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Biomedical subjects

R Patterson

Publications and source records attributed to R Patterson.

At least 505 records · Page 28Linked to original sources
PubMed1979

The evaluation of selected parameters of immune function in asthmatics after long-term corticosteroid therapy.

The availability of inhaled beclomethasone diproprionate permitted the discontinuation of continuous, long-term systemic corticosteroid therapy (SCT) in a group of asthmatics who had previously required SCT to control their asthma. Twelve patients had been on SCT for a period of 2-22 years with an average duration of 7 years. To determine whether this previous long-term SCT and the current use of inhaled beclomethasone diproprionate had an effect on leucocyte functions, a variety of studies reflecting T lymphocyte, B lymphocyte and granulocyte function was done. The results were compared with those of twelve asthmatic patients of similar age ranges who had never received steroids. Results showed that the two patient populations could not be differentiated on the basis of phytohaemagglutinin stimulation of lymphocytes, sheep erythrocyte rosette formation, IgG, IgA, IgM and IgE concentrations or granulocyte bactericidal activity. Delayed skin reactivity was present in both groups, with more positive reactions in the non-SCT group. Polymorphonuclear adherence values were slightly lower in the SCT female population using beclomethasone diproprionate. The latter two minor differences may be due to the previous SCT, the use of beclomethasone diproprionate or the limited population of patients studied. We conclude from these studies that the long-term use of SCT at the low doses required for control of asthma resulted in little permanent effect on the variety of lymphocyte and granulocyte functions tested.

Adrenal Cortex Hormones↗
PubMed1979

The management of allergic bronchopulmonary aspergillosis.

Twenty-five patients with allergic bronchopulmonary aspergillosis (ABPA) were observed for periods of 12 months to 10 years (average duration, 2.6 years) after initial therapy with prednisone, which was then tapered and discontinued unless maintained at minimal doses as required for control of asthma. Thirteen patients have had no recurrence, 4 patients did not comply with the initial regimen and could not be considered to be controlled, and 8 patients had 12 recurrent episodes of ABPA characterized by pulmonary infiltrates with no explanation other than ABPA. The exacerbations were closely correlated with sharp increases in total serum IgE, which subsequently decreased after resumption of prednisone therapy. The increase of IgE preceded the pulmonary infiltrates in 7 or 12 exacerbations. The exacerbations, characterized by increased serum IgE and pulmonary infiltrates, may be associated with minimal symptoms. Acute asthma without pulmonary infiltrates was not associated with increased IgE. Four exacerbations occurred during administration of beclomethasone diproprionate used for control of asthma, and therefore, this agent does not appear to prevent or reverse exacerbations of ABPA. Twelve exacerbations occurred in 8 persons, with 2 patients having 4 and 2 recurrences, respectively. This suggests that exacerbations are more likely to occur in certain patients. Serial measurements of total serum IgE appears to be a useful index of disease activity in ABPA. In the 4 patients who did not comply with the prednisone therapy regimen or regular physician visits, patterns of IgE changes, clinical evaluations, and chest roentgenograms were not of use in evaluation of the clinical state or progress of the patient. A treatment regimen is suggested for initial therapy and recurrences of ABPA on the basis of these observations.

Aspergillosis, Allergic Bronchopulmonary↗
PubMed1979

IgA and IgG antibody activities of serum and bronchoalveolar fluid from symptomatic and asymptomatic pigeon breeders.

Serum IgA and IgG antibody activities against pigeon serum were measured in 16 symptomatic pigeon breeders, 20 asymptomatic pigeon breeders, and 3 normal subjects by radioimmunoassay. The IgA and IgG antibody activities against pigeon antigen of the group of patients with disease was significantly greater than those of patients in the asymptomatic and the control group. The overlap of results for the symptomatic and asymptomatic breeders limits the diagnostic value of these individual IgA or IgG antibody determinations. Bronchoalveolar fluid and serum samples from a smaller group of pigeon breeders who underwent lung lavage were available for studies of antibody activity against pigeon serum. Ten asymptomatic and 6 symptomatic breeders were available for study. Both IgG and IgA antibody activities were detected by radioimmunoassay in serum samples and bronchoalveolar fluid. The IgA antibody activity determined by the radioimmunoassay was higher in the respiratory secretions.

