PubMed Health⌕ Search

Biomedical subjects

D K Wagner

Publications and source records attributed to D K Wagner.

At least 37 records · Page 2Linked to original sources
PubMed1988

Dysgonic fermenter 3-associated gastrointestinal disease in a patient with common variable hypogammaglobulinemia.

A gram-negative bacteria designated DF-3 was cultured on multiple occasions from stool samples of a patient with common variable hypogammaglobulinemia and chronic diarrhea. Antibiotic therapy resulted in elimination of the organism and resolution of the patient's symptoms. DF-3 has not been linked previously to human disease; because of its fastidious growth characteristics and unique isolation requirements, it may be a rarely identified cause of diarrhea and other gastrointestinal symptoms in immunocompromised patients.

Agammaglobulinemia↗
PubMed1988

Release of soluble interleukin-2 receptors (Tac peptide) in vivo during human immune responses to tuberculin.

Cutaneous levels of soluble interleukin-2 receptor (Tac peptide) have been measured in tuberculin responses in 13 human volunteers by assaying the fluid present in suction-induced blisters at various times after injection of standard purified protein derivative of tuberculin (PPD). Low levels of Tac peptide were found in blisters without prior injection of PPD and in PPD-negative individuals, and maximal levels of Tac peptide were correlated with increased induration at 48 hr (r = 0.69, P = 0.04) in PPD-positive subjects. This is the first report of measurement of Tac peptide in vivo in a defined immune response in man, and may offer a new approach to the study of human immune function in vivo.

Adult↗
PubMed1987

Activated lymphocytes during acute Epstein-Barr virus infection.

Activated lymphocytes, as identified by HLA-DR expression, associated with acute Epstein-Barr virus (EBV)-induced infectious mononucleosis (IM) were shown to be a heterogeneous population containing significantly elevated cytotoxic/suppressor (CD8) T cells, natural killer (CD16) cells and helper (CD4) T cells. CD8 T cells were the primary activated population representing 24.5% of the total lymphocyte population. The activated CD4 T cells and natural killer cells accounted for 6.7% and 3.5% of the total lymphocyte population, respectively. Analysis of serum soluble interleukin 2 receptors (IL-2R) demonstrated significantly (p less than 0.001) elevated levels in the serum of acute IM patients compared with normal controls. Elevated levels of serum IL-2R were correlated (r = 0.67) with increased percentages of Leu 2a+/HLA-DR+T cells (i.e., activated CD8 T cells). Patients with X-linked lymphoproliferative syndrome and virus-associated hemophagocytic syndrome, two syndromes associated with severe acute EBV infections, demonstrated the most dramatic increase in serum IL-2R levels. These data demonstrate that EBV is associated with intense immune stimulation and that during acute IM activated lymphocytes, other than the CD8 T cells, may contribute to the immune response to EBV.

Acute Disease↗
PubMed1987

Analysis of immunoglobulin G antibody responses after administration of live and inactivated influenza A vaccine indicates that nasal wash immunoglobulin G is a transudate from serum.

Following intranasal administration of live influenza A virus vaccine or parenteral inoculation of inactivated influenza virus vaccine, immunoglobulin antibody to the influenza virus hemagglutinin was detected in nasal wash specimens from adult volunteers. Several observations supported the suggestion that this immunoglobulin G hemagglutinin nasal wash antibody appeared to be mainly derived from the serum by a process of passive transudation.

Adult↗
PubMed1987

Differential immunoglobulin G subclass antibody titers to respiratory syncytial virus F and G glycoproteins in adults.

Two respiratory syncytial virus glycoproteins, F and G, which differ substantially in the amount of glycosylation were used as antigens in an enzyme-linked immunosorbent assay to determine immunoglobulin G (IgG) subclass titers in 30 experimentally infected healthy adults. The titers of antibodies to the F glycoprotein achieved in postinfection sera were highest in the IgG1 subclass, whereas those to the G glycoprotein were highest and comparable in the IgG1 and IgG2 subclasses. The high IgG2 response to the G glycoprotein suggests that it is seen by the immune system as a polysaccharide antigen, a hypothesis consistent with its large carbohydrate content.

Antibodies, Viral↗
PubMed1987

Soluble interleukin-2 receptor levels in patients with undifferentiated and lymphoblastic lymphomas: correlation with survival.

