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Biomedical subjects

M Schatz

Publications and source records attributed to M Schatz.

At least 19 recordsLinked to original sources
PubMed1978

Administration of local anesthetics to patients with a history of prior adverse reaction.

The clinical histories of 71 patients evaluated for suspected local anesthetic (LA) allergy were reviewed retrospectively. The clinical histories were classified into (1) immediate generalized reactions (15%), (2) localized swelling at the injection site (25%), (3) nonspecific systemic symptoms (42%), and (4) other histories (17%). Serial dilutional intradermal skin tests were performed with mepivacaine, lidocaine, and procaine in 59 patients. There were 5 skin test--positive patients found, and each had a positive reaction to an LA to which, by history, they had not reacted. In 50 patients, when an LA was subsequently required, a subcutaneous challenge was performed with an LA chosen for chemical nonsimilarity. No significant reactions were observed in this group. Three patients tolerated a challenge with an LA to which they were skin test--positive. These data indicate (1) the low incidence of reactions compatible with a systemic IgE-mediated mechanism by history in patients referred for evaluation of LA allergy, (2) the lack of specific and clinically relevant information provided by dilutional skin tests, and (3) the apparent safety and usefulness of careful challenge with an alternative LA.

Anesthetics, Local↗
PubMed1977

Immunopatholgenesis of hypersensitivity pneumonitis.

This review describes antigenic and host factors of possible significance in the immunopathogenesis of hypersensitivity pneumonitis (HP). Although certain immunologic studies suggest immune complex mechanisms in HP, recent experimental and clinical data accumulated support a role for cell-mediated immunity. In addition, some data support roles for anaphylactic and cytotoxic antibody-mediated reactivity as well. One type of reactivity alone may not be sufficient for production of HP, and local pulmonary immune responses may be most relevant to the pathogensis. Whether immune damage will be produced in an exposed individual or not may depend on the characteristics of the antigenic exposure as well as inherited and acquired individual differences in immunologic reactivity and possibly target organ sensitivity.

Adjuvants, Immunologic↗
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↗
PubMed1977

Mitogen-induced lymphocyte and cutaneous reactions in dogs.

The lymphocyte response of dogs to mitogens was determined using separated lymphocyte and whole blood lymphocyte proliferation techniques. Reactivity to optimal doses of the following mitogens was demonstrated in decreasing order of intensity: phytohemagglutinin, Pokeweed mitogen, conconavalin A and sodium periodate. The canine cutaneous reactivity to these mitogens was also determined. Grossly, erythema and induration with all mitogens was maximal at 24 h. Microscopically, lesions using all mitogens consisted of edema, hyperemia and diffuse dermal infiltration with polymorphonuclear leukocytes and mononuclear cells. These mitogen-induced lesions may represent a specific lymphocyte-mediated inflammatory response, although a nonspecific reaction cannot be excluded.

Animals↗
PubMed1977

Immediate-type hypersensitivity to keyhole limpet haemocyanin in the dog.

A model of immediate-type hypersensitivity (ITH) in the dog using keyhole limpet haemocyanin (KLH) as the antigen was studied. Long-lasting ITH was induced in fifteen of sixteen dogs by the i.v. (Kepron & Tse, 1975), intradermal (Rockey, Schwartzmann & Halliwell, 1971), inhalation (Patterson & Kelley, 1974) and i.d. plus inhalation (Rockey et al., 1971) routes. This ITH was demonstrated by direct skin reactivity, acute respiratory reactions and peripheral blood leucocyte and respiratory cell histamine release. The reaginic antibodies considered to mediate these reactions were larger than canine IgG, heat labile, 2-mercaptoethanol sensitive, and are probably canine IgE. In addition to cutaneous and respiratory reactions, these reagins were shown to mediate systemic reactions. In the course of these studies, an unexpected finding was the occurrence of ITH to KLH in three dogs which had had no prior experimental exposure to KLH. This ITH was of sufficient intensity to be associated with acute airway reactions to the inhaled antigen.

Animals↗
PubMed1976

Pigeons breeders' disease. I. Serum immunoglobulin concentrations; IgG, IgM, IgA and IgE antibodies against pigeon serum.

The clinical course of a patient with severe acute and chronic hypersensitivity pneumonitis of the pigeon breeders' disease (PBD) type was evaluated. A significant remission of symptomatic, roentgenographic and pulmonary function abnormalities occurred after cessation of exposure to antigen. Immunoglobulin G (IgG), A (IgA) and M (IgM) antibody activity against pigeon serum was demonstrated in the patient's serum by a solid phase radioimmunoassay (RIA) technic. The levels of these antibodies fell subsequent to elimination of antigen inhalation. The RIA technic was used to demonstrate IgG, IgA and IgM antibody activity in single serum samples of four other patients with PBD, and this technic may have diagnostic value. Although no immunoglobulin E (IgE) antibody was demonstrable by RIA, a heat-liable, reaginic antibody was also detectable in the serum of the primary case. In addition, Arthus type cutaneous reactivity was passively transferred to the skin of a volunteer subject using heated serum from a patient with PBD.

Aged↗
PubMed1976

Nonorganic adverse reactions to aeroallergen immunotherapy.

