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Biomedical subjects

G A Storch

Publications and source records attributed to G A Storch.

At least 73 records · Page 4Linked to original sources
PubMed1993

Evaluation of a genetically engineered cell line and a histochemical beta-galactosidase assay to detect herpes simplex virus in clinical specimens.

A novel histochemical method was compared with a cytopathic effect (CPE) assay for the identification of herpes simplex virus (HSV) in clinical specimens. The method utilizes a stably transformed cell line (BHKICP6LacZ-5) that expresses beta-galactosidase only after infection with HSV. A total of 96 specimens submitted to our diagnostic virology laboratory were analyzed. Thirty-one specimens contained HSV as evidenced by positive CPE, and all were positive for beta-galactosidase staining. CPE were not evident for 2 or more days in 15 of the 31 positive specimens, whereas the histochemical stain was positive in all 31 positives by 16 to 24 h. This preliminary study shows that the BHKICP6LacZ-5 cell line can be used in a rapid, sensitive, and specific assay for the detection of HSV in clinical specimens.

Animals↗
PubMed1993

Cytomegalovirus infection and pneumonitis. Impact after isolated lung transplantation. Washington University Lung Transplant Group.

Using aggressive surveillance of blood, bronchoalveolar lavage (BAL) fluid, and lung tissue, we sought to determine the incidence of cytomegalovirus (CMV) pneumonitis in isolated lung transplant recipients and to characterize its impact on pulmonary function, chronic rejection, and survival. Forty-six lung transplant recipients who survived greater than 30 days had prospective documentation of CMV infection in blood and BAL fluid and regular surveillance with transbronchial lung biopsy. CMV infection was documented in 92% of patients who were D-/R+, D+/R+, or D+/R-, and the incidence of histologically confirmed CMV pneumonitis among these patients was 75%. No D-/R- patient experienced CMV infection or disease. D+/R- patients experienced more frequent and severe episodes, and ganciclovir prophylaxis during the first 2 wk was not useful. CMV pneumonitis was accompanied by detectable radiographic changes in less than one third of cases. The detection of CMV in BAL fluid was not predictive of CMV pneumonitis on biopsy, except in D+/R- patients during the first 90 days after transplantation. There was no evidence of an adverse impact because of CMV infection on pulmonary function during the first year after transplantation. A relationship between CMV infection and bronchiolitis obliterans could not be documented; however, D+/R- patients had higher morbidity and a trend toward lower survival. In a multivariate analysis, D+/R- status was an independent predictor of death.

Adult↗
PubMed1993

Evolution of sequence divergence among human immunodeficiency virus type 1 isolates derived from a blood donor and a recipient.

Four neonates who were infected with a single unit of blood from a human immunodeficiency virus-1 (HIV-1)-infected adult (patient 1) were studied. Two of the infected children (patients II and III) developed symptomatic HIV-1 disease and died within the first 3 y of life. One child (patient IV) died at 8 mo of age of clinical problems that may have been HIV-related. In contrast, one child (patient V) has remained asymptomatic for 7.5 y and has exhibited a very gradual decline in CD4+ cell number. A previous study had shown very limited sequence diversity of isolates from patients I, II, and III (McNearney T et al.: Proc Natl Acad Sci USA 87:1917-1921, 1990). The current study examined additional HIV-1 sequences encoding the principal neutralizing V3 loop of the surface envelope protein of isolates from patients I and V. Amplified sequences were obtained using the polymerase chain reaction from a cultured isolate and uncultured peripheral blood leukocytes, and nucleotide sequences were determined for 13 clones from patient I and 19 clones from patient V. Clones derived from the cultured isolate exhibited less predicted amino acid sequence diversity on average (0-5.2%) than did sequences from uncultured leukocytes (0-19.8% differences). All clones were more closely related to those from patients II and III (0-19.8% amino acid differences) than to other North American or European isolates (18.8-27.0% amino acid differences) or African isolates (41.0-48.0% amino acid differences). Substitutions occurred at sites predicted to modulate host cell tropism and proteolytic cleavage of the V3 loop.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Use of polymerase chain reaction to demonstrate cytomegalovirus DNA in CSF of patients with human immunodeficiency virus infection.

