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Biomedical subjects

J Oppenheimer

Publications and source records attributed to J Oppenheimer.

At least 19 recordsLinked to original sources
PubMed2001

Feasibility of the membrane bioreactor process for water reclamation.

The feasibility of the membrane bioreactor (MBR) process for water reclamation was studied. Process evaluation was based on the following: literature review of MBRs, worldwide survey of MBRs, and preliminary costs estimates. The literature review and the survey have shown that the MBR process offers several benefits over the conventional activated sludge process, including: smaller space and reactor requirements, better effluent water quality, disinfection, increased volumetric loading, and less sludge production. The MBR process can exist in two different configurations, one with the low-pressure membrane modules replacing the clarifier downstream the bioreactor (in series), and the second with the membranes submerged within the bioreactor. Four major companies are currently marketing MBRs while many other companies are also in the process of developing new MBRs. The MBR process operates in a considerably different range of parameters than the conventional activated sludge process. The preliminary cost evaluation has shown that the MBR process is cost competitive with other conventional wastewater treatment processes.

Bioreactors↗
PubMed2000

Vancomycin anaphylaxis and successful desensitization in a patient with end stage renal disease on hemodialysis by maintaining steady antibiotic levels.

BACKGROUND: Vancomycin anaphylaxis is a major management problem in patients with methicillin-resistant Staphylococcus aureus (MRSA) sepsis. Lerner et al in 1984 have described a protocol for desensitization to vancomycin; however, antibiotic blood levels have never been used as a guide in this process. CASE REPORT: A 46-year-old female with ESRD on hemodialysis who developed a dialysis-catheter related MRSA sepsis was found to have anaphylaxis to vancomycin. She underwent successful desensitization to vancomycin using Lerner's protocol. Periodic antibiotic blood levels were used to guide the amount and frequency of vancomycin infusion to successfully maintain desensitization thereafter. DISCUSSION: Lerner described loss of desensitization to vancomycin when antibiotic infusion was stopped after 18 hours followed by successful desensitization to the same drug via the same protocol. This observation points out that desensitization to vancomycin appears to be dependent on some minimal drug level. In our case report, we have for the first time used the concept of blood levels to maintain successful desensitization to an antibiotic. CONCLUSION: We hypothesize that desensitization to vancomycin can be induced and maintained by keeping a minimum antibiotic blood level. Further studies are needed to quantify this.

Anaphylaxis↗
PubMed1998

Exacerbation of premenstrual asthma caused by an oral contraceptive.

BACKGROUND: The relationship between sex hormones and asthma has not been clarified. Studies have suggested a potential beneficial effect of exogenous sex hormones and/or contraceptive pills on asthma in premenopausal females whereas the data for postmenopausal females are inconsistent. CASE REPORT: A 33-year-old woman suffering from asthma with premenstrual exacerbations had a stable course until she began taking oral contraceptives. At that time she experienced clinical deterioration of her asthma associated with decline of pulmonary function tests. No other precipitating factors were identified. After discontinuing the contraceptives, her condition returned to baseline. CONCLUSION: We found only two reports of worsening of asthma related to hormonal therapy (estrogen in one case, contraceptive pills in the other) in premenopausal women. Our report, together with these observations, suggests that in some premenopausal women exogenous sex hormones and/or contraceptive pills may, contrary to expected, produce exacerbation of asthma.

Adult↗
PubMed1996

An assessment of the role of intradermal skin testing in the diagnosis of clinically relevant allergy to timothy grass.

BACKGROUND: Immediate skin testing is generally the preferred method for establishing the presence of allergy in clinical practice. There is no agreement, however, as to whether intradermal testing should be routinely performed if skin prick test results are negative. PURPOSE: The study was done to address the value of intradermal skin testing in the diagnosis of clinically significant sensitivity to grass pollen in patients exhibiting negative skin prick test responses to timothy extract. METHODS: Four groups were studied. Group I had a history of seasonal allergic rhinitis, negative skin prick test responses to timothy and Bermuda grass, but positive intradermal skin test responses to timothy grass. Group II had a history of seasonal allergic rhinitis and positive skin prick test responses to timothy grass. Group III had a history of seasonal allergic rhinitis but had negative responses to both prick and intradermal testing with timothy and Bermuda grass. Group IV had no history of rhinitis, had negative responses to skin testing with a panel of locally important allergens, as well as Bermuda and timothy grass, and had a serum IgE value of less than 20 IU/ml. Clinical sensitivity to grass was assessed by two methods: (1) nasal challenge with threefold increasing amounts of timothy pollen performed out of the pollen season and (2) correlation of subjects' daily symptom and medication scores with daily grass pollen counts during the grass pollen season. RESULTS: On the basis of nasal challenge with timothy grass, pollen allergic reactions were present in 11% of group I, 68% of group II, 11% of group III, and 0% of group IV. As determined by correlation of symptoms during the grass pollen season with grass pollen counts, 22% of group I, 64% of group II, 21% of group III, and 0% of group IV were considered allergic. If both criteria were required for a diagnosis of clinical allergy to grass, the percent positive was 0 for group I, 46 for group II, 0 for group III, and 0 for group IV. CONCLUSION: Under the conditions of this study the presence of a positive intradermal skin test response to timothy grass (1000 AU/ml) in the presence of a negative skin prick test response to timothy grass (100,000 AU/ml) did not indicate the presence of clinically significant sensitivity to timothy grass, and by inference, to other cross-reacting grasses.

