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Biomedical subjects

W A McLeod

Publications and source records attributed to W A McLeod.

At least 19 recordsLinked to original sources
PubMed1992

Dermatologic aspects of HIV in dermatology nursing.

Dermatology nurses are playing an increasing role in the assessment and care of HIV-infected patients. Recognition and proper care of the cutaneous manifestations of HIV disease are vital for improving the patient's health and comfort.

Female↗
PubMed1990

Acute HIV infection presenting with painful swallowing and esophageal ulcers.

We describe an acute human immunodeficiency virus (HIV) infection in 16 homosexual men who presented with painful swallowing (odynophagia). Eleven men had a maculopapular rash and 3 had palatal ulcers. At esophagogastroduodenoscopy (endoscopy), multiple discrete esophageal ulcers measuring 0.3 to 1.5 cm in diameter were observed. Electron microscopy of biopsy specimens taken from the ulcer margins in 8 men revealed viral particles 120 to 160 nm in diameter whose morphologic characteristics were those of retroviruses. Human immunodeficiency virus seroconversion was documented in 15 men by Western blot analysis. In 3 men, HIV-1 was isolated from peripheral blood mononuclear cells, in 2 men HIV-1 was isolated from peripheral blood monocytes, and in 1 man HIV-1 was isolated from tissue taken from the margins of the esophageal ulcers. These observations extend our knowledge of the clinical spectrum of acute HIV infection syndromes and suggest that cells in the esophagus are a target for HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Oral Kaposi's sarcoma in acquired immunodeficiency syndrome. Review of management and report of the efficacy of intralesional vinblastine.

Treatment of palatal Kaposi's sarcoma (KS) with intralesional injection of vinblastine was seen to provide effective palliation. Of the ten patients studied, four had a 25% to 50% response, two 50% to 75% response, and four had 75% to 100% response with one or two intralesional injections of vinblastine. Response to treatment was followed for a mean of 3.6 months, with recurrence of lesions in two of ten patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Evidence that prior immune dysfunction predisposes to human immunodeficiency virus infection in homosexual men.

To investigate the role of host susceptibility to HIV-1 infection, we studied subsequent seroconversion in 161 individuals, initially seronegative to HIV-1, who underwent skin testing for cutaneous anergy at an index visit within a prospective study of homosexual men. There were 23 seroconversions in these men by 45 months following the skin testing, yielding a crude rate of seroconversion of 14.3%. While results of purified protein derivative (PPD), Candida, and Trichophyton skin tests were not associated with subsequent course, anergy to dinitrochlorobenzene (DNCB) was predictive of subsequent seroconversion. Kaplan-Meier estimates for the risk of seroconversion during 45 months of follow-up in those men initially anergic and reactive to DNCB were 28.9 and 11.1%, respectively, yielding a relative risk of 2.6 (p = 0.006). The estimated relative risk was stable with adjustment by Cox regression for annual number of male sexual partners and frequency of receptive anal intercourse, and was not sensitive to various changes in the definition of seroconversion time and of eligibility criteria. These data suggest that an impaired host immune status may be associated with an increased risk of HIV-1 infection that is independent of risk of exposure to the virus, supporting earlier speculations that HIV-1 may itself be opportunistic. The notion of varying host susceptibility to infection, at least with regard to sexual transmission in homosexual men, may help to explain the frequent observation of individuals who have been repeatedly exposed to the virus and yet have remained uninfected.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Patterns of sexual behavior and condom use in a cohort of homosexual men.

To measure the magnitude of risk reduction within a cohort of homosexual men, questionnaire responses in April 1984-March 1985 were compared to those in October 1986-September 1987. A total of 361 subjects were eligible (231 seronegative, 130 seropositive). The annual number of sex partners declined significantly from a median of 8.0 to 5.0 with no difference between the serologic groups. The number of subjects reporting no receptive anal intercourse increased as did condom use during anal receptive intercourse. More seronegatives than seropositives subjects reported no condom use during receptive anal intercourse with regular partners (45.7 per cent versus 23.4 per cent), and with casual partners (14.9 per cent versus 1.5% percent). Among subjects with the most casual sexual contact at the second visit, 33.3 per cent of seronegatives and 29.2 per cent of seropositives did not report usual condom use during receptive anal intercourse with casual partners. Although we have documented marked risk reductions, safe sex practices are still not universal, and a few individuals continue to put themselves at extremely high risk.

Adult↗
PubMed1987

The Vancouver Lymphadenopathy-AIDS Study: 7. Clinical and laboratory features of 87 cases of primary HIV infection.