We used the polymerase chain reaction (PCR) to demonstrate cytomegalovirus (CMV) DNA in the CSF of a patient with the CMV radiculomyelopathy syndrome. To investigate the significance of this finding, we also performed PCR for CMV on CSF samples from 30 patients with human immunodeficiency virus (HIV) infection and neurologic disease, four patients with solid organ transplants including three with active CMV infection, and 10 patients with no clinical suspicion of HIV or CMV infection. There was CMV DNA only in patients with HIV, and it was present more often in patients with evidence of spinal cord dysfunction. Our results suggest that PCR may be useful in the rapid diagnosis of CMV infection of the CNS in patients with HIV and that the radiculomyelopathy syndrome may represent only part of a spectrum of CMV-induced spinal cord dysfunction in these patients.

Adult↗
PubMed1992

Failure of prophylactic ganciclovir to prevent cytomegalovirus disease in recipients of lung transplants.

In an effort to prevent cytomegalovirus (CMV) pneumonitis, seven consecutive CMV-seronegative lung transplant recipients of organs from seropositive donors (D+/R-) were given ganciclovir, 2.5-5 mg/kg intravenously twice daily for the first 10-21 days after transplantation, and commercial polyvalent immune globulin, 200-400 mg/kg every 7-14 days intravenously, for the first 2-3 weeks after transplantation. This regimen was followed by oral acyclovir. Six patients developed CMV viremia and all developed CMV pneumonitis. Viremia occurred later in these patients compared with D+/R- patients who received alternative forms of CMV prophylaxis or CMV-seropositive recipients who received no specific prophylaxis (P = .023 and P = .021, respectively). There was no statistical difference in incidence or time to onset of CMV pneumonitis. When given as described, prophylactic ganciclovir and immune globulin followed by oral acyclovir may have delayed CMV viremia but did not prevent it or pneumonitis in high-risk lung transplant recipients.

Acyclovir↗
PubMed1992

An outbreak of respiratory syncytial virus in a bone marrow transplant center.

An outbreak of respiratory syncytial virus (RSV) infection occurred among 31 patients in a marrow transplant center over a 13-week period beginning in January 1990. RSV infection was also documented in 35 family members and employees. Of 18 patients with pneumonia, 14 (78%) died. None of 13 with upper respiratory infection died. Preengraftment patients tended to develop pneumonia more frequently than did engrafted patients. Early administration of ribavirin may have had a beneficial effect in patients with pneumonia. Antigenic and genomic analysis of 14 available isolates suggested that at least four different viral strains were responsible for the outbreak. One group of patients and 1 employee in spatial proximity were infected with the same strain and likely acquired their infections nosocomially. RSV infection in marrow transplant patients is a serious and life-threatening infection with a high mortality rate once pneumonia develops.

Adolescent↗
PubMed1992

Use of a modified shell vial technique to quantitate cytomegalovirus viremia in a population of solid-organ transplant recipients.

A quantitative modification of the shell vial assay was used to investigate cytomegalovirus viremia in solid-organ transplant recipients. The level of viremia detected in 109 of 407 specimens ranged from 0.02 to 28 infectious foci per 100,000 leukocytes. By using a Poisson model, a technique was developed to determine 95% confidence limits for the measured levels of viremia. These confidence limits were used to determine the level of viremia that could be excluded by culturing a given number of cells. Longitudinal assessment of two transplant recipients revealed different patterns of viremia and demonstrated that significant disease sometimes occurred with low-level viremia. On the basis of the results of the studies, culture of at least 4 x 10(6) leukocytes is recommended for the sensitive detection of cytomegalovirus viremia.

Cytomegalovirus↗
PubMed1991

Antigenic and genomic diversity within group A respiratory syncytial virus.