Ten patients are presented who exhibited adverse reactions to immunotherapy (IT) which mimicked immunologically mediated reactions but were thought to be nonorganic in etiology. The nonorganic nature of the reactions was considered to be established in 6 of these patients and highly likely in the remaining 4. These reactions tended to occur in young patients, particularly women, at relatively low allergen extract doses and were associated with minimal or no objective findings. There was a high incidence of coexisting or contributory psychiatric problems in these patients, particularly involving hysterical or hypochondriacal personality traits. In some patients presenting with nonorganic adverse reactions to immunotherapy, it appears that the immunotherapy may be successfully continued after the patient gains insight into the nature of the reactions. In other patients, however, these reactions may necessitate discontinuing immunotherapy, and in still other patients, these reactions may confirm the need for psychiatric consultations.

Adult↗
PubMed1976

Pigeon breeder's disease. II. Pigeon antigen induced proliferation of lymphocytes from symptomatic and asymptomatic subjects.

Lymphocyte reactivity to pigeon antigens was demonstrated in a patient with severe symptomatic pigeon breeder's disease (PBD). The reactivity of the lymphocytes declined subsequent to cessation of exposure to antigen and in parallel with clinical improvement. Lymphocyte reactivity was also demonstrated in another patient with PBD, in a pigeon breeder with no evidence of PBD, and in a laboratory investigator with a history of exposure to birds other than pigeons. Lymphocyte reactivity in the latter subject increased following cutaneous injection of pigeon serum with the development of delayed-type cutaneous reactivity. Although lymphocyte reactivity to pigeon antigens may be a necessary immunologic feature for production of PBD, this reactivity does not occur only in symptomatic subjects.

Animals↗
PubMed1976

Effect of D2O on phytohemagglutinin-induced lymphocyte proliferation.

The effect of D2O on phytohemagglutinin (PHA)-induced proliferation of human lymphocytes in vitro was examined. A significant dose-dependent inhibition of the lymphocyte reactivity by D2O was observed. This inhibition did not require the simultaneous presence of D2O and PHA in the cultures. Both cytotoxic and cytostatic mechanisms for this inhibition are implicated.

Deuterium↗
PubMed1976

The prevalence of tuberculosis and positive tuberculin skin tests in a steroid-treated asthmatic population.

The prevalence of active tuberculosis and positive tuberculin skin tests was assessed in 132 corticosteroid-treated asthmatics for an evaluation period that represented 620 corticosteroid-years of therapy. There was no evidence of active tuberculosis in any of these patients. Positive intermediate-strength tuberculin tests were present in 28% of patients and correlated with increased age. In patients treated with daily corticosteroids, tuberculin negativity was associated with a higher dose of corticosteroids. Positive second-strength tuberculin tests were found in 42.3% of the patients with negative intermediate-strength tests and also correlated with increased age. Based on these data as well as the prevalence of significant liver disease in older patients receiving isoniazid (INH), routine INH chemoprophylaxis for corticosteroid-treated asthmatic patients, regardless of their tuberculin cutaneous reactivity, is not indicated.

Adolescent↗
PubMed1976

Pigeon breeders disease. III. A study of a family exposed to doves.

A family of five individuals exposed to doves in their home were studied to evaluate possible factors leading to sympotmatic hypersensitivity pneumonitis documented in one member of the family, while the other exposed members remained asymptomatic. Antbodies against pigeon serum were domenstrated by radioimmunoassay in all subjects, and significant lymphocyte reactivity against pigeon antigens was demonstrable in three of the five members. The presence of serum antibody activity or lymphocyte reactivity against avian antigens or both did not differentiate the sick from the well family subjects. However, the possibility that increased exposure to antigen may correlate with higher degrees of antibody and lymphocyte reactivity as well as clinical disease is suggested from observation made in this family. No correlation was found between HL-A type and either symptomatic disease or immunological reactivity in these subjects.

Adolescent↗
PubMed1975

Corticosteroid therapy for the pregnant asthmatic patient.

Corticosteroids were used during seventy pregnancies in 55 asthmatic patients. In this series there was one spontaneous abortion and 71 live births (including two sets of twins). There was no maternal, fetal, or neonatal deaths. On the basis of recorded gestation, slightly more premature births were noted in this series than would be expected in the general population. However, there was no increased incidence of toxemia, uterine hemorrhage, or congenital malformations when compared to the general population, Corticosteroids, when indicated for the treatment of severe asthma, do not appear to noticeably increase the risk of maternal or fetal complications, and thus should not be contraindicated in pregnancy.

Abnormalities, Drug-Induced↗
PubMed1975

The administration of radiographic contrast media to patients with a history of a previous reaction.

Ninety-five patients were seen in consultation for previous reactions which their physicians considered as possible contraindications for the use of radiographic contrast media (RCM). Twenty-seven patients received no further studies because of a lack of sufficient indication to do them. The previous incidents in 26 were such that they were not classified as immediate generalized reactions (IGRs). Two of these patients had IGRs with repeat RCM (7.7%). Forty-two patients had previous reactions considered to be IGRs and medical problems such that repeat administration of RCM appeared essential for diagnosis. After pretreatment with diphenhydramine, 43 repeat procedures were performed in these patients followed by reactions, generally mild, in 7 (16%). Five of these were classified as IGRs (11.8%). The data on 264 similar patients in the literature were also reviewed. There appeared to be a higher incidence of IGRs to RCM in patients with a good history of a previous reaction than in the general population, but no severe reactions or fatalitics occurred in this entire series. The results showed that repeat studies in patients with previous reactions to RCM may be done, provided that there is careful evaluation of the initial reaction, the need for the diagnostic study, and provided appropriate precautions are taken prior to the procedure.

Adult↗