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Biomedical subjects

N Bornstein

Publications and source records attributed to N Bornstein.

At least 55 records · Page 3Linked to original sources

CT and MRI in late-onset metachromatic leukodystrophy.

A 23-year-old patient suffering from mental deterioration was referred for CT study following her first epileptic fit. The study disclosed generalized atrophy and diffuse symmetric white matter hypodensities. Similar findings were found in her 13-year-old retarded sister. The diagnosis of metachromatic leukodystrophy (MLD) was confirmed by the finding of low arylsulfatase A (ASA) levels in cultured fibroblasts in both sisters. MRI study revealed widespread high intensity signals of T2 nature in the periventricular regions indicating changes in white matter composition.

Adult↗

Septicemia caused by Sphingobacterium multivorum.

Sphingobacterium multivorum was isolated in pure culture from the blood of a man undergoing chemotherapy for a lymphoma. He responded to appropriate antibiotics and later showed a significant rise in specific serum antibodies. Carbon substrate assimilation tests and fatty acid analysis proved useful in identifying the organism precisely.

Anti-Bacterial Agents↗

Computed tomographic findings of brain and skull in myotonic dystrophy.

Twenty-four patients with myotonic dystrophy underwent computed tomographic examination of the skull and brain. The results were compared with those of 20 normal subjects of similar age and sex distribution. Microcephaly and thickening of the calvarium were frequently observed. Some cases showed basal ganglia calcification. Our findings confirm that cranial hyperostosis and brain pathology is a common manifestation of this systemic disease.

Adult↗

Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia.

The prevalence of antibodies to 13 antigens of Legionellaceae were compared in three populations: 583 blood donors, 140 tuberculosis patients and 66 patients with acute non Legionellosis pneumonia. Antibody levels were determined by indirect immunofluorescence (IFA) using formalized antigens prepared from bacteria developed in embryonated hen yolk sac. The very weak prevalence of anti L. pneumophila antibodies in a healthy population [almost nil for serogroups 2, 3, 4 and 5; 1.5% for serogroup 6, maximum of 2.5% for serogroup 1 (titres of 16)] confirms the positive and presumptive criteria that have been recommended by Centers for Disease Control (CDC). But as regards the other Legionellae studied, these criteria cannot be applied owing to the prevalences that are higher in healthy populations (until 14.5% with levels of 16-32 and 1% with levels of 64-128 for L. bozemanii) and clearly amplified in tuberculosis patients and in acute pneumonia. Although the significance of these antibodies remains to be discussed, with formalized antigens, it seems reasonable as regards these species to assign a threshold of 256 for the presumptive and positive criteria following seroconversion.

Adult↗

[Doxycycline treatment of experimental legionellosis in guinea pigs infected by aerosol].

The efficacy of curative and preventive treatment by doxycyclin was studied with the same experimental model as during the study of erythromycin [14]. The infectious aerosol was done with a strain of Legionella pneumophila serogroup 1, Philadelphia (ATCC 33152). Male albinos Dunkin-Hartley guinea-pigs were exposed for 30 min to an aerosol dose of 1, 10 or 100 LD 50 (10(3), 10(4) or 10(5) viable organisms). After preliminary assays to find out the efficient posology, doxycyclin was administered intraperitoneally (IP) 18 h after the infection at a dosage of 60 mg/kg/day for 5 days in the animals infected with 1 LD 50, and 75 mg/kg/day in the animals with 10 and 100 LD 50. The preventive treatment (75 mg/kg/day) administered one day before and the day of the infection was tested with animals infected with 10 LD 50. The guinea-pigs were observed 8 days (weight, rectal temperature) and watched over 3 weeks after the end of treatment; serological and bacteriological tests (cardiac blood, lungs, spleen) were performed in every animal; doxycyclin assays (serum, lungs) during treatment were performed by high performance liquid chromatography (HPLC). The treatment of guinea-pigs infected by 1, 10 and 100 LD 50 gave a survival rate of 100%, 75% and 50% respectively. On the other hand the animals which received preventive treatment were all survivors. Seroconversions with antibody titres from 64 to 512 were observed for all the survivors. Bacteriological tests were all negative. The mean doxycyclin concentrations in serum (microgram/ml) and lung (microgram/g) were 1.66 and 11.42 after 24 h of treatment and 5.71 and 18.93 after 7 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗

[Treatment with erythromycin of experimental legionellosis in guinea pigs infected by aerosol].

