Biomedical subjects
Publications and source records attributed to I Sandor.
"The study analyses changes in regional mobility in [Hungary over] approximately three decades. Different forms of population movement are taken not as separate phenomena but as [an indication] of their interrelations and correlations.... The study is supplemented with an accurate bibliography of literature on the topic." (SUMMARY IN ENG)
Fifty patients with suspected allergy to penicillin were tested. Skin tests were done with Na-penicillin G and penicilloyl-polylysin. Specific IgE antibody assays were done with penicilloyl G and V conjugates by means of RAST. The overall agreement between skin test and RAST results was 87%, borderline cases not included. In one case, skin tests were positive to penicillamine only, while RAST for penicilloyl G and V both proved to be positive. One case of penicillin allergy could be diagnosed in vitro post mortem only. Two cases of Hoigné syndrome showed no evidence of allergy. Patterns of skin manifestations varied but urticaria was the most commonly seen feature. Twenty patients without adverse reactions to penicillin treatment and seven patients who had not received penicillin over the last 10 years served as controls. None of them were positive in either skin tests of RAST. Two or our twenty control patients developed penicillin allergy during the study. Both showed positive RAST results.
Dialysable transfer factor (TF) was given in 10 paediatric patients with severe atopic dermatitis (AD). Ten patients with AD, matched for age and severity of disease, served as controls. Prior to the therapy with TF and at weekly intervals thereafter, T- and B-cells in the blood, PHA-stimulation, total IgE and specific IgG antibodies to inhalant and food antigens were determined. Therapy with TF was followed by IgE depression in 8/10 patients and was most pronounced in three patients with initially high levels. Some decrease of IgE levels was seen in four controls also, none of them, however, fell to normal levels as was seen in two of the treated patients. Specific IgE levels decreased slightly, but always remained within the pathological range. T-cell counts in the blood increased in 2/10 cases as well as PHA-stimulation, B-cells counts remained within normal limits. Clinical improvement was seen in one patient, five improved slightly and four remained unchanged. Our results indicate, that transfer factor can lower total IgE levels in cases with atopic dermatitis. The effect is most marked in patients with high total IgE levels. Skin involvement, however, does not closely follow in vitro findings.
Based on the results of 500 patients suffering from bee-venom allergy, allergic rhinitis, bronchial asthma, atopic dermatitis and food allergy the necessary diagnostic procedures leading to specific immunotherapy are discussed. The immunstimulating potential of the vaccines varies from patient to patient and is decreased after some viral infections. Good results are seen in young patients and when a low number of allergens is incorporated in the vaccine. Side effects of minor importance are seen in about half the patients. Systemic reactions following specific immunotherapy are seen more often in aqueous solutions compared to depot vaccines. The treatment should be reconsidered, if the patient has not improved after half a year.
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.
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.
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.
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.
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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.
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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.
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
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.
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