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Biomedical subjects

T R Cate

Publications and source records attributed to T R Cate.

At least 37 records · Page 2Linked to original sources
PubMed1993

In situ hybridization and immunohistochemical analysis of cytomegalovirus-associated ileal perforation.

A patient with the acquired immunodeficiency syndrome (AIDS) with a cytomegalovirus (CMV) infection localized in the area of an ileal Kaposi sarcoma resulting in perforation is described. Because only one case of such an association of Kaposi sarcoma with CMV leading to perforation has been reported, the presence and distribution of CMV-related nucleic acids and proteins in the affected segment of intestine were evaluated. By using in situ hybridization and immunocytochemical analyses the presence of CMV was shown within epithelial, endothelial, smooth muscle, and inflammatory cells at the site of perforation. This study not only confirmed that CMV can be detected in virtually all components of the intestinal wall despite the absence of distinctive cytomegalic changes, but also generated critical information that illustrates the usefulness of immunohistochemistry and in situ hybridization in elucidating the pathogenesis of CMV-associated lesions. These findings lend further support to the concept that CMV plays a pivotal role in the pathogenesis of intestinal perforation and emphasize the critical importance of in situ hybridization in gaining insight into the mechanisms of CMV-induced injury.

Antigens, Viral↗
PubMed1993

Trivalent attenuated cold-adapted influenza virus vaccine: reduced viral shedding and serum antibody responses in susceptible adults.

Trivalent cold-adapted recombinant (CR) influenza virus vaccines containing types A (H1N1 and H3N2) and B viruses were evaluated in two double-blind, placebo-controlled trials. Susceptible adults were randomly assigned to receive the following vaccines by intranasal drops 1 month apart: two doses of trivalent vaccine, bivalent CR influenza A (Bi A) vaccine followed by monovalent B (Mono B) vaccine or vice versa, or two doses of placebo. All vaccines were well tolerated. Shedding of each of the three vaccine viruses was reduced after the first dose of trivalent vaccine compared with primary vaccination with Bi A or Mono B. Shedding was also reduced after second vaccinations, whether homologous (trivalent-trivalent) or heterologous (Bi A/Mono B or Mono B/Bi A). Reduced viral shedding was associated with reduced serum antibody responses. Thus, both simultaneous and sequential inoculations of susceptible adults with CR influenza vaccine viruses result in reduced viral shedding and serum antibody responses.

Administration, Intranasal↗
PubMed1992

Response of latent syphilis or neurosyphilis to ceftriaxone therapy in persons infected with human immunodeficiency virus.

OBJECTIVE: To evaluate the effect of ceftriaxone in treating latent syphilis or asymptomatic neurosyphilis in patients infected with the human immunodeficiency virus (HIV). DESIGN: Follow-up study of patients treated at two HIV-based clinics during 16 months from 1989 to 1991. PATIENTS: Patients were those in whom a clinical diagnosis of latent syphilis or asymptomatic neurosyphilis was made, who received all recommended doses of antimicrobial therapy, and who returned for follow-up visits for 6 or more months. RESULTS: Forty-three patients were treated with ceftriaxone, 1 to 2 g daily for 10 to 14 days. Thirteen underwent lumbar puncture before treatment; 7 (58%) had documented neurosyphilis (pleocytosis in 5, elevated protein levels in 6, VDRL reactive in cerebrospinal fluid [CSF] in 7), and 6 had documented latent syphilis (entirely normal CSF). The remaining 30 were said to have presumed latent syphilis. There was no relation between the diagnosis and the selected dosage of ceftriaxone. Response rates were similar in those who had documented neurosyphilis and documented or presumed latent syphilis. Overall, 28 patients (65%) responded to therapy, 5 (12%) were serofast, 9 (21%) had a serologic relapse, and 1 (2%) who experienced progression to symptomatic neurosyphilis was a therapeutic failure. Thirteen patients received benzathine penicillin for presumed latent syphilis; results were similar to those observed after ceftriaxone therapy, with 8 (62%) responders, 1 (8%) serofast, 2 (15%) relapses, and 2 (15%) failures. CD4 cell counts in responders were not different from those who failed to respond. CONCLUSIONS: Even in the absence of neurologic symptoms, half of the HIV-infected persons who have serologic evidence of syphilis may have neurosyphilis. Although ceftriaxone achieves high serum and CSF levels, 10 to 14 days of treatment with this drug were associated with a 23% failure rate in HIV-infected patients who had latent syphilis or asymptomatic neurosyphilis. Three doses of benzathine penicillin did not have a significantly higher relapse rate and may provide appropriate therapy, at least for documented latent syphilis in persons co-infected with HIV. Studies comparing ceftriaxone with 10 to 14 doses of procaine penicillin are needed to determine the most cost-effective treatment for asymptomatic neurosyphilis or presumed latent syphilis in this group of patients.

