PubMed Health⌕ Search

Biomedical subjects

P D Walzer

Publications and source records attributed to P D Walzer.

At least 109 records · Page 6Linked to original sources
PubMed1980

Serum immunoglobulin levels in childhood Hodgkin's disease. Effect of splenectomy and long-term follow-up.

Children with Hodgkin's disease had significantly elevated serum IgG and IgA levels but normal IgM and IgD levels when compared with healthy age- and sex-matched controls. The increased serum IgG and IgA levels occurred in all four clinical stages of Hodgkin's disease but were not related to histologic cell type. Following staging splenectomy, serum IgG, IgA, and IgD levels fell by 20% in patients who recieved radiation therapy then returned to preoperative levels; by contrast, serum IgM levels fell by 50% and remained there for at least 36 months. Patients who received chemotherapy had a persistent decline in serum levels of all immunoglobulin classes by at least 40%. Thus, staging splenectomy per se appears to be at least partly responsible for the postoperative decline in serum IgM levels and this effect is enchanced by aggressive treatment of the Hodgkin's disease.

Adolescent↗
PubMed1980

Growth characteristics and pathogenesis of experimental Pneumocystis carinii pneumonia.

Pneumocystis carinii pneumonia was produced in two groups of rats by the administration of corticosteroids, a low-protein (8%) diet, and tetracycline in the drinking water. A third group not on corticosteroids or a low-protein diet served as controls. Members of the first group were sacrificed weekly for 8 weeks, and lungs were examined. A highly significant correlation was found between the histopathological assessment of the intensity of P. carinii infection and the number of cysts counted in enzyme-digested lungs. P. carinii progressively filled alveoli, and cyst counts increased from less than or equal to 10(4) to 10(9) cysts/g of lung at peak intensity of infection at 7 to 8 weeks. The second group of rats was placed on a regular diet and tapering doses of corticosteroids after week 4, and they were sacrificed at varying intervals for up to 21 weeks. P. carinii was not cleared from the lungs until after week 13 (more than 6 weeks after discontinuation of all steroids). Histologically, there was an increased prominence of alveolar macrophages and the progressive development of interstitial mononuclear cell infiltrate and fibrosis. Thus, P. carinii grows grows slowly in vivo and interacts with specific host cells. The resulting changes may be important in the pathogenesis of the infection and in the clearance of the organism from the lung after immunocompetence has been restored.

Animals↗
PubMed1980

Interaction of Pneumocystis carinii with host lungs: an ultrastructural study.

Pneumocystis carinii pneumonia was produced in rats by the administration of corticosteroids, low (8%) protein diet, and tetracycline in the drinking water. The rats were sacrificed at weekly intervals, and their lungs were examined by electron microscopy. For the first 6 weeks, few alterations were noted in host pulmonary tissue, except a close attachment of P. carinii trophozoites to the type I pneumocytes. At 7 to 8 weeks, when the infection reached the peak intensity on light microscopy, degenerative changes occurred in the type I pneumocyte, beginning with subepithelial bleb formation and followed by denudation of the basement membrane. This denuded surface appeared to be the site both of exudation of serum and tissue fluid into the alveolar space and of spread of P. carinii into the interstitium. There was hypertrophy of type II pneumocytes, which also occurred in uninfected control rats ingesting tetracyclines. With tapering of the corticosteroid dose, P. carinii was slowly cleared from the lungs, but latent infection persisted for at least 21 weeks. The host response to the corticosteroid dose tapering included increased prominence of alveolar macrophages and progressive interstitial lymphocytic infiltrate and fibrosis. Thus, P. carinii interacts with, and is associated with damage to, specific host cells. This interaction is important in the host-parasite relationship in this infection.

Animals↗
PubMed1980

Comparison of histological and immunological techniques for detection of Pneumocystis carinii in rat bronchial lavage fluid.

We compared histological and immunological techniques in the early diagnosis of Pneumocystis carinii pneumonia in bronchial lavage fluid of steroid-treated rats. The rats were sacrificed weekly and lavage fluids were: (i) examined with cresyl echt violet and Giemsa stains; (ii) examined for P. carinii antigens by indirect fluorescent-antibody, counterimmunoelectrophoresis, and double-diffusion techniques, using high-titer spectific antisera to P. carinii raised in rabbits. P. carinii was detected in lavage fluid by cresyl echt violet at 2 weeks of steroids and persisted even with steroid tapering; the intensity of the infection in lavage fluid closely paralleled that in the lungs. P. carinii was not detected in lavage by Giemsa stain until 4 weeks and disappeared from the fluids with steroid tapering. P. carinii was detected by indirect fluorescent antibody as early as 1 week of steroids, and the results correlated well with those of cresyl echt violet. P. carinii antigens were not detected in lavage fluids or serum by counterimmunoelectrophoresis or double-diffusion techniques. Although precipitin lines sometimes occurred, they were nonspecific. In this model, cresyl echt violet and indirect fluorescent antibody were the preferred techniques for the early diagnosis of P. carinii infection in bronchial lavage fluid.

