56% to 118% predicted were studied. The MCH concentration required to decrease the FEV1 from baseline by 20% (PC20) ranged from 0.1 to 20 mg/mL (geometric mean = 1.85 mg/mL). Asthma symptoms in this population before the study ranged from 2 months to 14 years. They were followed for a mean of 10 months after the MCH challenge and then grouped into four groups according to overall severity of symptoms and treatment needed to control symptoms. The first grade was comprised of patients with intermittent symptoms only, with a respiratory tract infection (URTI), and no medication; grade 2 symptoms were severe enough to require intermittent bronchodilators (BD); grade 3 symptoms were severe enough to require daily BD; and grade 4 symptoms were severe enough to require daily BD and steroids. Geometric means PC20 were significantly different among the four groups when they were analyzed by ANOVA P less than .01. There was, however, marked overlap between the individual levels of PC20 among the four groups. There was no significant difference in mean FEV1, age, sex, or duration of symptoms among the four groups. There was no significant correlation between baseline FEV1 and the degree of airway hyperreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Cloned helper T cell for IgE: characterization of T cells cloned from an atopic donor with a high serum IgE.

T cells cloned from nonatopic and atopic donors were examined for the ability to help IgE production in vitro. Experiments with clones from nonatopic donors were unsuccessful in spite of isolation of four clones that promoted IgM and IgG when these were mixed with B cells from nonatopic donors and pokeweed mitogen. We reasoned that T cells regulating IgE might be found with greater frequency in atopic donors with very high serum IgE. Two T cell clones from an atopic donor with a serum IgE of 3000 IU/ml were found to drive atopic B cells to produce up to 10,000 pg/ml of IgE in vitro. This promotion of IgE secretion occurred in the absence of mitogen stimulus and appeared to decrease with higher ratios of T cells:B cells. One of the clones (A-H4) also promoted the production of IgM and IgG in addition to the IgE; however, when this clone was carried in culture for several months, this activity for IgM and IgG fell markedly, whereas help for IgE decreased less. We have speculated that these two T cell clones, with unusual activation properties, may be representative of a subset of atopic T cells responsible for maintaining the circulating B cells that spontaneously secrete IgE in vitro in patients with high serum IgE.

B-Lymphocytes↗
PubMed1986

Role of glucagon in splanchnic hyperemia of chronic portal hypertension.

The role of glucagon as a blood-borne mediator of the hyperdynamic circulation associated with chronic portal venous hypertension was assessed in the rat portal vein stenosis model. Selective removal of pancreatic glucagon from the circulation was achieved by intravenous infusion of a highly specific glucagon antiserum. Blood flow to splanchnic organs, kidneys, and testicles was measured with radioactive microspheres, and the reference-sample method. Glucagon antiserum had no effect on blood flow in the gastrointestinal tract of sham-operated (control) rats. However, the antiserum produced a significant reduction in hepatic arterial blood flow in the control rats, suggesting that glucagon contributes significantly to the basal tone of hepatic arterioles. In portal hypertensive rats glucagon antiserum significantly reduced blood flow to the stomach (22%), duodenum (25%), jejunum (24%), ileum (26%), cecum (27%), and colon (26%). Portal venous blood flow was reduced by approximately 30%. The results of this study support the hypothesis that glucagon mediates a portion of the splanchnic hyperemia associated with chronic portal hypertension.

Animals↗
PubMed1986

Characterization of malignant peripheral blood cells of juvenile chronic myelogenous leukemia.

Characterization studies were performed on the malignant peripheral blood cells from three patients with juvenile chronic myelogenous leukemia (JCML) by allowing the cells to increase numerically in liquid cultures. JCML cells proliferated rapidly and excessively in the absence of an added humoral growth factor, whereas control peripheral blood cells declined in number when cultured under identical conditions. Clonality of JCML cells was proven by cytogenetic analysis of the proliferating population. JCML cells were exclusively of monocytic lineage as determined by morphology, staining characteristics, and monoclonal antibody identification of cell-specific surface antigens, but cytochemical and functional studies identified aberrant properties indicating defective differentiation. Striking differences from control cells in ultrastructure and topography were also observed by transmission and scanning electron microscopy. These data provide new information on the cellular origin of JCML and form the basis for further study of leukemic cell biology in this disease.

Child, Preschool↗
PubMed1986

Anaphylactoid and systemic reactions following saline enema administration. Six case reports.

This report describes six children with spina bifida who have experienced a total of 13 episodes of generalized hives, angioedema and in two cases, anaphylactoid reactions immediately following saline enema infusions. The enemas were administered using a kit comprised of a plastic bag, tubing, and rectal end-piece. The reactions always occurred with the first use of new kits. A third child developed a systemic reaction with only the rectal end-piece in situ and without infusion of fluid. An in-hospital challenge using a new end-piece in one patient, who was clinically the most sensitive, produced an acute anaphylactoid reaction implicating the end-piece as the most likely source of the problem. The definitive mechanism(s) of the reactions and the agent(s) responsible for them presently remain unknown.

Anaphylaxis↗
PubMed1986

Biliary tract injuries following routine cholecystectomy.