Alveolitis, Extrinsic Allergic↗
PubMed1979

Ionophore and arachidonic acid stimulation of airway responses in rhesus monkeys.

Aerosolized doses of the ionophore, A23187, and arachidonic acid individually resulted in no airway response in rhesus monkeys. When these two agents were given simultaneously, by aerosol, an airway response occurred. The pulmonary function abnormalities that occurred qualitatively simulated those of an antigen-induced airway response. This is the first demonstration in our laboratory of two agents which singly will not produce a response but which are reactive when delivered in combination. Other fatty acids did not produce a similar response. The response to A23187 and arachidonic acid occurred only in rhesus monkeys from our colony which had been demonstrated to have airway responses to aerosolized antigen challenge, a response shown previously to be associated with hyperreactive airways to pharmacologic stimuli. The A23187 and arachidonic acid response was inhibited by aerosolized 5,8,11,14-eicosatetraynoic acid, an inhibitor of the cyclooxygenase and lipoxygenase pathways of arachidonic acid metabolism. Further, indomethacin, a prostaglandin synthetase inhibitor of the cyclooxygenase pathway, inhibited the response, although previous studies showed that this drug will potentiate an antigen-induced response in this animal model of asthma. The slow-reacting substance of anaphylaxis antagonist, FPL 55712, did not inhibit the A23187-arachidonic acid response under the conditions of these experiments. The mechanism of the A23187-arachidonic acid airway response in rhesus monkeys may or may not be the same as the antigen-induced response.

5,8,11,14-Eicosatetraynoic Acid↗
PubMed1979

A familial occurrence of allergic bronchopulmonary aspergillosis.

A family was recently studied in which two brothers with identical HLA serotypes had allergic bronchopulmonary aspergillosis. One of the two had a normal bronchogram. A field investigation of the family residence showed that a barn was the probable source of the organism causing disease in these patients. Immunologic characterization of the family members showed a broad spectrum of response to the environmental exposure.

Adolescent↗
PubMed1979

Hepatic encephalopathy precipitated by fecal impaction.

Two episodes of hepatic encephalopathy developed in a 64-year-old man with cirrhosis during the course of hospitalization. The first event was precipitated by spontaneous bacterial peritonitis; the second occurred four weeks later and was associated with a massive fecal impaction, an unreported precipitant. No other potential causes were demonstrated. Symptoms promptly resolved following disimpaction.

Fecal Impaction↗
PubMed1979

Muscular hypertonia: quantitative analysis.

By a statistical method of analysis, the force applied to move a limb passively can be translated into physiologically relevant parameters relating to the muscle. The parameters identified and measured are the dynamic and static activity of the muscle and their interactions with the varying length of the muscle during stretch. This method of analysis has been shown to be of assistance in evaluating the reflex status of persons with central nervous system disorders in preparation for treatment and in measuring the effects of treatment.

Humans↗
PubMed1979

Chronic active hepatitis in dogs associated with leptospires.

Chronic active hepatitis was diagnosed in five American Foxhounds from one kennel. Spirochetes were demonstrated in the liver in four of the dogs. A rising titer to Leptospira interrogans serovar grippotyphosa was found in the fifth dog, although spirochetes were not demonstrated in tissues. A serologic survey at the kennel revealed evidence of exposure of 6 of 13 dogs to grippotyphosa. This is the first report of an association between chronic active hepatitis leptospiral infection in any species.

Animals↗
PubMed1979

Cardiac output and contractility indices: establishing a standard in response to low-to-moderate level exercise in healthy men.