Adult↗
PubMed1991

Nosocomial influenza in a general hospital for indigent patients.

Surveillance of influenza virus infections was maintained on the medical and pediatric wards of a general hospital serving indigent patients of Harris County, Texas during the winter of 1987-88. Influenza A/Sichuan/2/87(H3N2) was the predominant virus during the community epidemic. Influenza A(H3N2) virus was isolated from six of 17 adult patients (35%) suspected to have nosocomial infections; two of these patients died of fulminating pneumonia. Another patient, admitted with alcoholism and hematemesis, developed pneumonia after a documented influenza infection, and the hospital stay was extended for two weeks. The paucity of virus positive community acquired infections on the medical wards suggested that the health care team was the probable source of the nosocomial infections. Community-acquired infections with influenza viruses were common on the pediatric service; however, most admissions were for acute conditions requiring brief hospital stays. Therefore, while nosocomial infections were unusual on the pediatric ward, they may have become evident after discharge. Recommendations for reducing the impact of nosocomial influenza virus infections include hospital-centred vaccination programs for both high risk patients and hospital personnel. Amantadine can be an important adjunctive therapy for reducing nosocomial spread during influenza A virus epidemics.

Adolescent↗
PubMed1990

Cold recombinant influenza B/Texas/1/84 vaccine virus (CRB 87): attenuation, immunogenicity, and efficacy against homotypic challenge.

Healthy susceptible young adults were inoculated intranasally with increasing doses of wild-type influenza B/Texas/1/84, or the cold-adapted vaccine possessing the genes specifying the hemagglutinin and neuraminidase of the wild-type parent and the six internal genes of cold adapted B/Ann Arbor/1/66 (CRB 87). Most volunteers inoculated with 10(6.6)-10(7.6) TCID50 of CRB 87 were infected, but a high frequency of serum antibody responses was seen only at the highest dose (17/29; 59%). The dose of CRB 87 necessary to infect 50% of all human volunteers (1 HID50) was approximately 10(5.4) TCID50. All volunteers given 10(3.9)-10(7.1) TCID50 of the wild-type virus were infected (i.e., 1 HID50 was less than 10(3.9) TCID50). The frequency of mild febrile reactions, mean peak titer of virus in respiratory secretions, and duration of virus shedding were significantly greater in volunteers given 10(7.1) TCID50 of wild-type virus than in those given 10(7.6) TCID50 of CRB 87. Thirteen volunteers were rechallenged with a second 10(7.6) TCID50 dose of CRB 87 3-4 months after vaccination. The frequencies of mild upper respiratory symptoms and signs, virus shedding, and infection were significantly reduced in prior vaccinees compared with volunteers inoculated with a similar dose for the first time. These data suggest that CRB 87 is attenuated, immunogenic, and can confer protection against homotypic virus challenge in this susceptible population.

Adaptation, Physiological↗
PubMed1990

Vaccination with inactivated influenza A virus during pregnancy protects neonatal mice against lethal challenge by influenza A viruses representing three subtypes.