The infectious strain L. pneumophila serogroup 1 Philadelphia (ATCC 33152) was cultured on charcoal dialysed yeast extract agar medium (CDYE agar) which produces more virulent strains than those grown on classical agar media. The aerosol was dispersed in a depression chamber by means of a nebuliser and the density was controlled by a density probe. Male albinos Dunkin-Hartley guinea pigs weighing 250-300 g were exposed for 30 minutes to an aerosol dose of 1 LD50 (10(3) viable organisms) and 10 LD50 (10(4) viable organisms). Erythromycin lactobionate (Abbott) was administered subcutaneously 18 hours after the infection, at dosages of 270 mg/kg/day for 4 days in the animals treated with 1 LD50 and for 6 or 7 days in the animals treated with 10 LD50. The guinea pigs were observed for 9 days (weight, rectal temperature; serological and bacteriological tests (cardiac blood, lungs, spleen) and erythromycin assays (serum, lungs) were performed and compared in the treated animals, the non-treated infected control animals and the control animals which only received erythromycin. The percentage survival in the treated guinea pigs after inhalation of 1 LD50 and 10 LD50 (2 tests) were 100%, 75% and 87.5% respectively. Three weeks after treatment, the survivors had antibody titres from 32 to 1,024; the bacteriological cultures and erythromycin assays were negative. In this study, an improvement in the treatment of experimental Legionnaires' disease was observed in comparison with previous experiments. The increased dosage and duration and the early initiation of treatment resulted in survival rates of 75%.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Prevalence of anti-Legionella antibodies in a healthy population and in patients with tuberculosis or pneumonia.

The prevalence of antibodies to 13 Legionella antigens was compared in three populations: 583 blood donors, 140 tuberculosis patients and 66 patients with acute non-legionellosis pneumonia. Antibody levels were determined by indirect immunofluorescence (IFA) using formalin-fixed antigens prepared from bacteria developed in embryonated hen yolk sac. The very weak prevalence of anti-L. pneumophila antibodies in a healthy population [almost 0 for serogroups (SG) 2, 3, 4 and 5; 1.5% for SG 6 and a maximum of 2.5% for SG 1 at a titer of 1: 16] confirms the criteria that have been recommended by the Centers for Disease control, USA. For the other legionellae studied, these criteria cannot be applied due to a higher prevalence in healthy populations (14.5% with levels of 1: 16-32 and 1% with levels of 1: 64-128 for L. bozemanii and progressively decreasing by as much as 2% for the other species: L. micdadei, L. longbeachae, L. gormanii, L. dumoffii and L. jordanis), in tuberculosis patients (12.1% with a level at 1: 64-128 for L. bozemanii, and for the same titer, 9.2% for L. gormanii, 5.7% for L. micdadei, 5% for L. longbeachae 2), and also in acute pneumonia (2 to 3.3% with levels of 1: 64-128 for L. longbeachae 1 and 2, L. jordanis, L. dumoffii, L. micdadei and L. bozemanii). Although the significance of these prevalences remains to be discussed, with formalin-fixed antigens, it seems reasonable for these species to assign a threshold of 1: 256 for the presumptive serodiagnosis following seroconversion.

Antibodies, Bacterial↗

Epidemiological evidence of legionellosis transmission through domestic hot water supply systems and possibilities of control.

The use of epidemiological markers for a survey is essential because of the ubiquity of legionellae, particularly L. pneumophila serogroup (SG) 1. The two settings under study were an administrative building associated with a fatal Legionnaires' Disease (LD) case due to L. pneumophila SG 1, and a hospital with 11 cases due to L. pneumophila SG 1 and 3 cases due to L. anisa. Monoclonal antibody serotyping allowed us to establish a link between the outbreaks of LD and the contamination of the hot water supply systems. Two subtypes of L. pneumophila SG 1 and L. anisa were detected in the hospital water system. However the finding of only one subtype of L. pneumophila SG 1 in the patients raised the problem of the difference in virulence of each Legionella strain. By means of aerosol tests on normal and cyclophosphamide-immunosuppressed guinea pigs, we demonstrated the potential pathogenicity of hospital water in the immunosuppressed animals. Two decontamination methods were applied: chlorination and a rise in hot water temperature. Time-limited control measures in the hospital were inadequate, resulting in only temporary eradication, followed by a rapid recolonization of legionellae and the appearance of new nosocomial cases. Decontamination of the administrative building was found to be effective when a constant concentration of 5 ppm free chlorine was obtained at tap outlets, and the water temperature was maintained at 55 C.

Cross Infection↗

Isolation of Legionella anisa from a hospital hot water system.

Several cases of Legionnaires' disease occurred in a French hospital in 1982. Thirteen strains of a legionella-like organism with several unusual characteristics were subsequently isolated from the hospital hot water system. The various features of these strains show that they are identical to the new species 'Legionella anisa' described by the Centers for Disease Control. The possible pathogenicity of these strains to man and their relationship with the recently described Legionella bozemanii serogroup 2 are discussed.

