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Biomedical subjects

D H Harter

Publications and source records attributed to D H Harter.

At least 19 recordsLinked to original sources
PubMed1987

Cervical epidural abscess.

We present 3 new cases of cervical epidural abscess (CEA), a rare condition, along with a review of 12 other case reports. The average patient age was 45 years; just over half were male. The abscesses usually involved the mid to lower cervical region and extended an average of three to four segments. Neck stiffness was present in all patients; root pain and paresthesias were present less often. Weakness of one to four extremities developed in all but one patient. Sensory levels were frequently present, sometimes below the site of the lesion. All but two patients were febrile. All but two had elevated CSF protein, and all but two had a pleocytosis; myelography always revealed a complete or partial block. Staphylococcus aureus was the causative organism in 8 of 11 patients. CEA should be considered in a patient with neck stiffness, paresthesias, and/or radicular pain so that CT or myelography followed by surgical decompression and/or antimicrobial drugs can be initiated before prolonged weakness develops. One of our patients developed a syrinx causing a new neurologic deficit 3 years after treatment. Delayed syringomyelia, a rare complication of extramedullary lesions, lends support to vascular occlusion as the major mechanism of damage in epidural abscess.

Abscess↗
PubMed1985

Meningitis due to Staphylococcus aureus.

A retrospective analysis of 10 adult patients with community-acquired Staphylococcus aureus meningitis was performed in order to elucidate the characteristics and treatment of this lethal disease. In all patients, a focus of infection outside the central nervous system was apparent at presentation. A poor prognosis was associated with severe underlying disease, greater degree of hyponatremia at presentation, development of seizures, failure of nuchal rigidity to develop, persistent or recurrent bacteremia, and the presence of concurrent S. aureus bronchopneumonia. Degree of deterioration in mental status and cerebrospinal fluid pleocytosis, protein levels, and glucose levels did not appear to have any prognostic significance. Therapy with rifampin and a semisynthetic penicillin effected a cure in all six patients treated with this regimen. In contrast, three of four patients treated with other antibiotic combinations died. On the basis of this experience, it is concluded that further trials with rifampin in combination with another anti-staphylococcal antibiotic for the treatment of S. aureus meningitis are warranted.

Adult↗
PubMed1981

Endogenous myelin basic protein-serum factors (MBP-SFs) and anti-MBP antibodies in humans. Occurrence in sera of clinically well subjects and patients with multiple sclerosis.

Sera of normal subjects and patients wtih multiple sclerosis (MS) have been frequently found to contain picomolar quantities of endogenous myelin basic protein-serum factors (MBP-SFs). These serum factors, collectively representing a heterogeneous spectrum, were detected and measured by means of a competitive inhibition radioimmunoassay (RIA) designed to distinguish their respective binding affinities with anti-MBP reagent antiserum. Anti-MBP antibodies in these same normal and patient sera were also detected and their differing binding affinities determined. In general, when sera of normal subjects were found to contain free MBP-SFs, the reagent anti-MBP antibodies in the reagent antiserum used to detect them were of relatively high binding affinity (8 X 10(8) M-1). When normal sera were found to contain free anti-MBP antibodies, the affinities of such antibodies were invariably lower (0.06-0.7 X 10(8) M-1). In contrast, sera of patients with active MS and exhibiting clinical fluctuations in their disease, infrequently contained high or medium high affinity MBP-SFs, whereas higher affinity anti-MBP antibodies were commonly detected. These patterns of MBP-SFs and anti-MBP antibodies in normal and MS human sera resemble those previously observed in studies of normal Lewis rats and rats developing experimental allergic encephalomyelitis (EAE). The findings here reported provide additional support for the view that circulating endogenous MBP-SFs may function as neuroautotolerogens that restrict expansion of MBP-reactive lymphoid cell clones having potentially injurious effector activity for central nervous system (CNS) tissue.

Adult↗
PubMed1981

Multiple brain abscesses.

A young woman with 12 separate brain abscesses was treated medically after aspiration of one abscess for diagnostic bacteriological examination. She made an excellent recovery with only minimal residual neurological dysfunction. Surgical aspiration for detailed bacteriological studies followed by appropriate antimicrobial therapy is an effective way of treating multiple brain abscesses in the neurologically stable patient.

Adult↗
PubMed1980

Legionnaires' disease with profound cerebellar involvement.

An acute febrile illness with pulmonary infiltration and severe cerebellar deficit developed in a woman. The diagnosis of Legionnaires' disease was confirmed by indirect fluorescent antibody tests. Legionnaires' disease should be considered as a diagnostic possibility in patients with pneumonia and cerebellar dysfunction.

Cerebellar Diseases↗
PubMed1977

Characterization of visna virus envelope neuraminic acid.

Visna virus particles inhibit influenza virus hemagglutination in an assay for neuraminic acid-containing viruses. Pretreatment of visna virus with neuraminidase abolished hemagglutination inhibition activity but did not significantly affect attachment, infectivity, or virus-induced cell fusion in sheep choroid plexus cell monolayers.

Adsorption↗