A single intraperitoneal injection of pregnant mice with a monovalent Formalin-inactivated influenza A virus vaccine protected their offspring against a lethal challenge dose of the same influenza A virus H3N2, H2N2, and H1N1 subtypes, as well as against challenge with the other two subtypes. Degree of protection was vaccine dose related. Cross-fostering of neonates indicated that protection was conferred by breast milk antibodies. Serum virus-specific neutralizing antibodies in the mothers and neonates correlated with resistance to vaccine virus, but were detected against other subtypes only in a complement enhancement test or when high doses of vaccine were given.

Animals↗
PubMed1988

Efficacy of sequential annual vaccination with inactivated influenza virus vaccine.

Inactivated influenza virus vaccine efficacy after annual revaccination has been reported to be less than that after first vaccination in boarding school children. We prospectively examined the immunogenicity and efficacy of this vaccine in healthy 30- to 60-year-old volunteers in Houston, Texas, over two epidemic seasons (1983-1985) encompassing outbreaks due to influenza A (H3N2 and H1N1) and influenza B viruses. A placebo group that had never (or not in recent years) received inactivated influenza virus vaccine, a group that received the vaccine for the first time (first vac), and a group given two or more recent vaccinations (multivac) were evaluated in a double-blind fashion each year. Vaccination induced higher frequencies of rise in serum antibody titer to vaccine components in first vac than in multivac volunteers, but mean postvaccination titers were similar. Clinical and virologic evaluations of illnesses during both epidemics and of influenza infections diagnosed serologically over the epidemic seasons revealed no overall reduction in illness from that in the placebo group for either vaccine group; modest reductions in influenza infection-related illness that were significant only for the multivac group against A/H3N2-related illness (55%; p less than 0.04); reduction in moderate-to-severe lower respiratory and/or systemic illness due to influenza for multivac (73%, p less than 0.025) but not first vac (15%, p greater than 0.10) volunteers during the A/H3N2 epidemic; reduction in influenza virus shedding in the multivac (54%, p less than 0.05) but not the first vac (16%, p greater than 0.10) group when compared with the placebo group for both years; and overall 63-81% reductions in documented infections with each influenza virus for both vaccine groups with the exception of A/H1N1 for the first vac group (24%, p greater than 0.10) and type B for the multivac group (58%, p = 0.067). Vaccine efficacy was only modest in these studies, but in contrast to the earlier report in boarding school children, efficacy appeared to be somewhat greater after repeated annual vaccination than after first administration.

Adult↗
PubMed1987

Clinical manifestations and consequences of influenza.

The spread of influenza virus through a community typically causes large increases in medical visits for febrile respiratory disease. Increased school absenteeism occurs early in the epidemic, and school children appear to be important for disseminating the virus. Industrial absenteeism, hospitalizations of adults and infants for pneumonia, and deaths due to pneumonia-influenza all tend to peak later in the epidemic. Although influenza infection rates are highest in persons of school age, hospitalizations and deaths occur primarily in infants and in the elderly, particularly among those with pulmonary, cardiovascular, or other debilitating disorders. Influenza viruses can be spread by aerosol or contact. The primary target cells are those of the respiratory epithelium. In healthy adults, the typical influenza syndrome includes fever, cough, and general aches for three to seven days, but lassitude, cough, and evidence of small-airways disease may persist for weeks. Laryngotracheobronchitis, pneumonia, and unexplained fever are prominent manifestations of influenza that lead to hospitalization of young children. Adults are more likely to have complications of bacterial pneumonia and worsening of chronic pulmonary disease or congestive heart failure. Less frequent complications include myositis, various neurologic disorders, and Reye's syndrome. These consequences of influenza clearly justify strenuous efforts at prevention and control.

Adult↗
PubMed1987

Influenza pneumonia.