We have been able to detect soluble interleukin-2 receptors (IL-2R) in pretreatment sera from 80 patients with undifferentiated lymphoma (predominantly Burkitt's lymphoma) and lymphoblastic lymphoma. The demonstration of IL-2R in lymphoma-derived cell lines by immunoprecipitation and direct staining indicates that IL-2R is synthesized by the tumor cells. Comparisons were made with two other subject groups: 42 sarcoma patients and 17 normal individuals. The distribution of soluble IL-2R values for lymphoma patients (geometric mean, 1,132 U/mL) was significantly greater than that of sarcoma patients (geometric mean, 332 U/mL; P = .0001) or normal individuals (geometric mean, 238 U/mL; P = .0001). Patients with undifferentiated lymphoma stages B, C, and D had significantly higher soluble IL-2R values (geometric mean, 1,648 U/mL) than stages A and AR (geometric mean, 706 U/mL; P = .0001) or lymphoblastic lymphoma (geometric mean, 826 U/mL; P = .0002). Within the lymphoma group, the soluble IL-2R level was found to be the most significant prognostic indicator of disease-free interval and survival when compared with other previously recognized factors such as histology, stage, bone marrow involvement at presentation, lactic dehydrogenase (LDH), uric acid (UA), and age. No factor was significantly associated with response to therapy, ie, the initial achievement of complete remission (CR) status, although small numbers of patients with a partial response limit interpretation. Soluble IL-2R levels were measured serially in two patients and were found to be elevated at presentation or relapse and to decrease to normal levels during periods of disease remission. IL-2R appears to reflect tumor burden and may prove to be a useful and specific marker for lymphoid tumors.

Adolescent↗
PubMed1987

Analysis of CD3 antigen expression in patients with ataxia-telangiectasia.

The expression of CD3 molecules by the lymphocytes of five patients with ataxia-telangiectasia was examined using the murine monoclonal antibody OKT3. By immunofluorescent staining, fewer of the patients' peripheral blood mononuclear cells and purified T cells expressed CD3 compared with normals. The proliferative response of the patients' cells to OKT3 was also less than normal. However, the mononuclear cells from all five patients produced IL-2 after OKT3 stimulation; in four patients IL-2 was normal, while one patient produced greater than normal levels. While the expression of cellular IL-2 receptors and the release of these receptors into culture supernatants was generally less in ataxia-telangiectasia patients, the levels of receptor expression were not significantly less than normal. As analysed by sodium dodecyl sulphate polyacrylamide gel electrophoresis, the CD3 molecules from ataxia-telangiectasia patients' lymphocytes were no different from those of normal individuals. These results suggest that patients with ataxia-telangiectasia have structurally normal CD3 molecules which may be used to activate cells normally for some but not all T cell functions.

Adolescent↗
PubMed1986

Antigen-specific murine T cell clones produce soluble interleukin 2 receptor on stimulation with specific antigens.

In this study, we used monoclonal antibodies to the murine IL 2 receptor (IL 2R) termed 3C7 and 7D4, which bind to different epitopes on the murine IL 2R, to develop an ELISA to measure soluble murine IL 2R. Surprisingly, stimulated murine spleen cells not only expressed cell-associated IL 2R, but also produced a considerable level of cell free IL 2R in the culture supernatant fluid. To assess the fine specificity of this response, myoglobin-immune murine T cell clones were stimulated with appropriate or inappropriate antigen and syngeneic or allogeneic presenting cells. Proliferation, measured by [3H] thymidine incorporation, and levels of soluble IL 2R were determined at day 4. The production of soluble IL 2R displayed the same epitope fine specificity, genetic restriction, and antigen dose-response as the proliferative response. Indeed, in some cases there was sharper discrimination of epitope specificity and genetic restriction with the soluble IL 2R levels. There was also reproducible clone-to-clone variation in the amount of soluble receptor produced in response to antigen among 12 T cell clones and lines tested. In time course experiments, proliferation was greatest at day 3, whereas soluble IL 2R levels continued to rise in subsequent days. To our knowledge, this is the first demonstration of release or secretion of soluble IL 2R by murine T cells, and the first demonstration of the fine specificity and genetic restriction of the induction of soluble IL 2R by specific antigen.

Animals↗
PubMed1986

Foley catheter extraction of blunt esophageal foreign bodies.

The case is reported of a successful Foley catheter extraction of two superimposed coins from the esophagus of an 8-year-old girl. The presence of the second coin was suspected only on review of the lateral cervical radiograph. In a previous report, failure to initially diagnose the presence of an additional coin resulted in an endoscopic failure to clear the esophagus. The technical aspects of Foley extraction are reviewed along with the controversy surrounding the procedure. Series totaling 294 cases document a cumulative success rate of 85% without significant complications. The technique, when performed by airway experts, is concluded to be a viable alternative to endoscopic removal. Lateral films, fluoroscopic extraction, and barium studies in select cases are recommended as safeguards against missing nonobvious foreign bodies of the esophagus.

Catheterization↗
PubMed1986

Needle aspiration of breast masses in the emergency department.

