Search PubMedSearch

Biomedical subjects

A H Kaplan

Publications and source records attributed to A H Kaplan.

10 recordsLinked to original sources

Human immunodeficiency virus type 1 Gag proteins are processed in two cellular compartments.

The structural proteins of the retroviral capsid are translated as a polyprotein (the Gag precursor) that is cleaved by a virally encoded protease. Processing of the human immunodeficiency virus type 1 Gag precursor Pr55 was analyzed through a combination of pulse-chase labeling, cell fractionation, and immunoprecipitation. We observed a membrane-associated processing pathway for the Gag precursor that gives rise to virions. In addition, we found that a significant amount of processing occurs in the cytoplasm of infected cells resulting in the intracellular accumulation of appropriately processed viral proteins. This observation suggests the viral protease is active in the cytoplasmic compartment of the cell. Processing of the Gag protein was blocked in both compartments by the addition of a viral protease inhibitor. A comparison of the amount of cytoplasmic processing seen in lytically infected cells with that seen in chronically infected cells showed that cytoplasmic processing was associated with the lytic infection. These observations raise the possibility that activation of the human immunodeficiency virus type 1 protease in the cytoplasm of lytically infected cells might result in the cleavage of cellular proteins and thus contribute to cytotoxicity.

Capsid

Short courses of antibiotics in selected febrile neutropenic patients.

To evaluate their policy of discontinuing broad spectrum antibiotics in patients with negative cultures who become afebrile but remain neutropenic, the authors retrospectively reviewed the charts of all pediatric patients diagnosed with cancer between 1980 and 1986. Two hundred seventy-one children had 385 admissions for infectious complications during the study period. In 39 of those episodes (9%), the patients had negative cultures, became afebrile, and were discharged with absolute neutrophil counts of less than 1000 cells/mm3 (mean 390 cells/mm3). They received relatively short courses of antibiotics with a median duration of 4 days. Only four of these patients became febrile during the followup period and there were no fatalities. Given the benign course of these patients, recommendations for prolonged antibiotic courses should be reconsidered.

Anti-Bacterial Agents

The HIV-1 gag precursor is processed via two pathways: implications for cytotoxicity.

All retroviruses studied thus far contain proteases which process viral precursors to liberate the structural and enzymatic proteins of the viral capsid. We have examined the processing of the Gag precursor of HIV-1 which is composed of the viral structural proteins. Our results indicate that Gag is processed via two pathways: an expected membrane-associated pathway which gives rise to virions and a cytoplasmic pathway in which processed viral proteins accumulate in the cytoplasm. The presence of an active protease in the cytoplasm of infected cells is a potential source of toxicity. A comparison of the extent of cytoplasmic processing in lytically infected cells compared with that in cells which are not killed by the virus demonstrates a close correlation between cytoplasmic processing and cell killing.

Cell Death

Recovery of resistant enterococci during vancomycin prophylaxis.

We report a case of a patient undergoing hemodialysis who developed a wound infection and subsequently bacteremia with a strain of vancomycin-resistant enterococcus identified as Enterococcus gallinarum. He had been receiving vancomycin prophylaxis before developing these infections. Both isolates were susceptible to ampicillin, rifampin, teicoplanin, and daptomycin (LY146032).

Aged

Cure of mucormycosis in a renal transplant patient receiving ciclosporin with maintenance of immunosuppression.

Rhinocerebral mucormycosis in renal transplant recipients is associated with high mortality and allograft rejection. We report the first case of successful treatment of mucormycosis in a renal transplant recipient receiving ciclosporin and corticosteroids with maintenance of renal function. It is postulated that the relatively specific immunosuppression caused by ciclosporin, together with aggressive medical and surgical intervention, may enable the cure of this life-threatening fungal infection without loss of donor kidney function.

Adult

The dying psychotherapist.

A previously unpublished paper by a dying psychotherapist describes the therapeutic use of the ensuing grief reactions of five patients to his terminal illness to help them deal with the effects of their previous losses, deprivations, and abandonments. Follow-up interviews with these patients and their subsequent psychotherapists shed light on the efficacy of such therapeutic efforts, the character of the communication of the terminal illness, the transference and countertransference reactions that interfered with the inevitable separation, and conclusions by previous authors regarding patients' reactions to the deaths of their therapists.

Abortion, Spontaneous

Infection due to Actinobacillus actinomycetemcomitans: 15 cases and review.

Actinobacillus actinomycetemcomitans is a small fastidious gram-negative coccobacillus that fails to grow on MacConkey's agar. Slow growth in broth may lead to delays in diagnosis. First described in 1912, A. actinomycetemcomitans has been recognized since 1962 as capable of causing serious infections in humans. Such infections include periodontal infection, soft tissue abscess (often in association with Actinomyces species), and systemic infection, most commonly endocarditis. Fifteen cases and a review of the English-language literature are presented to define the epidemiology and clinical features of infection due to A. actinomycetemcomitans. Therapy for infection due to A. actinomycetemcomitans has most commonly involved ampicillin or penicillin, often in conjunction with an aminoglycoside. However, resistance to penicillin or ampicillin is common. Antimicrobial agents with a high degree of in vitro activity included cefazolin, cefotaxime, cetriaxone, aminoglycosides, and chloramphenicol. Therapy should be guided by clinical response and in vitro susceptibility testing.

Actinobacillus Infections