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Charities↗
Biomedical subjects
R Marier
Publications and source records attributed to R Marier.
Tubulointerstitial nephritis and immunologic responses to Tamm-Horsfall protein in rabbits challenged with homologous urine or Tamm-Horsfall protein.
Tubulointerstitial nephritis was produced in 19 of 23 New Zealand White rabbits challenged i.v. with adjuvant-free homologous urine for greater than or equal to 16 wk and 11 of 14 challenged with adjuvant-free rabbit Tamm-Horsfall protein for 2 to 24 wk. Lesions were identical in the two groups of rabbits and were characterized by focal mononuclear infiltrates and microscopic scarring localized to distal nephron segments identified as the thick ascending limb of the loop of Henle. Concomitant immunoglobulin deposition was not detected despite antecedent elevations in serum IgG antibody directed against Tamm-Horsfall protein in 17 of 19 and 10 of 11 affected rabbits, respectively. Peripheral lymphocytes from affected rabbits were found to be cytotoxic and underwent blast transformation in the presence of homologous urine or Tamm-Horsfall protein in vitro. These lymphocytes were shown to produce a soluble cytotoxic product upon exposure to Tamm-Horsfall protein. Neither tubulointerstitial nephritis nor this pattern of cellular and humoral immune response to Tamm-Horsfall protein was found in two age-matched control groups: one unchallenged, and the other challenged i.v. with urine that had been selectively depleted of Tamm-Horsfall protein by 95%. It is concluded that the tubulointerstitial nephritis produced in rabbits by injection of urine or Tamm-Horsfall protein is the result of a predominately cellular immune response directed against Tamm-Horsfall protein.
Animals↗
A new method for measuring antibody using radiolabeled protein A1 in a solid-phase radioimmunoassay.
A micro solid-phase radioimmunoassay was developed which utilizes radiolabeled staphylococcal Protein A ([125I]Protein A) in place of radiolabeled anti-immunoglobulin ([125I]anti-IgG) for the measurement of antibody. For the assay, antigen is adsorbed to the wells of a microtiter plate followed by dilutions of serum and [125I]-Protein A in subsequent steps. We found that this assay can be used to measure antibody (Ab) against a variety of antigens in human and rabbit but not goat immune serum. Binding of [125I]Protein A and [125I]anti-IgG to human and rabbit IgG was comparable. It was possible to quantify this amount of Ab in human serum by reference to immune rabbit serum. The sensitivity of this assay for rabbit antibody was 1 ng/ml.
Antibodies↗
A solid-phase radioimmunoassay for the measurement of antibody to Aspergillus in invasive aspergillosis.
A solid-phase radioimmunoassay (SPRIA) to measure antibody responses to Aspergillus fumigatus and Aspergillus flavus antigens in invasive aspergillosis (IA) was developed and compared with immunodiffusion (ID) and counterimmunoelectrophoresis (CIE). SPRIA detected significant elevations in levels of aspergillus antibody in 15 (79)% of 19 patients with IA. Fewer patients with IA were positive by ID (give of 19) or CIE (four of 19). Only seven )8%) of 58 subjects with other fungal or bacterial infections were positive by SPRIA, as was one (5%) of 20 by ID and CIE. Weak cross-reactivity between aspergillus and candida antigens was demonstrated by SPRIA. IgG levels in patients with IA and control subjects were equivalent. Thus, an antibody response to Aspergillus can be detected in a greater percentage of patients with IA by SPRIA than by ID or CIE. Although a few patients without aspergillosis had elevated levels of aspergillus antibody, a rise in antibody level was specific for IA.
Adolescent↗
Breech presentation at term.
Of 835 cases of breech presentation occurring from 1964 through 1973, 507 which produced mature singleton babies, were studied. This presentation has a high correlation with prematurity. This report indicates that with the term patient, a rational and competent approach results in reduction of the morbidity and mortality rates to equal those for cephalic presentation.
Adult↗
Gram-negative endocarditis following cystoscopy.
