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Biomedical subjects

W B Klaustermeyer

Publications and source records attributed to W B Klaustermeyer.

At least 55 records · Page 3Linked to original sources
PubMed1983

Delayed cutaneous hypersensitivity in normals: choice of antigens and comparison to in vitro assays of cell-mediated immunity.

In 81 normal subjects, ages 19 to 100 yr (mean 52), we studied the prevalence of positive 48 hr skin reactions to six antigens: fluid tetanus toxoid, Candida albicans, SK/SD, Trichophyton, PPD, and coccidioidin. Of these, C. albicans was most frequently reactive (92%); SK/SD (51%) and tetanus (49%) were less so. Each of the remaining three antigens was reactive in less than 42% of the subjects. The minimum number of antigens required to detect delayed hypersensitivity in 100% of subjects was two: C. albicans and tetanus. We found no correlation between skin reactivity at 20 min, 6 hr, and 48 hr for most of the antigens studied, suggesting different mechanisms for reactions occurring at each time. In 60 of the subjects, lymphocyte stimulation index (LSI) with tetanus toxoid and monocyte chemotaxis (MC) assays were done. The natural log of the area of induration at 48 hr after tetanus skin testing (I48) increased as a function of LSI (p less than 0.005) and MC (p less than 0.025) by multiple regression analysis. Skin testing was less sensitive than LSI as a test for cell-mediated immunity in our population. However, because of availability and correlation with LSI, delayed cutaneous hypersensitivity should be tested initially. For this purpose, tetanus toxoid appears to be a useful antigen when used in combination with C. albicans.

Adult↗
PubMed1983

Acute symptoms secondary to formaldehyde exposure in a pathology resident.

Formaldehyde is ubiquitous and found at work and at home. The National Institute of Occupational Safety and Health (NIOSH) lists fifty-two occupations with substantial formaldehyde exposure. Pathology is one such occupation. This report describes the incapacitating symptomatology that developed from formaldehyde exposure in a pathology resident. Diagnosis and management of formaldehyde hypersensitivity are discussed and the literature reviewed.

Adult↗
PubMed1983

Intranasal beclomethasone in severe rhinosinusitis and nasal polyps.

The study was designed to measure the effect of inhaled beclomethasone on patients with severe symptomatic rhinosinusitis and nasal polyposis following 12 weeks of therapy. Only one of eight patients had improved nasal symptoms and a reduction in the degree of nasal obstruction. Except for an occasional patient intranasal beclomethasone in the recommended dosage is not effective in the management of chronic severe symptomatic rhinosinusitis.

Administration, Intranasal↗
PubMed1982

A comparison of skin and bronchial reactivity in asthmatic patients using single, group related and unrelated antigen mixtures.

To test the hypothesis that mixtures of antigens may provide an efficient technique for bronchial challenge, the authors measured the airway response to challenge with individual antigens and groups of related and unrelated antigens. The data suggest that the hypothesis is correct for grass antigens. Grass antigens were associated with all positive challenges observed in the group challenges. Positive bronchial challenges were not found in the mixtures that did not contain grass antigen.

Adult↗
PubMed1981

Inhibition of methacholine-induced bronchoconstriction with reproterol, a new beta agonist-xanthine derivative.

This study compared the efficacy of single oral doses of a new beta adrenergic agonist-xanthine derivative, reproterol, with placebo by measuring the degree of induced bronchodilation and inhibition of response to methacholine challenge in patients with bronchial asthma. In comparison with placebo, 30 mg reproterol was an effective bronchodilator. Attenuation of the response, but not complete blockage of the methacholine-induced bronchoconstriction, was observed with 30 mg reproterol. Methacholine-induced bronchoconstriction is of use in assessing effect and mechanism of the action of new pharmacologic agents.

Adult↗
PubMed1981

Inhibition of antigen-induced bronchoconstriction with reproterol, a new beta agonist-xanthine derivative.

