Biomedical subjects
Publications and source records attributed to D W Gregory.
The calf of a cow vaccinated with an E coli strain 1751 bacterin developed scours 14 hours after oral challenge with E coli strain B44. The calf became almost moribund but fully recovered in several days after repeated oral administration of the dam's colostrum.
Three patients with esophageal candidiasis were treated with a new orally administered antifungal agent, ketoconazole. Favorable results were obtained in two patients; in the remaining patient other foci of candidal infection developed while the patient was receiving ketoconazole.
Two cases of pericarditis associated with Hemophilus influenzae bacteremia and pneumonia are reported and the literature reviewed. Both patients were treated with antibiotics alone and had resolution of their illnesses without apparent adverse sequelae. Neither patient required pericardial drainage. It is suggested that there is a stage in the development of H influenzae pericarditis at which antibiotic treatment alone can be curative.
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Three groups of ewes were vaccinated with formalin inactivated, whole cell, aluminum hydroxide adjuvanted bacterins prepared from capsulated enteropathogenic Escherichia coli (EEC). Lambs born to and suckling these ewes, compared with lambs of nonvaccinated control ewes, were highly resistant to homologous EEC challenge exposure. Lambs of ewes vaccinated with products prepared from K99 antigen-positive, noncapsulated E coli were highly resistant to heterologous EEC challenge exposure. In both cases, lambs of vaccinated ewes had significantly (P less than 0.005) less morbidity and mortality, fewer challenge inoculum-type E coli per rectal swab evaluation, and had superior weight gains over a 4-day period. Immunoglobulin assay of 122 lamb sera (collected 12 hours after birth) failed to reveal any correlation between serum immunoglobulin values and morbidity or mortality. When tested by plate agglutination technique, using whole cell antigens, or by reverse radial immunodiffusion, using purified capsular antigens, colostral whey samples of vaccinated ewes did not have increased capsular antibody titers. The K99 serum antibody values of K99 antigen-vaccinated ewes were markedly higher than were those of ewes vaccinated with other bacterins or of control ewes.
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Four patients with disseminated histoplasmosis, two of whom had late relapses after previous therapy with amphotericin B, were treated with ketoconazole 200 to 400 mg daily for 1 year. All patients improved markedly during therapy, with resolution of symptoms decreasing liver and spleen size, and weight gain; resolution of oral ulcers occurred in the two patients in whom they were present. Decrease in serum alkaline phosphatase levels correlated well with clinical improvement. One patient who was much improved while receiving ketoconazole continued to harbor Histoplasma capsulatum in an abdominal aortic aneurysm, which became symptomatic 4 months after cessation of the drug. He underwent aneurysmectomy, and H. capsulatum isolated from the resected aneurysm was susceptible in vitro to ketoconazole. No significant adverse reactions to the drug were noted despite prolonged therapy. Our results indicate that ketoconazole may have a role in the therapy of disseminated histoplasmosis in adults.
An analysis of seven sporadic cases of Legionnaires' disease confirmed clinical features recorded during epidemics and identified aspects of the illness either unreported or not emphasized. Four patients had central nervous system abnormalities. Mental status changes included somnolence, obtundation, delirium, disorientation, and confusion. Three patients experienced visual hallucinations, and one patient without pneumonia had a grand mal seizure with residual memory deficit. Two patients had disseminated intravascular coagulation with thrombocytopenia, elevated split fibrin products, and prolonged partial thromboplastin and prothrombin times. Four patients had severe hypoxia; one patient had an exudative pleuritis. One patient whose treatment included erythromycin had radiologic improvement of his pneumonia despite deteriorating ventilatory function that led to death. The concept of Legionnaires' disease as a severe, diagnostically perplexing pneumonic illness is valid but too narrow. The emerging spectrum is that of a multisystem disease that, besides the lungs, often involves the central nervous system and can be accompanied by disseminated intravascular coagulation.
CBA mice, inoculated intravenously with large doses of adenovirus type 5, showed raised levels of serum aspartate aminotransferase (SAAT; EC 2.6.I.I) and died within a few days from histologically demonstrable hepatic necrosis. After inoculation of I LD50, virus was rapidly taken up by the tissues where infectivity then declined greatly. Organ titres then increased about 100-fold by 48 h p.i. but, in the liver, which showed intranuclear inclusion bodies, and by electron microscopy, scattered intranuclear and intracytoplasmic adenovirions, the increase was 10000- to 100000-fold. P antigen was detected by single radial diffusion in liver extracts, and by immunofluorescence in 80% of liver cells at 36 h p.i. Hexon, penton base and fibre antigens appeared later and in fewer cells. The maximum amount of hexon, of demonstrable type 5 specificity, was shown by radioimmunoassay to be equivalent to up to 5 x 1011 whole adenovirions/g liver. It is concluded that human adenovirus type 5 undergoes an abortive but lytic infection in most liver cells but that replication may proceed to completion in a few.
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Purified preparations of molluscum contagiosum virus contain a DNA-dependent RNA polymerase (EC 2.7.7.6) with similar but not identical properties to those of the enzyme found in vaccinia virions. The ultraviolet inactivation kinetics of the RNA polymerase from both viruses were similar, displaying fast and slow components. Ultraviolet irradiation destroyed the interfering capacities of molluscum and inactivated vaccinia virions, and the interferon-inducing capacity of molluscum virus slowly and with first-order kinetics. Inactivation studies of the interferon-inducing capacity of vaccinia virus were complicated by cytotoxic effects. Electron microscopical studies showed all stages of virus growth in vaccinia-infected mouse embryo cells; molluscum virus appeared to be degraded in lysosome-like bodies. In preliminary studies, marked changes in cytoplasmic RNA synthesis and in patterns of polypeptide synthesis were found in vaccinia-infected but not in molluscum-infected mouse embryo cells.
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When 102 patients with dyspepsia who had normal findings on barium-meal examination in 1964 were interviewed in 1970, 85 of them (76%) were symptomatically improved, and only three were later shown to have a peptic ulcer. This suggests that "x-ray-negative dyspepsia" has a good prognosis in a general practice setting.
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