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Biomedical subjects

J Gerstoft

Publications and source records attributed to J Gerstoft.

At least 163 records · Page 9Linked to original sources
PubMed1985

Antibodies to human T-cell lymphotropic virus type III in promiscuous healthy homosexual men. Relation to immunological and clinical findings.

Antibodies to human T-cell lymphotropic virus type III (HTLV-III Ab) were present in twenty-one out of sixty-four asymptomatic promiscuous homosexual men from Copenhagen. The presence of HTLV-III Ab was associated with lymphadenopathy (P less than 0.0005), cytomegalovirus isolation (P less than 0.01), low skin test reactivity (P less than 0.01) and episodes of fever within the 2 month period prior to investigation (P less than 0.05). No significant differences occurred in the total number of T-cells, T-suppressor cytotoxic cells, T-helper cells or helper to suppressor ratio (H/S ratio) between HTLV-III Ab positive and negative homosexuals. An H/S ratio less than or equal to 1.0 was significantly more frequent in homosexual men who both had HTLV-III Ab and excreted cytomegalovirus (P less than 0.01). The H/S ratio of HTLV-III negative homosexuals were significantly lower than that of the controls suggesting that a non-HTLV-III related immunosuppression occurs among homosexuals. Within 2 years after the investigation AIDS or the AIDS related complex developed in three of the men, who at the first investigation all had HTLV-III Ab, alterations in T-lymphocyte subsets and cutaneous anergy. It is suggested that a combination of T-cell subset determination and determination of HTLV-III Ab may provide more valuable prognostic information than isolated determination of HTLV-III Ab.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Cytotoxic capabilities of lymphocytes from patients with the acquired immunodeficiency syndrome.

Lymphocytes from 16 AIDS patients were tested in the cell-mediated lympholysis assay (CML). The ability to produce alloreactive cytotoxic lymphocytes in vitro was found to be substantially reduced when compared with concomitantly investigated normal controls. Addition of interleukin 2 (IL-2) to the inducer cultures increased the cytotoxic activity, but not to normal levels. The CML response did not correlate with the relative or absolute number of Leu 3+ cells or the proliferation in effector suspensions. The ability to produce cytotoxic cells in CML, and the degree of potentiation by IL-2, was positively correlated with the absolute number of Leu 2+ cells in peripheral blood of the patients, which was below normal in 56% of the patients. It is suggested that the low CML in AIDS patients is primarily caused by defective T-cell help. In addition patients with decreased absolute numbers of Leu 2+ cells may have a reduced number of CTL precursors. The natural killer (NK) activity of AIDS lymphocytes was reduced, but could be improved by incubation with IL-2 in vitro. The mononuclear cells from the patients showed a decreased ability to respond and to stimulate in the mixed lymphocyte culture. In one of the AIDS patients, the CML was found to induce autoreactivity in vitro.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Antibodies against HTLV-III in Danish haemophiliacs: relation to source of factor VIII used in treatment and immunological parameters.

18 out of 40 healthy Danish type A haemophiliacs had antibodies against HTLV-III as measured by an enzyme linked immunosorbent assay (ELISA). The overall seropositivity was 45%. A significant positive correlation was found between seropositivity and total lifetime dose of factor VIII and the age of the patients. 63% and 79% of the patients predominantly treated with commercial American and European preparations, respectively, had antibodies, compared with 11% among patients predominantly treated with Danish cryoprecipitate. Patients exclusively treated with preparations from a single source in the year prior to investigation showed 69% seropositivity when treated with American and European preparations. None of the patients treated with Danish cryoprecipitates prepared from voluntary Danish donors had antibodies. No difference between seropositive and seronegative groups was found in total lymphocyte count, leu 2+ cells, leu 3+ cells and leu 2+/leu 3+ ratio but the seropositive group had significantly higher total IgG and lower skin test score. It is concluded that treatment with local European preparation carries less risk of HTLV-III infection compared with commercial preparations from either the USA or Europe. The results also suggested that T-cell subset alterations among haemophiliacs are not primarily due to HTLV-III infection.

Antibodies, Viral↗
PubMed1985

The histomorphology of Kaposi sarcoma in three homosexual men.

Three homosexual men with acquired immunodeficiency syndrome (AIDS) were referred to Hvidovre Hospital, Copenhagen, during 1981. Biopsies from lymph nodes (case 2), skin (case 1 and 3), oral mucosal membrane (case 1) and lung (case 3) revealed Kaposi Sarcoma (KS). Furthermore, KS was found at autopsy in several other organs in case 3. While the tumor morphology of the lymph nodes, the oral mucosal membrane, and the internal organs was identical to that of classical KS, the skin lesions appeared different. Macroscopically, the skin lesions in case 1 and 3 were alike, but microscopically, the lesions in the two cases differed from each other. In both cases small tumor infiltrates were dispersed in the dermis with interjacent preserved dermal tissue. In case 1 the tumor infiltrates were composed of different vascular structures including irregular slits formed by dermal collagen fibres lined with long slim tumor cells. In case 2 the infiltrates were mainly composed of solid collections of pale tumor cells with faintly stained nuclei. The difficulties in establishing a diagnosis of KS on skin biopsies from patients with AIDS are emphasized.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Prognosis in glomerulonephritis. A follow-up study of 395 consecutive, biopsy-verified cases. I. Classification, renal histology and outcome. Report from a Copenhagen study group of renal diseases.