This retrospective study was done to review the epidemiology, etiology, method of treatment, and results of repairs of biliary tract injuries following routine cholecystectomy. Fourteen patients have been treated at our hospital for biliary tract injuries during a 10-year period (January 1974-December 1983). One injury occurred at our institution. During this same time span, 941 cholecystectomies were performed at our hospital giving an incidence of 0.11 per cent for the injury. Trained surgeons were responsible for nine injuries, family practitioners for two injuries, and a surgery resident for one injury. Two injuries were caused by individuals whose level of training could not be determined. In only one case was massive hemorrhage associated with the injury. Four patients had their injuries diagnosed and treated at the time of their original surgery. Two had successful initial repairs. The other two required further reconstructive surgery with good results. Ten patients had a delay in diagnosis, and nine required biliary tract reconstruction. Four of these had good results. Combining both groups, 13 patients required 20 procedures. Stents were used in 14 procedures with good results in 43 per cent. Stents were left in place 6.9 months. Five procedures were done without stents and four resulted in failure. Biliary tract injuries are devastating problems caused by trained surgeons through lack of attention. Better results can be obtained if the injury is recognized early and treated. The overall success rate was 62 per cent. The use of stents improved the success rate.

Adult↗
PubMed1985

Diabetic neuropathy.

The incidence and prevalence of diabetic neuropathies in Insulin Dependent (IDDM) and Non-Insulin Dependent (NIDDM) Diabetes Mellitus is not known because in previous studies the heterogeneity of diabetes and of the neuropathies was not taken into account, criteria for diagnosis and surveillance for neuropathy were variable, and studies were not prospective or population based. We have begun such prospective epidemiologic studies using a uniform algorithm for the classification of the diabetic disorders and uniform and validated approaches for the assessment of symptoms, neurologic deficits and various quantitative end-points of neural dysfunction. As regards cause, a key question which we are trying to answer is whether hyperglycemia and associated metabolic alterations affect neural tissue directly or whether there is an intervening tissue alteration between metabolic derangement and tissue change. Improved control of hyperglycemia does not appear to be associated with rapid neurologic improvement, possibly arguing for an intervening tissue alteration. The recently observed decrease in nerve oxygen tension and blood flow in streptozotocin diabetes suggests that an alteration of the nerve microenvironment may relate importantly to the cause of diabetic neuropathy.

Diabetes Mellitus, Type 1↗
PubMed1985

Capillary number and percentage closed in human diabetic sural nerve.

The number of capillaries per mm2, minimum intercapillary distance, number of endothelial nuclei per capillary section, and percentage of capillaries closed were evaluated in transverse sections of fascicles of 45 control and 36 diabetic sural nerves. All controls and patients were prospectively studied to ascertain their diabetic and neuropathic status. An index of pathology was introduced and it was found to provide a sensitive and reliable measurement of the presence and severity of neuropathy. The number of capillaries and minimum intercapillary distance of diabetic nerves were not significantly different from those of controls (P greater than 0.05). Diabetic nerves exhibited a small but statistically significant increase in the number of endothelial nuclei per capillary that was positively correlated with the severity of neuropathy. The most striking abnormality was the statistically significant increase in the percentage of capillaries closed in patients with neuropathy as compared to those without neuropathy and controls. Among diabetics, this percentage increased with the severity of neuropathy (P = 0.008). The two capillary abnormalities that have been demonstrated may play a role in the development of diabetic polyneuropathy.

Adult↗
PubMed1985

Anaphylactic response to hydrocortisone in childhood: a case report.

Anaphylactic reactions to hydrocortisone have been well described in adults, but have not been reported in children. We wish to report such a reaction in a 6-year-old girl who had a positive intradermal reaction to methylprednisolone. Control subjects were non-reactive. Previous literature is briefly reviewed and discussed.

Anaphylaxis↗
PubMed1984

Characterization of a long-term T-helper-cell line which produces IL-2 and induces immunoglobulin secretion.

Six OKT4+ human T-cell lines that require continuing PHA stimulation and TCGF for continuous growth were established. The cells from all six of these T-cell lines became smaller in size and lost the cell surface Ia antigen when they were grown in phytohemagglutinin (PHA)-depleted growth factor. These cells were unable to survive in the absence of PHA even if exogenous factor was present in great abundance. One of the cell lines (FL) was capable of providing helper functions. In the presence of PHA and phorbol myristate acetate, FL cells produced a growth factor, tentatively identified as Interleukin 2 (IL-2) by its ability to promote the proliferation of an IL-2-dependent murine T-cell line. Moreover, when FL cells were cocultured with B cells, pokeweed mitogen-induced immunoglobulin production was enhanced.

Antibodies, Monoclonal↗
PubMed1984

Idiopathic hypercalciuria associated with hyperreninemia and high urinary prostaglandin E.

A patient with idiopathic hypercalciuria and some features suggestive of Bartter syndrome is reported. Excessive urinary prostaglandin E (PGE) excretion and renal calcium leak were documented in this child. Treatment with aspirin and indomethacin reduced urinary PGE excretion and was associated with a decrease in daily calcium excretion. At the lowest levels of urinary PGE, the renal calcium leak was no longer evident although mild hypercalciuria persisted. These results suggest that PGE may play a role in some cases of idiopathic hypercalciuria.

Aspirin↗