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Biomedical subjects

D M Musher

Publications and source records attributed to D M Musher.

At least 109 records · Page 6Linked to original sources
PubMed1988

Ig class and IgG subclass responses to Treponema pallidum in patients with syphilis.

The Ig class and IgG subclasses of anti-Treponema pallidum antibodies in human serum were quantified using solid-phase enzyme-linked immunosorbent assays. Development of these assays with monoclonal antibodies, each specific for a human immunoglobulin class or IgG subclass, provided quantitative data concerning the major antibody specificities. In patients with primary syphilis, anti-T. pallidum activity was limited almost exclusively to IgG1 and IgM. Coordinate, restricted expression of IgG1 and IgG3 responses in T. pallidum-specific assays was observed with sera from patients with active secondary syphilis. IgG1 and IgG3 accounted for roughly 53 and 43% of the total anti-treponemal IgG antibody activity, respectively. While IgM antibody levels were elevated in the patients with secondary syphilis, IgG2 and IgG4 levels, if present at all, represented less than 10 and 2% of the total IgG activity, respectively. Ig in sera from patients who had been treated adequately for secondary syphilis were restricted almost entirely to IgG3 and IgG1. Considering the low level of IgG3 in serum, disproportionately high percentages of antitreponemal antibodies were found in this subclass during and after treatment for secondary syphilis. The restricted, coexpression of the IgG1 and IgG3 isotypes may reflect the close genetic linkage of the gamma 1 and gamma 3 genes and possibly the impact of immunoregulatory mechanisms in response to the induction and expression of autoantibodies which arise during the course of secondary syphilis.

Adolescent↗
PubMed1988

Wound zygomycosis (mucormycosis) in otherwise healthy adults.

Two previously healthy men sustained trauma that caused extensive soft tissue damage together with soil contamination. Within three days, rapidly advancing necrosis was observed at the wound margins. Histologic examination revealed the presence of non-septate branching hyphae characteristic of Mucorales within tissues and in the lumen of blood vessels. In one case, the disease was unrecognized until widespread dissemination had taken place, and the patient died; in the other, a cure resulted from aggressive medical and surgical management. Infections due to Mucorales generally occur in immune-compromised hosts. In cases of extensive trauma, inoculation of devitalized tissues with soil may initiate infection by zygomycetes, even in persons whose immunologic status appears to be normal.

Adult↗
PubMed1988

Vaccination of 18-month-old children with conjugated polyribosyl ribitol phosphate stimulates production of functional antibody to Haemophilus influenzae type b.

Eighteen-month-old children were immunized with polyribosyl ribitol phosphate (PRP) of Haemophilus influenzae type b or with PRP that had been conjugated to diphtheria toxoid. Conjugated vaccine stimulated significant mean increases in antibody titer as measured by radioimmunoassay and bactericidal effect, as well as a modest increase in opsonizing activity. In contrast unconjugated vaccine caused lesser albeit significant rises in antibody titer, but a negligible antibacterial effect. These results suggest that vaccinating infants with conjugated PRP is more likely to stimulate production of antibodies that are protective against systemic infection caused by H. influenzae type b than vaccinating with unconjugated PRP.

Antibodies, Bacterial↗
PubMed1988

Q fever.

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Adult↗
PubMed1987

Manifestations of sepsis.

The clinical manifestations of sepsis may be flagrant or subtle. Awareness of the signs and symptoms of sepsis allows early recognition and prompt, appropriate management. The clinical presentation, relative frequency, and current pathophysiologic understanding of the manifestations of sepsis are reviewed. Special emphasis is placed on the cardiopulmonary manifestations, which are examined in a temporal sequence of preshock, early shock, and late shock states. While therapy for the underlying infection (such as antibiotics and drainage of abscesses) is often sufficient, therapy for the specific manifestations of sepsis may also be necessary. Guidelines for therapy for these manifestations of sepsis are given.

Bacterial Infections↗
PubMed1987

Syphilis.

Inoculation of Treponema pallidum during intimate physical contact is followed by development of a papule that rapidly erodes, yielding the syphilitic chancre. Hematogenous dissemination results in secondary syphilis, a multisystem disease characterized by skin rash, lymph node enlargement, hepatitis, arthritis, and central nervous system involvement. In the absence of treatment, a latent period is reached after which tertiary syphilis may appear in an increasing proportion of patients, depending upon the duration of the follow-up.

Female↗