Animals↗
PubMed1979

Diffuse pulmonary infiltrates in immunosuppressed patients. Prospective study of 80 cases.

Over a two year period, we studied prospectively 80 cases of diffuse pneumonia at Memorial Sloan-Kettering Cancer Center. In 72 per cent of these, the patient had leukemia or lymphoma. Diagnostic procedures consisted of extensive serologic testing for antibody to known respiratory pathogens, including the agent of Legionnaire's disease, and culturing of biopsy specimens for bacteria, viruses, mycoplasmas and fungi. Of 44 cases in which open lung biopsy was performed, a specific cause was found in 61.4 per cent: Pneumocystis carinii in 38.6 per cent, other infections in 9.1 per cent and tumor involvement in 13.7 per cent. There were nonspecific pulmonary changes in 38.6 per cent. Of the 56 cases in which biopsy, autopsy or both were performed, a specific diagnosis was made in 69.7 per cent: P. carinii infection in 37.5 per cent and other infections in 12.5 per cent. In cases in which neither biopsy nor autopsy was performed, a specific infection was diagnosed in 33 per cent; no specific diagnosis was made in the remainder. One patient in the entire group had a significant antibody titer for Legionnaire's disease. Although diagnostic in some cases, extensive serologic testing proved relatively unfruitful. Pneumocystosis was the most frequent diagnosis in this study. The cause of some cases remained obscure, even after lung biopsy.

Adolescent↗
PubMed1979

Presumed respiratory syncytial virus pneumonia in an adolescent compromised host.

A 15-year-old boy with nephrotic syndrome, renal insufficiency, and cutaneous anergy had severe pneumonia with pleural effusion. There was serologic evidence of respiratory syncytial virus infection, and extensive microbiologic, histologic, and serologic studies failed to identify any other etiologic agent. Respiratory syncytial virus as a possible cause of severe pneumonia in immunocompromised hosts has not been previously reported.

Adolescent↗
PubMed1979

Treatment of Pneumocystis carinii pneumonia with trimethoprim-sulfamethoxazole and pentamidine: efficacy and toxicity.

A 39-year-old man with Pneumocystis carinii pneumonia responded poorly to oral trimethoprim-sulfamethoxazole (TMP-SMX) therapy, despite excellent serum concentrations of the drug. He developed severe thrombocytopenia when pentamidine was added to the regimen. This case illustrates problems of drug efficacy and toxicity in the treatment of P carinii pneumonia and suggests caution in the use of TMP-SMX and pentamidine in combination.

Adult↗
PubMed1979

Experimental Pneumocystis carinii pneumonia in different strains of cortisonized mice.

Pneumocystis carinii pneumonia was produced in eight different strains of mice by the administration of corticosteroids, low (8%)-protein diet, and tetracycline in the drinking water. Heavier degrees of P. carinii infection were most consistently found in C3H/HeN mice; intermediate levels occurred in BALB/c AnN, C57BL/6N, B10.A(2R), AKR/J, and Swiss Webster mice; lighter degrees were found in DBA/2N and DBA/IJ mice. Histopathologically, P. carinii organisms were morphologically indistinguishable from human and rat P. carinii, and elicited a predominantly mononuclear response that was similar among the various mouse strains. The optimal cortisone acetate regimen was 1 mg injected subcutaneously twice weekly. Higher doses shortened the life span of the mice, presumably by inducing overwhelming bacterial infection. This problem occurred not only in different strains of mice, but also in the same strain of mice obtained from different breeders. Thus, cortisonized mice should be useful in the study of experimental P. carinii infection. Success of this model depends on the corticosteroid dose, as well as the strain, source, general health, and preexisting microbial flora of the mice chosen for study.

Animals↗
PubMed1979

The morphologic changes of the rat type II pneumocytes induced by oxytetracycline.

Ultrastructural changes in pulmonary alveoli of adult Sprague-Dawley rats administered oxytetracycline (1 mg. per ml.) in their drinking water were compared with those of control rats whose drinking water contained no antibiotics. Groups of rats were sacrificed after 4 and 8 weeks of oxytetracycline treatment. Type II pneumocytes of oxytetracycline-treated rats showed an increase in size and number of lamellar bodies, as well as in their cell volume, when compared with controls. Electron microscopic morphometry confirmed these findings; the lamellar inclusion bodies increased 6 and 10 per cent and the cell volume increased 3 and 5 per cent at 4 and 8 weeks, respectively. The type I pneumocyte and alveolar macrophage showed engulfed myelin figures, and the Clara cells appeared quiescent. These findings suggest that the type II pneumocyte hypertrophy can be induced independently from the diffuse alveolar damage. The oxytetracycline treatment may provide a model system in which the pathologic morphology and function of the type II pneumocyte can be studied independently.