Between 1967 and 1977, 395 consecutive cases of glomerulonephritis (GN) were collected by a Copenhagen study group. The diagnosis was established by histological and biochemical criteria. Light microscopy investigations of thin silver-stained sections were applied. In a follow-up in 1980 all cases were categorized by one of the following end points: death without uremia, uremia, recovery, or censored cases. The course is presented in figures showing the cumulated distribution of outcomes in relation to observation time. Each histological subgroup of GN had its own characteristic course with respect to initial rates of changes in the renal state, as well as to frequency of recovery, uremia and death. The prognosis was good in minimal changes GN and proliferative GN, bad in unclassified GN and worst in extracapillary GN. When part of a connective tissue disease, GN carried a poor prognosis. We conclude that histological classification of GN based on light microscopy offers a reliable means of predicting the long-term prognosis.

Adolescent↗
PubMed1985

The acquired immunodeficiency syndrome (AIDS) in Denmark. A report from the Copenhagen study group of AIDS on the first 20 Danish patients.

Twenty Danish patients with the acquired immunodeficiency syndrome (AIDS) had been diagnosed by January 1984, 14 of them after 1982. Eighteen patients were male homosexuals, 8 of whom had visited the USA after 1979, 2 were heterosexual males with a history of sexual contacts in Central Africa, suggesting a transmission of AIDS from woman to man. AIDS has not been observed in drug abusers, hemophiliacs or transfused non-risk persons in Denmark. The clinical picture varied according to the presence of Kaposi sarcoma or the type of opportunistic infections, but was in general similar to that reported from the USA. Investigation of T-lymphocyte subsets revealed that the AIDS patients differed from controls and healthy homosexual men by having either a very low number of helper cells or a low helper/suppressor cell ratio. Functional immunological studies revealed a decreased natural killer cell activity and decreased blast transformation by mitogens. The survival two years after diagnosis was 16%.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Prevalence of Cryptosporidium among patients with acute enteric infection.

Twelve hundred faecal samples from patients suspected of acute enteric infection were examined for Cryptosporidium oocysts by means of a modified Ziehl-Neelsen technique. Smears prepared from the formol-ether sediment of 400 faecal samples were compared with those made directly from faeces. The numbers of positive patients were identical, but the diagnosis was easier to make with smears prepared from sediment. Cryptosporidia were found in 21 samples and after correction for duplicates the net result was 16 cases (2%) of cryptosporidiosis diagnosed among 800 patients. Except in one case Cryptosporidium was the only pathogen found. Fourteen patients had diarrhoea while excreting the parasite. All the patients recovered spontaneously within 3 weeks. Nine of them had recently travelled abroad; for three others, infected calves may possibly have been the source of infection. Carriers were not found among 120 persons without gastro-intestinal symptoms.

Acute Disease↗
PubMed1984

T lymphocyte subsets in homosexual men from Copenhagen.

Screening of sixty-six asymptomatic homosexual men from Copenhagen revealed significantly lower Leu-3a/Leu-2a ratios as compared to controls. Ten (15%) of the homosexuals had a ratio less than or equal to 1.0. The low Leu-3a/Leu-2a ratios were the result of an increase in the absolute number of Leu-2a cells. Homosexuals with many partners and those who had been sexual partners of patients with the acquired immuno-deficiency syndrome (AIDS) had significantly lower ratios than those without these features. Cytomegalovirus was isolated from urine and/or sputum of 15% and this was associated with a Leu-3a/Leu-2a ratio less than or equal to 1.0. The observed immunological abnormalities could either represent latent infection with the putative AIDS agent or alternatively be caused by repeated infections and/or exposure to allogenic spermatocytes or lymphocytes.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The prognosis of asymptomatic homosexual men with decreased T-helper to T-suppressor ratio.

Screening of 70 asymptomatic homosexual men in Copenhagen revealed that 13 (19%) had T-helper to T-suppressor (H/S) ratios less than or equal to 1.0. Clinical and immunological follow-up examinations for 2-7 months (mean, 5.2 months) disclosed that none of the 13 men developed the acquired immunodeficiency syndrome (AIDS) or AIDS-like symptoms. An increase in H/S ratios to greater than 1.0 was observed in 11 of the 13 men during the time of observation. The decreased H/S ratios were due to an increase in the T-suppressor population. The T-helper population did not at any time differ from that found in 31 male control subjects. The biological relevance of the observed decrease in H/S ratios was supported by the demonstration of a positive correlation to a decrease in the proliferative response of the lymphocytes. Serological studies did not reveal any specific infectious background for the low H/S ratio found in the 13 men, and the reason for the 'spontaneous' increase during the time of observation remains unknown. The present results indicate that most asymptomatic homosexual men with a decreased H/S ratio will experience normalization of the immunological variables.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Alterations in T-lymphocyte subsets among Danish haemophiliacs: relation to source of factor VIII preparations and high dose factor VIII treatment.