Antigenic analysis using monoclonal antibodies and genomic analysis using ribonuclease protection was done on 47 isolates of group A respiratory syncytial virus (RSV) recovered from children in St. Louis during four RSV seasons. Antigenic analysis identified four subgroups; of the three that included more than one member, those designated A/2 and A/2V had characteristic ribonuclease protection patterns. A third subgroup, A/4, exhibited more extensive genomic heterogeneity, but all isolates were distinguishable from those in subgroups A/2 and A/2V. Individual RSV epidemic seasons included isolates representing multiple subgroups of group A and multiple intrasubgroup variants, in addition to isolates from group B. Isolates that were indistinguishable by either antigenic or genomic analysis were present in more than one epidemic season. The subgroups may represent parallel evolutionary lineages, whose relevance to RSV immunity and pathogenesis requires further study.

Antibodies, Monoclonal↗
PubMed1990

Comparative laboratory diagnosis of experimental herpes simplex keratitis.

We compared two commercially available tests, a direct immunofluorescence assay and an enzyme-linked immunosorbent assay (ELISA), to viral isolation in tissue culture for the laboratory diagnosis of untreated and partially treated experimental herpes simplex virus keratitis. New Zealand albino rabbits were inoculated bilaterally with herpes simplex virus-1 McKrae strain after corneal scarification. One eye of each rabbit was treated with a 1% trifluorothymidine solution daily, starting on the third day after inoculation. The direct immunofluorescence assay showed lower sensitivity for herpes simplex virus detection than viral isolation in tissue culture for both untreated and partially treated eyes. The Herpchek ELISA demonstrated similar sensitivity to tissue culture in detecting herpes simplex virus in untreated eyes. In the treated group, however, the Herpchek ELISA showed a higher percentage of eyes positive for herpes simplex virus than did viral isolation in tissue culture. After the initiation of antiviral therapy, eyes that no longer harbor infectious virus that can be isolated in tissue culture may remain herpes simplex virus antigen-positive and thus be more amenable to laboratory diagnosis using the rapid ELISA method.

Animals↗
PubMed1990

Comparison of culture and serology for the diagnosis of cytomegalovirus infection in kidney and liver transplant recipients.

This study compared culture, including the shell vial procedure, with serology, including IgM cytomegalovirus (CMV) antibody testing, for the diagnosis of CMV infection in 42 subjects undergoing cadaveric renal or liver transplantation. Of 35 subjects who developed active CMV infection, 31 had positive cultures, while IgM CMV antibodies were detected in 29. Subjects with symptomatic CMV infection were more likely than asymptomatic subjects to have positive cultures of leukocytes (17/18 vs. 9/17, P = .01). In contrast, symptomatic and asymptomatic subjects did not differ in their IgG or IgM CMV antibody test responses. In subjects with symptomatic infection, viral shedding typically began early in the course of infection, often preceding symptoms, while the serologic response usually followed the appearance of symptoms. With the use of the shell vial procedure to facilitate detection of positive cultures, symptomatic CMV infections following kidney or liver transplantation can be recognized earlier and more reliably using viral culture than by serologic testing.

Adult↗
PubMed1989

Characterization of prolonged apneic episodes associated with respiratory syncytial virus infection.

We used high-speed polygraphic recordings to document in detail the sequence of events during prolonged apneic spells in two infants with respiratory syncytial viral (RSV) infection. Also, we elicited upper airway reflexes by stimulating the airway with saline during sleep. Spontaneous prolonged apneic spells were recorded in both infants, and these consisted of two distinctly different apnea types. A number of similarities between apnea of prematurity, upper airway reflex apnea and the apneas in these two infants with RSV infection suggests the possibility that these various kinds of apnea may have related causal mechanisms.

Apnea↗
PubMed1989

Comparison of the Oxoid Signal blood culture system with supplemented peptone broth in a pediatric hospital.