In an ongoing prospective study of homosexual men conducted in Vancouver since November 1982, 87 cases of human immunodeficiency virus (HIV) seroconversion have been documented to date. Comparison of laboratory results obtained a mean of 4.9 months before and 5.4 months after the estimated date of seroconversion revealed that a significant increase in the serum IgG level (from 1149 to 1335 mg/dl on average) and in C1q binding (from 8.8% to 14.2% on average) was associated with early HIV infection (p less than 0.001). A marginally significant decrease in the ratio of helper to suppressor (CD4 to CD8) cells (from 1.55 to 1.29 on average) was also noted (p = 0.025). A marked decrease in absolute number of CD4 cells was not seen with seroconversion, which suggests that profound loss of these cells may be a long-term effect of HIV infection. The occurrence of symptoms (including fatigue, fever, night sweats, unintentional weight loss, diarrhea, joint pains, cough unrelated to smoking, shortness of breath, oral thrush, herpes zoster and rash) did not increase with seroconversion. This finding suggests that most cases of HIV seroconversion may be asymptomatic or associated with relatively minor symptoms. On the other hand, generalized lymphadenopathy was found to develop after HIV seroconversion in about 50% of cases.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Unusual esophageal ulcers containing enveloped viruslike particles in homosexual men.

Eight homosexual men presented with odynophagia. Five had a maculopapular rash and 2 had oral ulcers. Upper panendoscopy revealed the presence of multiple discrete ulcers measuring 3 mm-1.5 cm in diameter in the esophagus of each patient. The intervening mucosa appeared normal. Endoscopic brushings and biopsy specimens taken from the ulcer margins and examined by light microscopy showed no inclusion bodies or giant cells. Fungal stains were negative. Biopsy specimens examined by electron microscopy revealed enveloped virus-like particles 100-140 nm in diameter, exhibiting morphologic features consistent with retroviruses. No virus was isolated after incubation in either rhesus monkey kidney or human foreskin fibroblast culture. Serology for cytomegalovirus and herpes simplex virus was consistent with past infection. In each patient the esophageal ulcers healed completely. In summary, an illness characterized by the presence of esophageal ulcers is described in 8 homosexual men, 5 of whom also had a skin rash and 2 of whom had oral ulcers. The cause of the esophageal ulcers is likely to be the enveloped viruslike particles observed at electron microscopy.

Adult↗
PubMed1985

Activation of bee venom phospholipase A2 by oleoyl imidazolide produces a thiol- and proteinase-resistant conformation.

Assay methods for bee venom phospholipase A2 are presented which respond to different aspects of enzymic behaviour and which allow basal activity, fatty acid activation and acyl-group activation to be distinguished. The stability of the enzyme to thiols and proteinases is dramatically increased by activation with the selective acylating agent, oleoyl imidazolide. These results support the model of activation by conformation change. Limited-fixation studies indicate that enzyme conformation is determined by interaction with the substrate. The oleoyl-enzyme is partially inactivated by trypsin, but its electrophoretic mobility is unchanged. This protective effect is highly selective and only one other component of the venom is protected against trypsin by oleoyl imidazolide. Combination of trypsin and thiol treatment produces a large fragment of the activated enzyme which could be used for structural studies of the activation site.

Bee Venoms↗
PubMed1985

Eosinophilic histiocytosis: a variant form of lymphomatoid papulosis or a disease sui generis?

Five patients are reported on whose clinical skin disease consisted of polymorphous papulonodular lesions healing with a depigmented scar. Although all cases had been termed lymphomatoid papulosis after clinical or histologic examination, the lesions consisted principally of masses of histiocytes and eosinophils. Individual lesions healed spontaneously or with minimal treatment, but the chronic course of disease was not altered by any therapy used. Follow-up 3 to 17 years later indicated persistent or recurrent disease, and one patient died of histiocytic malignancy. Eosinophilic histiocytosis is the microscopic picture of an unusual group of patients with chronic papulonodular necrotic skin disease that may deserve to be considered a disease pattern per se.

Adolescent↗
PubMed1985

Penicillamine induced pemphigus.

Three cases of penicillamine induced pemphigus are described and compared to 35 previously reported cases with typical direct immunofluorescence. The incidence in our clinic was 0.57%. The penicillamine dose ranged from 250 to 1500 mg/day and the mean duration of treatment was 11 months at the onset of pemphigus in the 38 cases. Morphology and immunopathology was indistinguishable from spontaneously occurring pemphigus. The majority of cases resolved within 4 months after stopping, penicillamine; however, 8 cases, including 2 in this report, have persistent pemphigus.

Aged↗
PubMed1984

Lichen spinulosus with immunofluorescent studies.

A typical case of lichen spinulosus in a 15-year-old boy is described. Keratotic papules and plaques occurred on the knees, elbows, and lower legs. A biopsy showed follicular hyperkeratosis consistent with lichen spinulosus. Studies for immunofluorescence demonstrated linear IgM at the basement membrane zone without colloid bodies. The relationship of lichen spinulosus and lichen planus is discussed. The patient responded to treatment with a salicylic acid gel.

Adolescent↗