Adult↗
PubMed1996

Asthma mortality in New Jersey residents.

Researchers at the Asthma & Allergy Research Center noted that from 1972 to 1992, the asthma mortality rate doubled with increased mortality noted in minorities as compared to whites; in females as compared to males; and in individuals over the age of 55 years.

Adolescent↗
PubMed1995

Chronic angio-oedema of the tongue associated with pernicious anaemia and Hashimoto's thyroiditis.

The cause of chronic urticaria and angio-oedema (CUA) often remains undetermined. CUA has been associated with thyroid disease and most recently with thyroid autoimmunity (i.e. elevated titres of thyroid microsomal and/or thyroglobulin antibody). There is growing speculation that in this subset of patients, CUA may represent an autoimmune phenomenon. We describe a case in which chronic angio-oedema of the tongue was the sole presenting complaint in a patient with underlying quiescent pernicious anaemia and Hashimoto's thyroiditis. Awareness of the association of Hashimoto's thyroiditis with pernicious anaemia and CUA resulted in correct diagnosis and treatment of the underlying diseases.

Anemia, Pernicious↗
PubMed1995

Suppression of the skin reaction to histamine by ebastine.

BACKGROUND: Ebastine is a nonsedating histamine H-1 antagonist undergoing evaluation for treatment of allergic rhinitis and urticaria. OBJECTIVE: To compare the suppression of prick and intradermal skin reactions to histamine over a period of 24 hours produced by a single dose of ebastine. Also to record side effects and assess changes in the electrocardiogram, particularly the QTc interval. METHOD: Single doses of 1, 3, 10, and 30 mg of ebastine or placebo were administered double-blind at approximately 8 AM after baseline measurement of the reaction to intradermal testing with 5 micrograms histamine base and prick skin testing with three concentrations of histamine. Intradermal testing with histamine was repeated hourly for four hours, every two hours for eight hours, and after 24 hours. Titrated prick skin testing with histamine was performed at 6, 12, and 24 hours. Potential side effects were recorded each time skin testing was performed. Electrocardiograms were repeated at 4 and 24 hours. RESULTS: Intradermal skin test reactions were suppressed between 4 and 24 hours and prick skin tests to 10 mg/mL histamine base were suppressed between 6 and 24 hours with all doses of ebastine. Prick skin test reactions were significantly smaller at 12 and 24 hours in the group receiving the 30 mg dose of ebastine than in all other groups. CONCLUSION: Ebastine is a potent antihistamine that suppresses skin reactions to histamine for 24 hours following single doses in the doses tested (1 to 30 mg). No differences from placebo were noted in either the incidence of side effects or in the QTc intervals of serial electrocardiograms.

Adult↗
PubMed1994

Safety and efficacy of oral immunotherapy with standardized cat extract.

Fifty-three subjects with positive skin prick test results to cat extract and rhinoconjunctival symptoms on exposure to cat dander were enrolled in a double-blind, placebo-controlled study of oral cat immunotherapy. Responses were assessed by development of symptoms and nasal blockage on exposure to an apartment contaminated with cat dander, by titrated skin prick tests, and by cat-specific IgG and IgE. A total cumulative dose of 2.5 x 10(6) allergy units or 436 U Fel d I were administered over a period of 3 months. Both groups of subjects had significantly fewer symptoms on exposure to cat dander during the course of the study, but there was no significant difference between active and placebo groups. There were no significant changes in either group in nasal blockage, skin prick test results, or specific IgG levels. Both groups had significant increases in cat-specific IgE, but there were no differences between groups. Subjects receiving active treatment had a slight excess of gastrointestinal complaints. Two subjects receiving active treatment experienced systemic symptoms: one had pulmonary edema, and the other had persistent asthma and urticaria, which may have represented reactions to the treatment. We conclude that oral cat immunotherapy with the preparation and doses used in this study is not effective.

Administration, Oral↗
PubMed1993

Epithelioid osteosarcoma of bone. Immunocytochemical evidence suggesting divergent epithelial and mesenchymal differentiation in a primary osseous neoplasm.