We compared the Oxoid Signal bottle (Oxoid, U.S.A.) with supplemented peptone broth (SPB) tubes (B-D Vacutainer; Becton Dickinson Vacutainer Systems) for performing blood cultures in a pediatric hospital. Blood from 3,066 samples was divided equally between the two systems. Of 131 probable pathogens isolated, 121 were detected in the Signal bottle and 111 were detected in the SPB tubes (P greater than 0.05). Of 167 probable contaminants, 122 grew in the Signal bottle and 109 grew in the SPB tubes (P greater than 0.05). The recovery of staphylococci, both probable pathogens and probable contaminants, was increased in the Signal bottle. The recoveries of other organisms, including streptococci, members of the family Enterobacteriaceae, and yeasts, were similar in the two systems. However, the Signal bottle failed to detect three isolates of Haemophilus influenzae, and the time to availability of isolated colonies of other isolates of H. influenzae was delayed. Overall, the Signal bottle was easy and convenient to use, and its innovative detection system should facilitate the early recognition of positive cultures. If its ability to recover H. influenzae can be improved, the Signal bottle could be a useful alternative to existing systems for use in a pediatric setting.

Bacteria↗
PubMed1989

RNA fingerprinting of respiratory syncytial virus using ribonuclease protection. Application to molecular epidemiology.

We have used the technique of ribonuclease protection to define genomic variation among circulating isolates of subgroup A respiratory syncytial (RS) virus. RNAs extracted from HEp-2 cells infected with strains to be analyzed were hybridized with a 32P-labeled RNA probe corresponding to the RS virus G glycoprotein (A2 strain). Areas of nonhomology were detected by cleavage with ribonuclease A. Using this technique, multiple distinct RNA cleavage patterns could be distinguished among viral isolates recovered from infants residing in the same metropolitan area and infected during the same epidemic season. Epidemiologically related isolates (from coinfected twins, from infants infected during a nosocomial outbreak at an extended care facility, and from institutionalized adults infected during an outbreak) yielded identical patterns. In two separate outbreaks, differences in cleavage patterns among certain isolates corresponded to epidemiologically significant differences among the individuals from whom the isolates were recovered. We conclude that substantial genomic heterogeneity exists among circulating isolates of subgroup A RS virus. Ribonuclease protection can be used as a molecular fingerprinting tool for expanded studies of the molecular epidemiology of this virus.

Adult↗
PubMed1989

Laboratory diagnosis of HIV infection.

The implications of a diagnosis of HIV infection are far-reaching. Thus, accurate interpretation of laboratory tests becomes critical. The authors provide descriptions of the tests now available and discuss the utility of each.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Granulomatous hepatitis associated with cat scratch disease.

In three patients with cat scratch disease the liver was affected. All three had high fever (39 degrees C) for more than 3 weeks. Two of them had no peripheral adenopathy. Computed tomography of the abdomen revealed focal hepatic defects in two patients and periportal and periaortic adenopathy in the third. At laparotomy, there were nodules on the liver surfaces of all patients and histological examination revealed necrotising granulomata. The Warthin-Starry silver stain showed organisms consistent in appearance with the cat scratch bacillus in the liver and a periaortic lymph node of one patient, in the liver of the second patient, and in the axillary lymph node of the third. In all three patients the clinical findings and radiological abnormalities improved without specific therapy. A review of the surgical pathology files of Washington University revealed only two other cases of granulomatous hepatitis in children over a 6-year period. These findings indicate that cat scratch disease should now be included in the differential diagnosis of granulomatous hepatitis, at least in children. The absence of peripheral adenopathy in two of the three patients with granulomatous hepatitis suggests that the clinical spectrum of cat scratch disease may be broader than previously appreciated.

Cat-Scratch Disease↗
PubMed1988

Evaluation of a latex agglutination test for herpes simplex virus.

We evaluated a new commercial latex agglutination test for herpes simplex virus antigen detection (Virogen Herpes Slide Test, Wampole Laboratories, Cranbury, N.J.). In testing of eluates from 100 lesion swabs, mostly from genital sites, the following test parameters were ascertained: sensitivity, 73%; specificity, 89%; positive predictive value, 89%; negative predictive value, 72%. Testing was also performed on 160 supernatants from 153 cell cultures inoculated with clinical samples. In this application, sensitivity and specificity were each 100%, provided supernatants were sampled for testing when the cytopathic effect involved at least 25% of the cell monolayer.

Antigens, Viral↗