Measurement by impedance cardiography (ZCG) of cardiac output and contractility indices during exercise is a recent addition to exercise testing of the cardiac patient. To provide a needed standard of normal responses to exercise at integrals of resting oxygen consumption (METS), 10 healthy men were tested. Basal oxygen consumption (1MET) under standardized conditions was measured by mass spectrometry. Over several days the subjects were exercised on a treadmill at 2METS through 6METS with monitoring of heart rate, electrocardiogram, oxygen consumption per minute (VO2) and ZCG. The exercise routine was then repeated to look for test-retest effect. Values closely approximating presently accepted basal oxygen consumptions were achieved under these standardized but practical conditions. Cardiac output during sitting, fully supported rest was slightly higher than that at 2METS on treadmill owing to higher stroke volume. From 2METS through 6METS the curvilinear mean heart rate and stroke volume were mirror images, producing a linear increase in mean cardiac output which at 6METS was 145% of basal and 160% of the 2MET value, while the contractility index increased to 217% of basal. Comparison of the 2 trials revealed no significant test-retest effect.

Adult↗
PubMed1978

Allergic angiitis and granulomatosis. Prolonged remission induced by combined prednisone--azathioprine therapy.

Two patients with acute, rapidly progressive generalized vasculitis initially had symptoms of asthma. Progressive increase in severity of asthma was followed by systemic disease, including pulmonary infiltrative disease, mononeuritis multiplex, and abdominal pain. Examination of the tissues demonstrated vasculitis with eosinophilia, and clinically both cases appeared in a near terminal state. High-dose prednisone did not induce a remission. In particular, the lesions of mononeuritis multiplex progressed after initiation of high-dose prednisone. The addition of azathioprine to the regimen was followed by a gradual and then complete remission of clinical and laboratory abnormalities, except for some residual nerve damage and asthma of varying severity in the two patients. These two patients, whose cases are classified as the allergic granulomatosis variant of polyarteritis nodosa, have had a remission of seven and almost two years, respectively, after combined prednisone-azathioprine therapy.

Adolescent↗
PubMed1978

The assessment of immunologic and clinical changes occurring during corticosteroid therapy for allergic bronchopulmonary aspergillosis.

Twenty-two patients with allergic bronchopulmonary aspergillosis have been treated and evaluated for a period ranging from two months to nine years. Twelve are available for periodic blood sampling. Data are presented suggesting the following: (1) Patients with allergic bronchopulmonary aspergillosis have high initial levels of total serum immunoglobulin E (IgE). These levels are significantly higher in those patients who had not been previously treated with prednisone for the control of asthma. (2) Treatment with alternate day prednisone (0.5 mg/kg given on alternate days) caused clinical and roentgenologic improvement as well as marked decreases in total serum IgE but does not necessarily prevent recurrence of the disease. (3) Total and specific IgE against Aspergillus antigen may increase prior to and during exacerbations of disease. (4) Specific IgG and IgE against Aspergillus antigen are increased in most patients with allergic bronchopulmonary aspergillosis and reflect disease activity as evidenced by x-ray and clinical exacerbations in some cases. (5) Lymphocyte transformation using Aspergillis antigen, as measured by the whole blood technic, is present in patients with allergic bronchopulmonary aspergillosis, but serial changes in lymphocyte transformation do not correlate with disease activity. (6) Precipitin reactions are present in patients with allergic bronchopulmonary aspergillosis, but presence or absence does not reflect disease activity in most cases.

Antigens, Fungal↗
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↗
PubMed1978

Long-term effects of beclomethasone dipropionate on prednisone dosage in the corticosteroid-dependent asthmatic.

The average prednisone dosage of 54 corticosteroid-dependent asthmatics was computed for one year prior to initiation of beclomethasone dipropionate. This was compared to the average prednisone dosage after nine months on the beclomethasone with progressive tapering of prednisone to either dose compatible with control of asthma or discontinuation. Beclomethasone was found clinically useful in the great majority of these patients because it permitted a significant decrease in dosage of prednisone, a change from daily to alternate-day prednisone, or discontinuation of prednisone after cautious tapering. The first two advantages were most evident in those asthmatics who initially required higher doses of oral steroids while the latter was evident in those requiring lower doses. Those patients whose prednisone dosage does not appear to be beneficially affected by the use of beclomethasone should be suspect as to adherence to proper medical dosage schedule.

Administration, Oral↗