Patients with bacteriuria are at risk for local and distant infectious complications at the time of urologic procedures. The American Heart Association recommends that penicillin and streptomycin be given prophylactically to patients with rheumatic or congenital heart disease without reference to the presence or absence of bacteriuria. A patient with unrecognized calcification of the mitral annulus who underwent cystoscopy for evaluation of urinary retention is reported. Although bacteriuria was present preoperatively antibiotics were not given. Subsequently, Serratia marcescens and possibly Proteus morgani mitral valve infection developed and the patient died. Calcification of the mitral valve annulus and an extensive urinary tract infection were identified at autopsy. This case suggests that calcification of the mitral annulus may be an endocarditis risk factor. The spectrum of prophylactic antibiotic coverage given at the time of urologic procedures to patients with congenital or aquired heart disease, including calcification of the mitral annulus, should include whatever organisms are present in the urine.
Aged↗
Antibody to Tamm-Horsfall protein in patients with urinary tract obstruction and vesicoureteral reflux.
Urinary tract obstruction and vesicoureteral reflux, which are often associated with urinary tract infections, may lead to progressive renal damage. Relatively little is known about the pathophysiology of this process, and a need exists for noninvasive methods of its detection in its early stages. Because urine is refluxed into the venous and lymphatic drainage of the kidney in severe vesicoureteral reflux and urinary tract obstruction, an immune response to urinary tract components might play a role in the pathophysiology of progressive renal damage and serve as a serologic marker for its presence. A solid-phase radioimmunoassay for a protein found only in the urine (Tamm-Horsfall protein [THP]) was developed and used to measure antibody to THP in the serum of 60 subjects. Significant elevations of antibody to THP were observed in five of 15 patients with obstruction and infection of the urinary tract and in one of 10 patients with infection alone, when these patients were compared with 12 healthy control subjects. Similar elevations of antibody to THP were not seen in uninfected patients with urinary tract obstruction or in patients with low-grade vesicoureteral reflux or sepsis of nonrenal origin. These results suggest that the measurement of antibody to THP might be useful in the identification of patients with obstruction and infection of the urinary tract.
Adolescent↗
Comparison of continuous and discontinuous counterimmunoelectrophoresis with immunodiffusion in identification of candida antibody using HS antigen.
We have compared continuous counterimmunoelectrophoresis (CCIE) and discontinuous counterimmunoelectrophoresis (DCIE) with immunodiffusion (ID) in the identification of Candida albicans antibody using HS antigen. Eighteen sera with a titer of 1/1 to 1/32 1/32 by CCIE were titered by CCIE and ID. Fewer were positive by CCIE and ID (13 of 18 and 9 of 18, respectively). Furthermore, the titers were lower when measured by these two methods in comparison to DCIE (4 of 18 and 3 of 18 sera had titers greather than or equal to 1/8 in comparison with 7 of 18 greater than or equal to 1/8 by DCIE). Finally, DCIE was found to be much faster than CCIE and ID. After 20 min of electrophoresis, 17 of 21 sera were positive by DCIE, whereas none were positive by CCIE. Even after 90 min, only 10 of 21 were positive by CCIE, whereas 4 of 21 were positive by ID. The increased sensitivity and speed of DCIE over CCIE and ID suggest that DCIE is preferable to these other methods in the measurement of candida antibody using HS antigen.
Antibodies, Fungal↗
Usefulness of serial antibody determinations in diagnosis of candidiasis as measured by discontinuous counterimmunoelectrophoresis using HS antigen.
We have followed the candida antibody response in 115 patients with different types of candidiasis by discontinuous counterimmunoelectrophoresis using HS antigen to learn whether any early antibody response occurs in systemic candidiasis and whether there are differences in the antibody response in candidiasis involving different organ systems. We found that 23 of 32 (72%) patients with systemic candidiasis had a rise in antibody titer within the first 2 weeks of infection and that high titers were relatively insensitive indicators of infection. No differences were seen in the antibody response in different types of candidiasis. Patients with aspergillosis and torulopsosis had titer rises as well which were attributed to either inapparent candida infection or cross-reacting antibody. A rise in titer was not seen in any patient with candida colonization, bacterial or viral infection, or no infection in contrast to titers greater than or equal to 1/1 or greater than or equal to 1/8 which were seen in these conditions.