BACKGROUND: The combination of a primary osteosarcoma of bone with a second carcinomatous cell type has been recognized, although immunohistochemical studies currently have not been performed in an attempt to understand the histogenesis of such a tumor. METHODS: In this report, the authors performed immunohistochemical studies on a primary osseous carcinosarcoma. Using a biotin-streptavidin peroxidase conjugate technique, the expression of keratin, epithelial membrane antigen, and vimentin was analyzed. RESULTS: The epithelial cells expressed cytokeratin and epithelial membrane antigen but did not express vimentin. The mesenchymal cells strongly expressed vimentin, and only rare cells expressed cytokeratin. CONCLUSIONS: The clinical, morphologic, and immunophenotypic data in this instance strongly suggest divergent differentiation of a primitive multipotential uncommitted stem cell in a primary osseous tumor.

Adolescent↗
PubMed1993

Double-blind trial of a heated nasal aerosol in the treatment of perennial allergic rhinitis.

BACKGROUND: The effect of heated, moisturized air, delivered at 40 L/min and 43 degrees C, on allergic rhinitis was evaluated in two studies. METHODS: In the first study patients with chronic nasal symptoms and long-term exposure to a perennial allergen to which they were sensitive underwent 1 week of baseline observation and 1 week of treatment with either heated or room temperature moisturized air for 30 minutes twice daily. The effect of treatment was assessed by changes in nasal symptoms and nasal blockage index and by a global evaluation by the subjects at the end of the treatment period. In the second study subjects with a documented history of grass or weed pollen allergic rhinitis underwent titrated nasal pollen challenges immediately after treatment with either heated or room temperature moisturized air. The outcome was assessed by the end point of the nasal challenge and change in blockage index at the end point. RESULTS: In both models there was no significant difference in the response between those treated with heated and those treated with room temperature moisturized air. CONCLUSION: This study did not demonstrate any evidence of a therapeutic effect of heated, moisturized air in the treatment of allergic rhinitis.

Adult↗
PubMed1993

A double-blind, placebo-controlled evaluation of sublingual immunotherapy with standardized cat extract.

BACKGROUND: In light of the controversial status of sublingual immunotherapy in patients with allergic rhinitis, we undertook a double-blind study of this form of treatment. METHODS: Forty-one subjects with cat allergy presenting as rhinoconjunctivitis underwent 105 days of sublingual immunotherapy, with 20 subjects receiving a standardized cat extract (total dose approximately 4,500,000 allergy units) and 21 a matching placebo. Effectiveness of treatment was assessed by changes in symptoms and nasal-blockage index during 90 minutes of exposure in an apartment containing cat dander, which was performed before and after the course of treatment. Changes in cat-specific IgG and IgE levels and skin-test reactions were also monitored. RESULTS: Although there were fewer symptoms and less nasal obstruction on cat dander exposure at the end of the study the changes were not significantly different in those receiving active or placebo treatment. Specific IgG and IgE levels and prick skin test results did not change significantly during the course of the study. CONCLUSIONS: We conclude that sublingual immunotherapy with high-dose standardized cat extract was no more effective than placebo in reducing symptoms or affecting immunologic measures of cat sensitivity.

Administration, Sublingual↗
PubMed1987

Variations in rat mesenteric tissue thickness due to microvasculature.

Studies of microvascular, tissue and lymphatic transport using microphotometric and microfluorometric techniques are potentially subject to artifact due to variations in tissue specimen thickness. Absorbance techniques utilize the Lambert-Beer law in which A = log I0/I = act, where A is absorbance, I0 is incident light intensity, I is transmitted intensity, a is an absorbance coefficient, c is concentration of substance, and t is path length. If differences in t are known to be present, then inferences of changes in c from changes in A become suspect. In microfluorometry the amount of light gathered is proportional to the number of fluorochromes in the effective cuvette, which is determined by the microscope's numerical aperture and the sample thickness. If variations in thickness are known to occur, the effective cuvette volume may be changing; therefore, inferences of changes in fluorochrome concentration from changes in intensity become suspect. Existing data suggest that rat mesentery is 15-30 microns thick, but variation over a tissue region is unknown. Our goals are to determine thickness variation in avascular, fat-free mesenteric tissue regions; thickness variation near blood vessels; and average tissue thickness. Sprague-Dawley rats were anesthetized with Inactin. Mesenteric tissue from a loop of small intestine was draped over a platform for observation; thickness was measured with an oblique microscope and a microgravimetric technique. The average variation in avascular fat-free tissue was 1.1 micron/100-microns distance, and average thickness was 17.4 microns. There was a significant increase in thickness over the microvasculature.

Animals↗