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There is little physiologic data concerning the possible toxicity of nasal decongestants on respiratory cilia. Consequently, a chicken embryo tracheal organ culture system was employed to study the effect on ciliary activity of various preparations and concentrations of the following medications: tetrahydrozoline hydrochloride (Tyzine), xylometazoline hydrochloride (Otrivin), Dristan, Sinex, NTZ oxymetazoline hydrochloride (Afrin), naphazoline hydrochloride (Privine), and phenylephrine (Neosynephrine). Only two dilutions of injectable phenylephrine 0.25% and 0.10% produced essentially no ciliotoxicity when compared to the cilia in control cultures. All the other topical nasal medications in the concentrations tested possessed some toxicity for cilia. The use of these medications should be tempered with the warning of possible cilia damage. [ABSTRACT FROM AUTHOR]

As part of a large study designed to develop schedules for smallpox immunization with reduced morbidity, 799 children received primary immunization with subcutaneous vaccine. Four vaccines (New York City Board of Health calf lymph, New York City chorioallantoic membrane, CV-1 and Lister) at three dosages (l0(3), 10(4), 10(5) pock-forming units) were administered. Eighty-two percent responded with hemagglutination-inhibiting antibody at one month, and only 22% with neutralizing antibody. There was no correlation between concentration of vaccine and antibody response. The CV-1 strain was slightly but significantly less likely to induce antibody than the other three vaccines. Subcutaneous vaccination was not associated with significant temperature elevation in general. However, some children developed erythema at the vaccination site or a swollen arm, and fever did tend to occur in this small group. Four children developed nonspecific vaccinia-related rashes, and one had generalized vaccinia. [ABSTRACT FROM AUTHOR]

Six months after subcutaneous vaccination with one of four smallpox vaccines, 655 children were challenged with a standard percutaneous smallpox vaccine. Response to reimmunization was characterized by a significant acceleration and diminution of skin response, but not to the degree seen in an equivalent group who had received their primary immunization percutaneously. Fever after revaccination was absent if there had been a "take" with primary subcutaneous vaccination. The overall incidence of minor vaccine-related complications with revaccination was 2-1/2%. The neutralizing antibody response to revaccination was markedly reduced, as compared to that of children who received either one or two successful percutaneous vaccinations. Subcutaneous vaccination followed by percutaneous vaccination is not recommended as a schedule for smallpox immunization, because complications are not avoided, and the incidence and mean titer of resultant neutralizing antibody are low. [ABSTRACT FROM AUTHOR]

A standard challenge with percutaneous smallpox vaccine was administered to 629 children six to 12 months after percutaneous primary inoculation with one of four vaccines (New York City Board of Health strains grown in calf lymph or chorioallantoic membranes, the Lister vaccine, or the CV-1 strain). Of those who had had major reactions on primary vaccination, 8%-21% responded to revasccination with a typical primary-type skin response. In contrast, such a primary-type response occurred in 50% of those who on primary vaccination had developed serum antibody in the absence of major reactions and in 83% of those who had had no serologic or clinical evidence of primary "take." Skin lesions on revaccination tended to be largest in thosewhose primary vaccination was with CV-1, although fever and minor complications were not more frequent. Moreover, even in children who had received CV-1 vaccine, skin responses to challenge vaccine were clearly attenuated when compared with responses of children who had not had takes on primary vaccination. Sizes of lesions and acceleration of skin erytherma after challenge were related in most children to titers of both hemagglutination-inhibiting and neutralizing antibody at the time of revaccination. One month after revaccination, neutralizing antibody was present in 93%-96% of those with takes onprimary vaccination with New York City or Lister vaccines, but only 75% of CV-1 vaccines. [ABSTRACT FROM AUTHOR]

In an investigation of the antigenicity and reactogenicity of four smallpox vaccines, 786 children received primary percutaneous vaccination with vaccine in one of three concentrations, 10(6), 10(7), or10(8) pock-forming units/ml. Dose-response curves indicated that the three licensed vaccines (New York City Board of Health strains grown in calf lymph or chorioallantoic membrane, and the Lister vaccine) had similar potencies, but the CV-1 strain was about 10-fold less infectious. CV-1 also produced smaller skin lesions than the other three vaccines, and the incidence of fever in CV-1 vaccines who developed either "major reactions" or serum antibody was not significantly different from that in children in all vaccine groups with no evidence of "take." Hemmagglutination-inhibiting antibody was consistently seen in individuals who received potent New York City and Lister vaccines, and neutralizing antibody was induced in 82%-85% of children in this group who had some evidence of take (production of hemagglutination-inhibiting antibody or or major reaction). Only 30% of CV-1 vaccines with takes produced neutralizing antibody. Minor complications occurred in all groups, but most often in children who received the New York City strains." [ABSTRACT FROM AUTHOR]

The present four-center collaborative study was undertaken in an attempt to define the best vaccine and/or vaccination procedure for use in areas of the world that are free of smallpox. The study was designed to compare the effect of different vaccinial strains, viral concentrations, and routes of administration on the morbidity and antibody response associated with primary vaccination and standard challenge revaccination. Primary vaccinations were performed on 1,585 children; 49.6% of the children were vaccinated by the percutaneous route, and 50.4% received vaccine subcutaneously. The overall age and sex distributions of percutaneous and subcutaneous vaccinees were comparable, but there were marked differences in participants among the four study centers. Vaccines in Kentucky had a greater mean age; the greatest number of Negroid children were enrolled in St. Louis, and more of them were vaccinated by the subcutaneous route; and the dropout rate was much greater in San Diego and Colorado. An analysis of comparative interlaboratory serologic procedures with the use of 20 coded duplicate samples of serum revealed good agreement in the hemagglutination-inhibition test; results of neutralization tests had greater variability of mean titers. On duplicate samples of serum from study participants there was generally good correlation between each of the four study centers and the Center for Disease Control's reference laboratory in titers of hemagglutination-inhibiting antibody. In contrast, 38% of the neutralization titers determined at the four study centers were greater than or equal to 0.67 log10 higher than the respective titers noted at the Center for Disease Control. [ABSTRACT FROM AUTHOR]

Throat and bronchoscopy specimens for mycoplasma isolation studies were collected from 22 patients with chronic bronchitis and 20 patients without chronic bronchitis. Twenty-six of 50 patients attending a chronic bronchitis clinic had throat, nasal, or sputum specimens collected for attempted mycoplasma isolation, and all of these patients had multiple serum samples taken for mycoplasma antibody studies. Mycoplasmas were recovered from throat and bronchoscopy specimens of the chronic bronchitic and non-bronchitic patients with about equal frequency. The concentration of organisms in the bronchoscopy specimens of two patients with chronic bronchitis was greater than in their throat specimens, suggesting downward spread and multiplication of mycoplasmas rather than contamination by passage of the bronchoscope. Eighty-three per cent of the rises in mycoplasma antibody titre in chronic bronchitic patients occurred during or immediately after an acute respiratory illness, and this relationship of rise in antibody titre to acute illness was significantly more frequent than rises in antibody titre not associated with illness. We suggest that mycoplasmas may be present in the bronchi of some patients suffering from chronic bronchitis and that, while such mycoplasma infections are often silent, they may become sufficiently active during infection by other agents to stimulate a mycoplasma antibody response. [ABSTRACT FROM PUBLISHER]