Adolescent↗
Meningitis and bacteremia caused by Pasteurella ureae. Report of a case following intracranial surgery.
An otherwise healthy 53-year-old woman underwent intracranial surgery for trigeminal neuralgia. One week later she developed meningitis and bacteremia caused by Pasteurella ureae and was treated successfully with antimicrobials. This organism is known to colonize the respiratory tract in certain individuals and is an extremely rare cause of meningitis or bacteremia. This is the first reported case of bacteremia in an adult.
Female↗
Trichosporon cutaneum endocarditis.
A 61-year-old man with Trichosporon cutaneum (T. cutaneum) prosthetic valve endocarditis is reported. He had had an aortic valve replacement for rheumatic heart disease 3 years earlier. Onset of the valve infection was subacute. A systolic murmur was noted on admission. Subsequently, he developed conjunctival hemorrhages, hematuria and transient episodes of confusion, aphasia and cranial nerve palsies. Three of 17 blood cultures taken over 3 weeks were positive for T. cutaneum. He was given amphotericin B (AmB) and 5-fluorocytosine (5FC); T. cutaneum infection of prosthetic aortic valve was identified. The aortic valve was replaced. Postoperatively he developed refractory ventricular fibrillation and died. Striking synergy to AmB-5FC and AmB-rifampin combinations was demonstrated in vitro.
Amphotericin B↗
The reporting of communicable diseases.
Surveillance of communicable diseases in the United States depends on the reporting of cases by primary physicians. It is widely recognized, however, that significant numbers of such cases are not reported. Reporting rates for many communicable diseases have never been determined. In this study, discharge records of 11 hospitals in Washington, DC were searched for cases of selected communicable diseases, and the percentage of these cases reported was determined. Five hundred and seventy of 93,563 (0.61%) patients hospitalized over the study period had one of these communicable diseases. Reporting rates for each were as follows: viral hepatitis, 11%; H. influenzae meningitis, 32%; salmonellosis, 42%; meningococcal meningitis, 50%; shigellosis, 62%; tuberculosis, 63%; total cases, 35%. There is indirect evidence that low reporting rates are not restricted to the area studied. Supplemental reporting by medical laboratories, hospital infection control, and record room personnel were suggested as additional soruces of case reports.
Communicable Diseases↗
Maternal, fetal, and intra-amniotic hormonal and biologic changes resulting from a single dose of hydrocortisone injected in the intra-amniotic compartment.
A single intra-amniotic injection of 500 mg. of hydrocortisone sodium succinate was done 48 hours before elective cesarean section in nine patients in week 39 of gestation. Following that single injection, estriol values fell in all three compartments. Cortisol was rapidly increased in the maternal compartment but returned to normal levels at the time of cesarean section in maternal and umbilical vein cord plasma while remaining elevated in the amniotic compartment. Progesterone was increased in the fetal and amniotic compartments but remained essentially unchanged in the maternal compartment. The foam test was constantly improved in the direction of an intermediary or positive test and the quantitative lecithin-sphingomyelin values were increased by almost twofold. In our series, none of our babies developed a respiratory distress syndrome nor had any difficulty with the first breath or the Apgar score. We did not deliver any low-birth-weight infants and the creatinine values were even improved by our injection.
Adolescent↗
Coxsackievirus B5 infection and aseptic meningitis in neonates and children.
In metropolitan Washington, DC, an outbreak of aseptic meningitis in children was recognized in the summer and fall of 1972. Age-specific attack rates were highest in children less than 1 year of age. The incidence of cases showed two peaks: one in July and another in October. Coxsackievirus B5 was associated with cases occurring in July, August, and September, but was not implicated in the October cases. Seventy-six percent of the confirmed coxsackievirus B5 infections in aseptic meningitis patients occurred in infants less than 2 months old. Specific meningeal symptoms were less frequently observed in these young infants, although viral isolations were more common (13 of 15) compared to patients over 2 months of age (four of 19). Analysis of reported coxsackievirus B5 infections in Washington, DC, and the United States as a whole suggests a five- or six-year periodicity.
Adolescent↗