Influenza A and B viruses exhibit frequent minor antigenic drift and type A viruses undergo a major antigenic shift every one to four decades, thus assuring that at least a portion of the population is always susceptible. Children and young adults have the highest incidence of influenza infection each winter, but the highest incidences of severe or complicated influenza illness leading to hospitalization or death are in infants, elderly persons (especially those in nursing homes), and persons of all ages with underlying heart or lung disease. Influenza viruses infect respiratory epithelial cells and can themselves cause diffuse pulmonary infiltrates and severe hypoxia, but concomitant or secondary bacterial pneumonia is a much more frequent complication of influenza. Although pneumococci predominate in these secondary pneumonias, the relative incidence of Staphylococcus aureus pneumonia also increases during influenza epidemics; empiric antibiotic therapy in this setting should be directed against both of these organisms. A variety of other bacteria can cause postinfluenzal pneumonia, especially in patients with alcoholism or chronic obstructive pulmonary disease, and broad antimicrobial coverage including gram-negative bacteria is justified in such patients when diagnostic studies provide no guidance. Early amantadine therapy of influenza-like illness during an influenza A epidemic will reduce the duration of symptoms and possibly reduce complications. Successful therapy of influenza virus pneumonia with ribavirin aerosol has been reported but not yet officially approved. Annual vaccination of persons at greatest risk for severe or complicated influenzal disease will reduce the morbidity and mortality due to this infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1983

Immune responses in serum and respiratory secretions following vaccination with a live cold-recombinant (CR35) and inactivated A/USSR/77 (H1N1) influenza virus vaccine.

One hundred adult volunteers were administered inactivated vaccine (20 micrograms/0.5 cc) intramuscularly (IM) or intranasally (IN), or 10(4.7) TCID50 of a live cold-adapted vaccine (CR35) IN. Microneutralization (Nt) and radioimmunoprecipitation methods were employed to measure hemagglutinin antibody responses in sera, nasal washes, and in bronchopulmonary lavage fluids. In unprimed recipients, the relative frequency of serum antibody response and magnitude of rise was highest following the IM-inactivated vaccine (100%) and lowest after IN-live vaccine (29%). However, in individuals with pre-existing antibody, the three vaccines given were comparably immunogenic. Occurrences of secretory IgA hemagglutinin antibody in nasal washings were more frequently associated with topical administration of live or inactivated vaccine, whereas, IgG hemagglutinin antibody responses occurred with equal frequency in nasal washings in all three vaccine groups. Analysis of the hemagglutinin antibody responses in the lower respiratory tract showed that the IN-live vaccine favored the induction of secretory IgA hemagglutinin antibody and the IM-inactivated vaccine stimulated a more frequent IgG hemagglutinin antibody response.

Administration, Intranasal↗
PubMed1983

Increased sensitivity and reduced specificity of hemagglutination inhibition tests with ether-treated influenza B/Singapore/222/79.

Hemagglutination inhibition (HI) tests against whole virus (WV) influenza B/Singapore/222/79 antigen detected prevaccination serum antibody in only 15 (20%) of 50 predominantly elderly volunteers and fourfold or greater titer rises in only three (6%) after they received 1981-1982 trivalent influenza vaccine containing antigens of this virus. HI titers against ether-treated (ET) B/Singapore/222/79 were about eightfold higher than those against WV antigen and were comparable to microneutralization titers against this virus. The ET HI detected prevaccination antibody in 84%, a postvaccination titer rise in 32%, and a final titer of 80 or higher in 66%. Among 51 additional persons with known or presumed influenza B virus infections early in 1982, ET B/Singapore/222/79 was also more sensitive than WV for serodiagnosis (69 versus 49%), but eight persons with both WV and ET B/Singapore/222/79 HI responses also had an HI titer rise to WV A/Brazil/11/78 (H1N1) antigen. Conversely, among 14 college students with febrile, culture-proven influenza A (H1N1) infections early in 1982, 6 (43%) developed HI titer rises to ET B/Singapore/222/79 with no other serological evidence of influenza B virus infection. Moreover, young adult volunteers with mild experimental influenza A (H1N1) infections also exhibited a 17% (3 of 18) incidence of ET B/Singapore/222/79 HI titer rises, versus none in matched, uninfected volunteers. These data indicate that ET B/Singapore/222/79 virus has increased sensitivity but reduced specificity compared to WV as an HI antigen and that caution is needed in interpretation of a single HI test for serodiagnosis, whether with WV or ET antigen.

