Biomedical subjects
M J Chusid
Publications and source records attributed to M J Chusid.
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A nosocomial pneumococcal wound infection.
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Pseudomonas pneumonia associated with use of a home whirlpool spa.
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The effect of temperature on the chemiluminescence response of neutrophils from rainbow trout and man.
An investigation was undertaken to evaluate the ability of rainbow trout neutrophils to function at the normal temperatures for this species. These studies were carried out with the chemiluminescence (CL) assay and the results were compared to those obtained with cells from man. The magnitude of the CL response was approximately equivalent for the 2 species, but trout neutrophils developed peak responses at lower temperatures than did human neutrophils. However, at the normal body temperatures for the 2 species, the peak of the CL response to a phagocytic but not to a soluble stimulus was more delayed for trout neutrophils than for those of man. The response of trout neutrophils to a phagocytic stimulus was more rapid at 23 degrees C than at 15 degrees C, the normal temperature for trout. Neutrophil oxidative metabolism thus appears to be adapted fairly well to the relatively low temperatures at which rainbow trout live, although the response to a phagocytic stimulus appears to develop more rapidly at a somewhat higher temperature.
Defense against infection with filamentous fungi in rainbow trout.
1. Healthy rainbow trout effectively resisted infection after subcutaneous inoculation with isolates of filamentous fungi recovered from cutaneous infections in fish. 2. The organisms were capable of growth on the tissues of freshly sacrificed fish following inoculation by the same method. 3. Microscopic examination of the inoculation sites revealed a prominent cellular infiltrate with higher proportions of neutrophils than those found at control sites or in peripheral blood. Inflammatory cells were found to be adherent to the surface of fungal hyphae removed from the inoculation site after 24-72 hr. 4. Neither precipitating antifungal antibody nor plasma factors capable of inhibiting fungal growth were found in the fish used in these experiments. 5. These studies suggest that inflammatory cells, particularly neutrophils, may be involved in the defense against filamentous fungi by rainbow trout.
Antibiotic synergism in experimental Pseudomonas aeruginosa infections.
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Ga-67 chest imaging. Chronic granulomatous disease.
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Experimental Pseudomonas aeruginosa sepsis: absence of synergy between ticarcillin and tobramycin.
An in vivo model of Pseudomonas aeruginosa sepsis was developed with normal and neutropenic guinea pigs injected intravenously with a strain of Pseudomonas demonstrated in vitro to be synergistically susceptible to ticarcillin and tobramycin. Therapy with ticarcillin, tobramycin, or a combination of the two starting 4 hr after intravenous injection of microorganisms was administered every 2 hr for periods up to 40 hr. Each therapy was associated with significant reductions in bacterial counts in blood, liver, spleen, and kidney compared with untreated animals. In no tissue in either normal or granulocytopenic animals did therapy with a combination of ticarcillin and tobramycin reduce bacterial counts significantly more effectively than did the better single antibiotic agent alone. These findings suggest that when ticarcillin and tobramycin are administered to animals at doses equivalent to therapeutic doses given in humans, a synergistic effect in reduction of bacterial counts in parenchymal organs and blood is not observed. These studies may help explain clinical reports in humans describing a lack of synergistic activity of combination antibiotic therapy in patients with Pseudomonas sepsis.
A retreat for first-year house staff members.
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Splenic torsion in an infant associated with secondary disseminated Hemophilus influenzae infection.
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Colitis in chronic granulomatous disease.
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Diarrhea induced by sorbitol.
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Imaging the intracranial complications of Hemophilus influenzae meningitis.
Computed tomography (CT) and radionuclide imaging of the central nervous system (CNS) are important modalities in both the diagnosis and management of CNS complications from Hemophilus influenzae meningitis. Both examinations are sensitive indicators of CNS abnormalities associated with bacterial meningeal infections and are important determinants of the therapy and ultimate prognosis of such complications. Representative findings from CT and radionuclide imaging of children with complications from H. influenzae infection of the meninges are presented.
Ga-67 imaging: Kawasaki disease.
The authors describe a child with Kawasaki disease (mucocutaneous lymph node syndrome), in whom myocardial inflammation associated with the disease was readily detected with Ga-67 imaging.
Pneumococcal arthritis and osteomyelitis in children.
Five children with pneumococcal bone and joint infections are described. Three of the children were less than one year of age and two had sickle cell disease. All but one had a primary or coincident focus of acute pneumococcal infection elsewhere. In the four children with septic arthritis, osteomyelitis was diagnosed subsequently in bones contiguous to the infected joint. All patients were successfully treated, although one developed permanent joint dysfunction. Although an unusual infection, pneumococcal infection of bones and joints should be sought in the appropriate clinical setting since such infection requires specific surgical therapy and may be associated with significant morbidity.
A genetic defect of granulocyte oxidative metabolism in a man with disseminated aspergillosis.
A 26-year-old man presented with progressive pneumonia, and Aspergillus was grown from cultures of lung, cutaneous nodules, and urine. His PMNs had a poor CL response after exposure to phagocytic stimuli (S. aureus, latex, aggregated IgG and IgG-coated latex) (p less than 0.01 vs. controls) and soluble stimuli (PMA, sodium fluoride, and Con A) (p less than 0.05). His PMNs failed to reduce NBT, oxidize 14C-1 glucose (p less than 0.001), or iodinate proteins (p less than 0.001), normally, compared with controls, and his PMNs killed Candida albicans and Staphylococcus aureus abnormally (p less than 0.05). The patient was anergic; his plasma inhibited responsiveness of his lymphocytes to stimulation with Aspergillus and Candida antigens. His lymphocytes failed to produce the lymphokine LMIF normally. The patient's 10-month-old daughter was demonstrated to have the same defects of PMN metabolism and function. The findings in this patient were similar to those in CGd, but transmission of the defect from father to daughter and the presence of lymphocyte abnormalities make this diagnosis unlikely. Inhalation of Aspergillus by patients with defective PMN oxidative metabolism may be associated with development of significant infection.
Experimental bacterial keratitis: a quantitative model of leukocyte migration following transfusion.
A model for the study of polymorphonuclear leukocyte (PMN) migration after transfusion employing induction of keratitis in guinea pigs was developed. Initial studies demonstrated that compared with other agents, intracorneal injection of Pseudomonas aeruginosa following in vivo labelling of PMN by administration of 3H-thymidine produced the greatest influx of radiolabelled PMN into corneas. In subsequent studies, donor peritoneal PMN were radio-labelled by injection of donors with 3H-thymidine. Neutropenia was induced in recipients by whole body irradiation, and they were infected intracorneally with Pseudomonas prior to transfusion. Corneal radioactivity was assayed 24 h after induction of keratitis and the number of donor PMN in corneas was calculated. Half-life of transfused PMN in non-neutropenic recipients was 1.9 h. Arrival of labelled PMN at infected corneas in recipient animals ranged between 0.1-1.0% of transfused cells. Exposure of donor PMN to sonication or to 45 degrees C for 20 min reduced the proportion of PMN arriving at infected corneas (P less than 0.001). Storage of PMN for 24 h at 4 degrees C led to a greater ingress of donor PMN compared with storage at 37 degrees C (P less than 0.01). This model allows quantitation of in vivo PMN function after transfusion and should allow assessment of the effects of most aspects of PMN transfusion technique upon such function.