The discovery of a breast mass is often the source of great concern for a patient. The mass may, however, be no more than a benign cyst that may be treated in the emergency department. This article describes the technique of needle aspiration--a simple, safe procedure that in many cases is both therapeutic and curative.

Biopsy, Needle↗
PubMed1986

Topical cocaine prior to treatment of penile tourniquet syndrome.

A case of the penile tourniquet syndrome is reported in a 5-year-old boy. Release of the constricting strands of hair was possible only after topical cocaine achieved adequate local anesthesia. The syndrome is briefly reviewed and emergency care recommendations are made.

Anesthesia, Local↗
PubMed1986

Inhibition of neutrophil killing of Candida albicans pseudohyphae by substances which quench hypochlorous acid and chloramines.

Using a microtiter plate killing assay, we investigated the in vitro killing of Candida albicans by human neutrophils and by hypochlorous acid/hypochlorite ion (HOCl/OCl-) or chloramine solutions to evaluate the inhibition of this process by quenchers of these oxidants. Methionine, tryptophan, and alanine were able to effectively inhibit neutrophil killing of candida pseudohyphae. These substances were capable of quenching the oxidant activity of NaOCl, monochloramine (NH2Cl), and to a lesser extent, taurine chloramine. NaOCl and NH2Cl were able to kill C. albicans in the absence of inhibitors in concentrations of less than 5 microns M, whereas greater than 100 microns M taurine chloramine was required for killing. Methionine and tryptophan were capable of markedly inhibiting killing by all three oxidants, whereas alanine affected only killing by NaOCl. The oxidant activity of NaOCl was more readily quenched by opsonized or unopsonized Candida yeast than was the oxidant activity of either NH2Cl or taurine chloramine. These results suggest that some substances which quench the oxidizing activity of the products of the neutrophil myeloperoxidase system can inhibit the killing of C. albicans by these cells.

Alanine↗
PubMed1986

Serum immunoglobulin G antibody subclass responses to respiratory syncytial virus F and G glycoproteins after primary infection.

Because the immunoglobulin G (IgG) response to carbohydrate antigens is typically from the IgG2 subclass and the IgG response to protein antigens is typically from the IgG1 and sometimes the IgG3 subclass, two respiratory syncytial virus glycoproteins, F and G, which differ substantially in the amount of glycosylation, were used as antigens in an enzyme-linked immunosorbent assay to determine IgG subclass responses in 20 infants and young children with naturally acquired respiratory syncytial virus infection. Both glycoproteins elicited primarily IgG1 and IgG3 responses, indicating that the protein moieties of the glycoproteins may be immunodominant in this age group.

Antigens, Viral↗
PubMed1986

Percutaneous gastrostomy in a child.

A 2-year-old girl with cyanotic congenital heart disease needed to undergo gastrostomy. To avoid the use of general anesthesia, a percutaneous gastrostomy was performed as an interventional radiologic procedure with the patient under sedation and with the use of local anesthesia. The placement of a nasogastrocutaneous guide wire under fluoroscopic guidance provided a stable tract for placement of the gastrostomy tube.

Child, Preschool↗
PubMed1985

Epidural abscess, vertebral destruction, and paraplegia caused by extending infection from an aspergilloma.

An aspergilloma developed in a lung cyst in a 53-year-old man. Aspergillus infection then contiguously spread to the epidural space, causing an abscess, vertebral destruction, and paraplegia at the level of T4. Chronic alcoholism, liver cirrhosis, and corticosteroid treatment may have been predisposing factors in this patient. Although Aspergillus epidural abscess has been described infrequently, this complication has not been described in association with an aspergilloma. Symptoms, signs, or roentgenographic or laboratory findings suggestive of vertebral or meningeal pathologic lesions in patients with aspergilloma should alert the physician to the possibility of contiguous spread of infection.

Abscess↗
PubMed1985

Successful treatment of post-mitral valve annuloplasty Aspergillus flavus endocarditis.

Aspergillus endocarditis is associated with a very high mortality. Of approximately 67 cases reported in the English language literature, there have been only two known survivors. This report describes a patient with Aspergillus flavus endocarditis after mitral valve annuloplasty who recovered with combined surgical and antifungal therapy. This is the first successfully treated case due to A. flavus and the first involving an annuloplasty ring.

Amphotericin B↗
PubMed1985

Blastomycotic osteomyelitis of the mandible: successful treatment with ketoconazole.

Blastomycotic osteomyelitis of the mandible in a 40-year-old man was treated with ketoconazole for 26 months. Clinical, roentgenographic, and scintigraphic improvement was observed, and 13 months after cessation of treatment he remains free of disease. This case and three other previously reported cases indicate that ketoconazole is effective in the treatment of blastomycotic osteomyelitis.

Adult↗