Aged↗
PubMed1982

Live influenza A/Victoria/75 (H3N2) virus vaccines: reactogenicity, immunogenicity, and protection against wild-type virus challenge.

Four live influenza A/Victoria/75 (H3N2) recombinant virus vaccines were administered intranasally to a total of 50 volunteers who had little or no detectable serum neutralizing antibody. A recombinant with ts-1[E] having a 38 degrees C shut-off temperature caused febrile reactions or systemic reactions or both in 21% of the volunteers, but one with ts-1A2 having a 37 degrees C shut-off temperature caused no illness. Two recombinants prepared with cold-adapted A/Ann Arbor/6/60 caused 9% febrile reactions or systemic reactions or both. Virus shedding occurred in a minority of the 50 volunteers, but 90% developed a serum neutralizing antibody response. Wild-type A/Victoria/75 virus challenge of 34 of the vaccinated volunteers and 12 others who had had prior natural A/Victoria/75 virus infection revealed similar and significant protection when compared with the 96% infection and 68% febrile illness or systemic illness or both observed in 25 unvaccinated volunteers with little or no serum antibody. These results encourage continued efforts toward development of live influenza virus vaccines.

Adult↗
PubMed1982

Interferon production by leukocytes infiltrating the lungs of mice during primary influenza virus infection.

Lung fluids and leukocytes were obtained from unprimed C3H mice by transpleural lavage at intervals after infection with influenza A/Hong Kong/68 virus and were tested for interferon activity. Lavage fluid interferon titers correlated directly with lung virus titers and with initial increases in leukocyte yields from infected lungs. In contrast to cultured lymph node cells from infected animals or leukocytes from lungs of uninfected mice, washed leukocytes obtained from the lungs of mice infected 2 to 6 days earlier produced interferon spontaneously in culture. The physiochemical, biological, and antigenic properties of both the interferon in lavage fluids and that produced by lung lavage leukocytes were similar and characteristics of alpha interferon. Fractionation studies indicated that macrophages and T lymphocytes were primarily responsible for the interferon produced in culture. The early presence and significant numbers of interferon-producing leukocytes in infected lungs suggests that these cells have an early role in defense against influenza virus infection.

Animals↗
PubMed1982

Characterization of human serum strain-specific antihemagglutinin antibody to A/Port Chalmers/73 (H3N2) influenza virus by radioimmunoprecipitation assays.

We performed radioimmunoprecipitation assays in which iodinated preparations of A/Port Chalmers/73 (A/PC/73) hemagglutinin were used as the test antigens and high concentrations of unlabeled A/Hong Kong/68 viral protein were used to inhibit the binding of cross-reactive antibodies to quantitate strain-specific antibody responses in postvaccination sera. Strain-specific antibodies comprised 8 to 48% (mean, 20%) of the total A/PC/73 antigen-binding capacity of the sera tested. Competition radioimmunoprecipitation assays in which disrupted preparations of purified whole virus representative of several of the H3N2 variants were used indicated that the A/PC/73 strain-specific antibody that was present after adsorption of serum by A/Hong Kong/68 antigen was capable of reacting with A/England/72 and A/Victoria/75 hemagglutinins, but generally with lower avidity than with A/PC/73 hemagglutinin. A comparison of the A/PC/73 antibody titers measured by radioimmunoprecipitation and hemagglutination inhibition tests before and after adsorption with A/Hong Kong/68 whole virus suggested that cross-reactive and strain-specific antibodies were comparable in efficiency of inhibiting viral hemagglutination. These data indicated that vaccines containing later variants within a subtype could induce antihemagglutinin antibodies of restricted specificity, but that these antibodies may not be directed against unique antigenic determinant(s).

Antibodies, Anti-Idiotypic↗