Animals↗
PubMed1978

Empyema with Trichomonas species.

A 35-year-old alcoholic male patient developed an empyema secondary to presumed aspiration pneumonia. Trichomonads were demonstrated on wet mounts and Wright-Giemsa-stained, air-dried smears of pleural fluid. Treatment with metronidazole, other antimicrobial drugs, and drainage was successful in curing the empyema.

Adult↗
PubMed1977

Nude mouse: a new experimental model for Pneumocystis carinii infection.

Experimental infection with both human- and rat-derived Pneumocystis carinii has been produced in nude mice by intrapulmonary injection of lung homogenates that contained P. carinii and by environmental transmission. Most infected mice did not appear ill, and their lungs exhibited a mild and nonspecific inflammatory response. Thus, P. carinii can be transmitted from one animal species to another, and this result suggests that a defect in thymic-dependent lymphocytes is important in the development of the infection. Experimental work with P. carinii in the nude mouse should be performed in isolators because of the communicability of the organism.

Animals↗
PubMed1977

Pneumocystis carinii infection.

Over the past decade, P carinii has become an important cause of pneumonia in the compromised host. Progress has been made in clinical awareness of the organism, in methods of diagnosis, and in developing new forms of treatment. However, there is still a lack of basic knowledge about the biology, taxonomy, and epidemiology of P carinii; of specific host immune factors involved in the pathogenesis of the infection; and of a clinically reliable serologic test. With recent advances in P carinii research, progress hopefully will be made in these areas in the future.

Animals↗
PubMed1976

A case of asymptomatic babesiosis in Georgia.

An asymptomatic infection with Babesia sp. was diagnosed in an epidemiologic investigation of transfusion-acquired malaria. This is the seventh human piroplasmosis infection that has been reported in the literature.

Animals↗
PubMed1976

Pneumocystis carinii pneumonia in the United States: epidemiologic, diagnostic, and clinical features.

Analysis of 194 patients with confirmed Pneumocystis carinii pneumonia in the United States over a 3-year period revealed that P. carinii pneumonia occurred almost exclusively in the immunosuppressed host who had a serious underlying disease. The epidemiologic features of pneumocystis pneumonia primarily reflected those of the underlying disease. P. carinii was identified antermortem in 81% of the cases usually by biopsy or needle aspiration of the lung, procedures associated with considerable morbidity and morbidity and mortality. Laboratory identification of P. carinii was usually accurate, but errors resulting from fault staining tecnique occurred. Most patients had been ill less than 2 weeks with bilateral diffuse interstitial pneumonia. Leukopenia (white blood cell count less than or equal to 3,00/mm3) and probably severe hypoxia were negative prognostic factors. Although treatment with pentamidine was effective, the drug frequently cased adverse reactions, particularly impaired renal function, when given with other nephrotoxic agents.

Adolescent↗
PubMed1976

Pneumocystis carinii pneumonia and primary immune deficiency diseases.

During a 3-year period, 50 cases of Pneumocystis carinii pneumonia in children less than 5 years old were reported to the Parasitic Disease Drug Service, Center for disease Control. Primary immune deficiency diseses constituted the most frequent underlying diseases in patients less than 1 year old (24/29 cases, 83%), whereas acute lymphatic leukemia was the most common underlying diseases in children 1-4 years old (17/21 cases, 81%). Severe combined immunodeficiency was the most common type of immune deficiency disease (15/25 cases, 60%). Six (24%) of the immunodeficient patients each had a sibling who died during infancy of an immunologic deficiency disease and P. carinii penumonia. Although the pathogenesis of the association between immune deficiency and P. carinii pneumonia is poorly understood, defects in both humora and cellular immunity appear to be operative.--Natl Cancer lst Monogr 43: 65-72, 1976.

Age Factors↗
PubMed1974

Idiotypic specificity of surface immunoglobulin and the maturation of leukemic bone-marrow-derived lymphocytes.

Certain cases of chronic lymphocytic leukemia are associated with monoclonal immunoglobulins in the serum. In the present study it was possible to demonstrate that the surface immunoglobulin of the leukemic lymphocytes was idiotypically identical to the serum monoclonal immunoglobulin of the same individual. This was done through the use of fluorescent antibodies that were prepared against the isolated immunoglobulin M kappa serum protein from patient Ei. Such antibodies, after absorption, failed to react with the lymphocytes of other individuals. Capping experiments indicated that both the immunoglobulin M and the immunoglobulin D on the leukemic cells possessed the same idiotypic specificity.A population of plasma cells was also identified in the peripheral blood of patient Ei that showed strong intracellular staining with the idiotypic antiserum and was the apparent source of the specific serum immunoglobulin. The accumulated evidence indicates that the plasma cells were derived from the leukemic lymphocytes by a process of differentiation. Surface immunoglobulin D disappeared and surface immunoglobulin M decreased markedly in this process.

Aged↗