Biomedical subjects
Publications and source records attributed to G T Werner.
Pretreatment with BCG yielded a high degree of protection against experimental vaccinia virus infections in mice. