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Biomedical subjects

J E Parrillo

Publications and source records attributed to J E Parrillo.

At least 199 records · Page 11Linked to original sources
PubMed1983

Bacteremia due to Mycobacterium avium-intracellulare in the acquired immunodeficiency syndrome.

The presence of Mycobacterium avium-intracellulare has frequently been demonstrated in tissue specimens from patients with the acquired immunodeficiency syndrome. The importance of this mycobacterium as a cause of constitutional symptoms and organ dysfunction has been unclear, however, because of the sparse inflammatory response evoked and the frequent concurrence of other pathogenic organisms. We detected M. avium-intracellulare in blood samples from eight patients with the acquired immunodeficiency syndrome, seven of whom had a previously recognized M. avium-intracellulare infection. Blood cultures were positive on 1 to 14 occasions over 135 days using the Dupont isolator system or the Bactec 12B medium system. Cultures were positive within 14 to 51 or 7 to 14 days with the respective techniques. The ability to rapidly isolate M. avium-intracellulare from blood may provide a useful diagnostic technique for detecting disseminated mycobacterial disease in patients with the acquired immunodeficiency syndrome as well as in other patient populations. This technique may also be useful for assessing the efficacy of drug therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Circumflex coronary artery aneurysm visualized by real-time cross-sectional echocardiography. A possible sequelae of previously unrecognized coronary arteritis in the adult.

Real-time cross-sectional echocardiography disclosed an aneurysm of the circumflex branch of the left coronary artery in an asymptomatic 30-year-old man. Plain chest roentgenogram showed an abnormal silhouette along his left heart border. He also was found to have an abnormal contraction pattern of the posterolateral wall of the left ventricle and a reduced left ventricular ejection fraction. Left ventricular and coronary angiography showed a similar impairment in left ventricular function and occlusion of the circumflex branch of the left coronary artery. Surgery and pathologic examination confirmed the presence of the aneurysm. The echocardiographic characteristics of this lesion and the left ventricular contraction abnormalities suggest the possibility that it resulted from a remote episode of coronary arteritis. Real-time cross-sectional echocardiography, by virtue of its ability to provide visualization of structures along the posterior border of the heart as well as information about regional wall motion, may be of considerable value in localizing and defining lesions occurring in this area.

Adult↗
PubMed1979

Immunologic reactivity in the hypereosinophilic syndrome.

Because previous studies have suggested an important link between eosinophilia and immunologic reactivity, we investigated various components of the immune system in a large number of patients with the idiopathic hypereosinophilic syndrome (HES) to elucidate a possible role for immunologic phenomena in the etiology and pathogenesis of this disease. Immunoglobulin G, A, or M levels were only rarely abnormal. However, in 8 of 21 (38%) patients with HES, IgE levels were markedly elevated suggesting an association of an IgE-mediated mechanism with eosinophilia in this subgroup. Severe dermatographism was present in three fourths of patients, and 2 patients with intermittently elevated histamine levels manifested an unusual form of immediate-pressure urticaria. Serum complement determinations showed elevated C4 and C3 levels in 27% and 77% of patients, respectively. Antigen-antibody complexlike material measured by C1q binding was elevated in the serum of 7 of 22 (32%) patients; this finding may relate to the known ability of eosinophils to avidly phagocytose antigen-antibody complexes. When compared with normals, lymphocytes from patients with HES showed a variety of abnormalities of lymphocyte surface receptors and lymphocyte function. Thus, patients with HES demonstrate a variety of immunologic abnormalities which may be related primarily or secondarily to the pathogenesis of this syndrome.

Antigens, Surface↗
PubMed1978

Comparison of the effector cells in human spontaneous cellular cytotoxicity and antibody-dependent cellular cytotoxicity: differential sensitivity of effector cells to in vivo and in vitro corticosteroids.

The effector cells mediating antibody dependent cellular cytotoxicity (ADCC) and spontaneous cellular cytotoxicity (SCC) in humans have been reported to possess similar characteristics. Multiple cell separation techniques were employed in an attempt to physically separate and distinguish the effector cells in these two types of cellular cytotoxicity. Subpopulations of mononuclear cells obtained by a variety of fractionation procedures which either enriched or depleted monocytes, lymphocytes bearing a receptor for sheep erythrocytes (SRBC), a receptor for complement (CRL) or an Fc receptor for IgG always had similar effects on both ADCC and SCC. Aggregated gamma globulin blockade of Fc receptors produced similar dose-dependent depressions of ADCC and SCC. Despite our inability to physically separate the effector cells of ADCC and SCC, administration of in vivo dexamethasone caused a relative increase in ADCC but a profound decrease in SCC. Furthermore, in vitro dexamethasone in pharmacologic and suprapharmacologic concentrations caused no change in ADCC but significantly decreased SCC. This study demonstrates that although the effector cells cannot be physically separated, ADCC and SCC are differentially sensitive to corticosteroids and are hence functionally distinct either on the basis of different subsets of effector cells with similar surface markers or different mechanisms of cytotoxicity by the same effector cell.

Adrenal Cortex Hormones↗
PubMed1978

Therapy of the hypereosinophilic syndrome.

Previous studies of patients with the hypereosinophilic syndrome have found very significant morbidity and a high mortality of 77% at 3 years. Our study analyzes the therapy and prognosis of 26 patients with the hypereosinophilic syndrome. Five patients showed no evidence of progressive organ-system dysfunction and were given no therapy; all have done well. Sixteen patients with progressive organ dysfunction were treated with corticosteroids; six of the 16 had a good response and needed no further therapy. Five patients were treated with various chemotherapeutic agents that proved to be ineffective. In eight patients who were unresponsive to corticosteroid therapy, hydroxyurea produced excellent responses in six and partial responses in two. With the above regimen, our 26 patients (including 12 with poor prognostic indicators) have had a marked increase in survival (3-year mortality of 4%) when compared with the historical control group.

Adolescent↗
PubMed1978

Dermatologic manifestations of the hypereosinophilic syndrome.

We report the histopathologic and dermatologic manifestations of eight patients with hypereosinophilic syndrome (HES). Skin lesions occurred in eight patients (53%) in a group of 15 patients with HES, and were generally of two types: (1) erythematous pruritic papules and nodules, or (2) urticaria and angioedema. As HES was treated with appropriate therapy, the skin lesions improved. Skin eruption may be the only manifestation of disease in otherwise asymptomatic patients with HES.

Adult↗
PubMed1978

Comparison of the relative cytotoxic effector cell capabilities and the proportions of cells bearing various surface markers in human tonsil and peripheral blood mononuclear cells.

The relative cytotoxic effector cell capabilities and the proportions of cells bearing various surface markers in human tonsil and peripheral blood mononuclear cells has been studied. The peripheral blood contained a substantial proportion of monocytes (22 +/- 2.9%) compared to tonsil cell suspensions (2.5 +/- 0.3%). The percentages of T lymphocytes was significantly higher in the blood than in the tonsil (P is less than 0.01); however, the percentages of cells forming rosettes with 7S EA were not significantly different in each group (P greater than 0.5). Mitogen-induced cellular cytotoxicity by blood and tonsil mononuclear cells against Chang cells was proportional to the percentages of T lymphocytes in these cell suspensions, and both antibody-dependent and mitogen-induced cellular cytoxicity against sheep red blood cells was proportional to the percentages of monocytes in these suspensions. Tonsil mononuclear cell suspensions were incapable of mediating antibody-dependent cellular cytotoxicity against Chang cells, whereas blood mononuclear cells functioned normally. These findings are in contrast to the findings of similar percentages of Fc receptor-positive lymphocytes in blood and tonsil mononuclear cell suspensions. Previous studies have shown that the effector cells against antibody-coated Chang cells are Fc receptor-positive lymphocytes. These studies show that in the case of cytotoxicity mediated by an Fc receptor-bearing lymphoid cell, there may be a clear discrepancy between the relative proportions of Fc-bearing lymphoid cells in different organs and the relative levels of cytotoxicity.

Antibody-Dependent Cell Cytotoxicity↗
PubMed1977

Characterization of the direct effects of cyclophosphamide on cell-mediated immunological responses.

The direct immunosuppressive effects of cyclophosphamide were examined by incubating normal guinea-pig mononuclear cells with activated cyclophosphamide prepared from the serum of separate animals which were treated with cyclophosphamide in vivo. Treated cells were subsequently assayed in a panel of tests of cell-mediated immunity either immediately or following recovery during variable periods of incubation. It was found that cyclophosphamide (1) induces changes in lymphocyte functions which are not due simply to cell death; (2) is markedly antiproliferative in mitogen-induced blastogenesis; (3) depresses migration inhibitory factor production only after a delay of several hours and (4) depresses certain cytotoxicity reactions immediately following treatment, such responses are subsequently normalized when the cells are allowed to recover in culture.

Animals↗
PubMed1977

The hypereosinophilic syndrome: dramatic response to therapeutic intervention.

The Hypereosinophilic Syndrome (HES) is a disease of unknown etiology and pathogenesis characterized by blood and bone marrow eosinophilia associated with infiltration of eosinophils into tissues and multi-system organ dysfunction. Patients with HES historically have very significant morbidity and a high mortality of 77% at 3 years. This study is a prospective (9 years) and retrospective (24 years) analysis of the therapy and prognosis of 26 patients with HES. Five patients (19%) showed no evidence of progressive organ system dysfunction and were given no therapy; all have done well. Sixteen patients with progressive organ dysfunction were treated with corticosteroids; 6 of the 16 (38%) had a good response and required no further therapy. Six of 8 patients who were corticosteroid unresponsive and had serious prognostic signs had excellent responses to hydroxyurea therapy, while 2 patients showed partial responses. Employing the above regimen, we have demonstrated that our 26 patients (including 12 with poor prognostic indicators) have a marked increase in survival (3 year mortality 4%) when compared with the historical control.

Adolescent↗