The purpose of this study was to compare the efficacy of a new bronchodilator, reproterol with standard bronchodilators terbutaline and theophylline in patients with allergic asthma. Efficacy was determined by measuring the initial bronchodilating effect and the inhibition of antigen-induced bronchoconstriction. In a double-blind, randomized, controlled study with single doses of medication, patients were given reproterol (20 mg and 30 mg), anhydrous theophylline (200 mg), terbutaline (5 mg) and placebo prior to challenge with antigen. Prior to administration of antigen both reproterol and terbutaline had measurable bronchodilating effect when compared to placebo. The bronchodilating effect of theophylline was less than placebo. In comparison to placebo both doses of reproterol and terbutaline significantly attenuated the response to antigen challenge whereas the effect of theophylline was negligible.

Adult↗
PubMed1980

Mortality in status asthmaticus: a nine-year experience in a Respiratory Intensive Care Unit.

Failure to recognize the severity of an asthmatic attack and its consequent lack of aggressive management have been incriminated as contributing factors in mortality from asthma. We reviewed our experience with patients in status asthmaticus admitted to the Respiratory Intensive Care Unit (RICU) over a nine-year period to determine the course and mortality of patients managed in the RICU. Between May, 1968, and April, 1977, 86 patients in status asthmaticus were admitted, 11 with multiple admissions, for a total of 111 admissions. There were two fatalities recorded. Psychological dependence on therapeutic modalities probably contributed to these two deaths, and both may have been preventable. The low mortality rate probably reflects the more intensive management and monitoring that these severe asthmatics receive in an RICU setting.

Acute Disease↗
PubMed1980

A comparison of diluent and methacholine challenge with spirometry and the body plethysmograph.

Bronchial reactivity to inhaled diluent and methacholine was determined for asthmatics using automated spirometry. These data were compared with challenge data from a matched group of asthmatics previously studied plethysmographically. High correlations were obtained between all indices both groups, suggesting that spirometry is adequate for the clinical characterization of the methacholine response.

Adult↗
PubMed1980

Intravenously given methylprednisolone in refractory asthma.

A study was designed to compare the time course response of two high-dose methylprednisolone regimens in adult refractory corticosteroid-dependent asthmatics: Group A received 125 mg intravenously every six hours for three days; group B received 125 mg every six hours for ten days. Sixteen patients during 22 hospital stays were randomly assigned to one of the two groups. Forced vital capacity (FVC), forced expired volume in one second (FEV(1)) and forced expiratory flow between 25 percent and 75 percent of vital capacity (FEF(25%-75%)) improved significantly over the ten days in both groups (P<.005) in all patients. No differences in baseline two-, four-, seven- or ten-day spirometric values were noted between groups (P>.2). In most steroid-dependent asthmatic patients, three days' therapy with 125 mg every six hours of methylprednisolone given intravenously resulted in obvious and sustained ventilatory improvement. Close observation with spirometric and clinical evaluation is then necessary to detect the occasional patient in whom relapse will occur and longer periods of high-dose steroid therapy will be needed.

Asthma↗
PubMed1980

Aseptic necrosis of the femoral head in corticosteroid-treated pulmonary disease.

During a ten-year period, aseptic necrosis of the femoral head developed in six patients with pulmonary disease treated with corticosteroids. Five of the six patients had severe bronchial asthma. The sixth patient had desquamative interstitial pneumonia. The literature provides some insight into the possible pathogenesis of corticosteroid-related aseptic necrosis of the femoral head and factors that may prevent this complication.

Adult↗
PubMed1980

The asthmatic airway response to inhaled antigen.

The airway response to inhaled antigen was measured in asthmatic patients at 5, 10 ad 20 minutes following bronchial challenges. The over-all frequency of positive responses in the 26 individual challenges was 27%. There were no significant differences between the 5-, 10- or 20-minute responses. Patients with positive responses to bronchial challenge manifested high grade skin reactivity by intradermal tests. Positive responses to bronchial challenge occurred only at 1 X 10(-3) weight/volume (w/v) concentration of inhaled antigen. Although the degree of methacholine reactivity was related to positive antigen challenge, two subjects with a positive challenge had minimal methacholine reactivity.

Adult↗
PubMed1979

Characteristics of the asthmatic airway response to inhaled diluent.

This study was designed to analyze the airway response to an aerosolized diluent in patients with asthma. Fifty percent of the patients responded to diluent with less than a 10% variation from baseline (non responders), but 20% of the patients responded with more than a 25% difference from baseline (responders). This study stresses the need for control data with diluent prior to bronchial challenge with a provocative agent.

Aerosols↗