Screening of 43 healthy Danish haemophiliacs revealed a significantly lower helper/suppressor (H/S) ratio than in controls. 8 of the haemophiliacs had an H/S ratio less than or equal to 1.0. A significant negative correlation occurred between the total lifetime factor VIII treatment and the H/S ratio. However, high-dose factor VIII treatment given to patients with antibodies against factor VIII was not associated with immunological abnormalities. Children had a significantly higher H/S ratio than the adult haemophiliacs. Patients exclusively treated with Danish cryoprecipitate during the last year had a significantly higher H/S ratio than patients receiving preparations from other sources. This difference might, however, be explained by lower age and lower total lifetime dose in the group receiving Danish preparations. Haemophiliacs treated with American preparations did not differ immunologically from those treated with preparations of other origin. Total serum IgG was increased in 23% of the patients. This parameter was negatively correlated with the H/S ratio. The possible relation of the observed immunological alterations among otherwise healthy haemophiliacs to the acquired immune deficiency syndrome warrants further attention.

Adolescent↗
PubMed1984

Cytomegalovirus retinitis in the acquired immunodeficiency syndrome (AIDS). Light-microscopical, ultrastructural and immunohistochemical examination of a case.

The light-microscopical, ultrastructural and immunohistochemical findings in the first reported European case of ocular changes in the acquired immuno-deficiency syndrome (AIDS) are presented. The syndrome occurred in a 31-year-old homosexual man who died of Kaposi sarcoma in the skin and internal organs, cytomegalovirus (CMV) infection of the larynx, the lungs and the small intestine, and mycobacterial infection of the lungs, the lymph nodes and the spleen. A right-sided necrotizing retinitis was shown to be caused by CMV and was clinically and histopathologically similar to previously described changes in CMV retinitis. CMV was cultured from the left eye where no ophthalmoscopic changes were observed. It is stressed that in these cases regular ophthalmological examination is advisable, even if no ocular complaints are present.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Increased prevalence of cytomegalovirus antibodies in homosexual men with syphilis: relation to sexual behaviour.

Serum samples from 146 homosexual males, 40 heterosexual males and 51 females with at least one episode of syphilis were tested for the presence of IgG and IgM antibodies against cytomegalovirus (CMV IgG and CMV IgM). 100 blood donors served as a control group. CMV IgG was present in 95% of homosexual men compared with 68% of heterosexual men (p less than 0.001) and 73% of females (p less than 0.001) with past or present syphilis. CMV IgM was found in 43-68% of the venereal patients and with the highest percentage in homosexual men. Only 7% of blood donors had CMV IgM. It is concluded that CMV infection may be regarded as a venereal disease.

Adolescent↗
PubMed1984

Cryptosporidium enterocolitis in homosexual men with AIDS.

Two homosexual Danish men with the acquired immunodeficiency syndrome (AIDS) contracted cryptosporidium enterocolitis. One patient died in another opportunistic infection, the other developed severe chronic enterocolitis with malabsorption. The cryptosporidia escape detection on routine stool examination, but are easily demonstrated by a modified Ziehl-Neelsen stain. It is suggested that this procedure should be applied when persons from AIDS high risk groups or patients with other forms of immunological incompetence develop prolonged diarrhoea.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The renal excretion of prostaglandins and changes in plasma renin during treatment with either sulindac or naproxen in patients with rheumatoid arthritis and thiazide treated heart failure.

Ten patients with rheumatoid arthritis (RA) and concomitant heart failure were treated with either naproxen or sulindac in an open randomized study to study the drugs' effects on the urinary excretion of prostaglandins on the plasma renin level and on the renal function of the group. Both drugs were given for 14 days and caused a similar and marked decrease in renal excretion of the prostaglandins PGE2 and PGF2 alpha and in plasma renin in all patients. There was no significant effect on the diastolic blood pressure, the body weight or the 24-h creatinine clearance and the clinical effect on the joint symptoms was identical. We conclude that both sulindac and naproxen inhibit the renal prostaglandin synthesis in patients with RA.

Adult↗
PubMed1983

[New aspects of AIDS].

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Acquired Immunodeficiency Syndrome↗
PubMed1982

Severe acquired immunodeficiency in European homosexual men.

Four previously healthy Danish homosexual men developed Kaposi's sarcoma or opportunistic infections with fever of unknown origin and lymphadenopathy. One patient died of a Pneumocystis carinii pneumonia. Three patients had defective cell-mediated immunity with absent leucocyte interferon production and decreased proliferative response to mitogens and antigens. T lymphocyte helper subsets and natural killer cell activity were reduced. Unstimulated mononuclear cells produced leucocyte migration inhibitor factor. Two patients were sexual partners and three had never been to the USA, where cases of severe acquired immunodeficiency have been reported. Thus, the syndrome must also be suspected in European homosexual men who present with fever of unknown origin, opportunistic infections, or Kaposi's sarcoma.

Adult↗