Animals↗

Determination of the activity on Legionella of eight macrolides and related agents by comparative testing on three media.

It has proved difficult to develop a standard method for the determination of minimum inhibitory concentrations (MICs) of antibiotics against the Legionellaceae. A major obstacle has been the inactivation of certain antibiotics by components of Charcoal Yeast Extract agar, especially charcoal. To determine the MICs of eight macrolides and related agents (erythromycin, spiramycin, oleandomycin, josamycin, midecamycin, lincomycin, clindamycin and pristinamycin) for 36 strains of Legionella, we used two charcoal-free media: Buffered Yeast Extract agar and Buffered Antibiotic Medium no. 1 (BAM1), the latter having been developed in our own laboratory. The inhibitory effect of charcoal was most marked on josamycin and pristinamycin. This effect was absent on the charcoal-free media, which both, however, inhibited spiramycin. BAM1 agar seemed the better of the two charcoal-free media as it gave more consistent growth. The most active agents were josamycin (0.06-0.25 mg/l), pristinamycin (0.06-0.5 mg/l) and erythromycin (0.12-0.5 mg/l). Midecamycin (0.12-1 mg/l) and spiramycin (1-5 mg/l) also had useful activity.

Anti-Bacterial Agents↗

Septicemia caused by Agrobacterium sp.

Agrobacterium radiobacter biovar 2 was repeatedly grown from the blood of an elderly patient receiving artificial ventilation and broad-spectrum antibiotics. No source of the organism was found, but the septicemia ceased when cefotaxime was given. Sera from the patient showed a fourfold rise in antibody against the organism and higher titers than sera from all but 1 of 50 healthy blood donors. The organism did not contain the plasmid associated with plant oncogenicity. This case may be only the second in which Agrobacterium sp. has been clearly linked with human infection.

Aged↗

[Evaluation of the incidence of serological cross reactions between Legionella and Mycoplasma or Chlamydia].

Because of the possible serological cross reactions frequently described in the literature between L. pneumophila and M. pneumoniae or between L. pneumophila and Chlamydia, we decided to determine their frequency with our sera and our own methods. The anti M. pneumoniae and Chlamydia antibodies were researched in 162 sera samples from 46 cases of legionellosis serologically diagnosed and in 51 sera from 26 hyperimmunised rabbits. Conversely, anti L. pneumophila antibodies were researched in 165 sera from mycoplasmosis (61) or chlamydiosis (25 cases). None of the sera from mycoplasmosis or chlamydiosis tested by IFA and MA had antilegionella antibodies. None of the rabbits' sera hyperimmunised with Legionella had anti M. pneumoniae or Chlamydia antibodies. On the contrary, by complement fixation and IFA, out of the 46 cases of legionellosis under study, 6 showed a seroconversion in M. pneumoniae and 2 in Chlamydia. The Ig class determination did not show IgM titers in 7 of these 8 sera. The mechanisms of these cross reactions are discussed: antigens and methods used, booster effect during legionellosis, concurrent mycoplasmosis or chlamydiosis.

Agglutination Tests↗

Pain and hyperpathia in pontine haemorrhage.

A 56-year-old man had acute onset of left sided weakness, spontaneous pain and hyperpathia in the left limbs. CT demonstrated a small pontine haemorrhage, in the floor of the fourth ventricle.

Cerebral Hemorrhage↗

Comparison of microagglutination with the indirect immunofluorescence assay for the diagnosis of infection with Legionella pneumophila serogroup 1.

A comparison was made of the indirect immunofluorescence assay and microagglutination in the diagnosis of infections caused by Legionella pneumophila serogroup 1. Control sera consisted of 709 sera from patients without pneumonia and 99 sera from patients with Mycoplasma or Chlamydia infection. The 468 test sera were from 51 patients with serologically confirmed or suspected Legionella pneumophila serogroup 1 infection, and from 230 patients with pneumonia of unknown aetiology. There was good agreement between the results of the two methods for detection of antibodies to Legionella pneumophila serogroup 1. However, contrary to what is currently reported in the literature, microagglutination was the more sensitive method in this study, especially if the first serum samples were compared. The detection of IgM by microagglutination probably explains this increased sensitivity.

Agglutination Tests↗

[Severe Legionella pneumopathy in an immunologically normal infant].

A case of legionnaires' disease is described in a 9 months old boy. He had a rapidly extensive bilateral pneumoniae. There was no premorbidity. The diagnosis was made by demonstrating legionella pneumophila serogroup 1 in pulmonary biopsy and pleural liquid, by direct immunofluorescence assay and positive culture. There was no seroconversion. An adenovirus type 2 was also isolated in pulmonary biopsy, with an strong seroconversion. The course was favorable, with Doxycycline therapy.

Humans↗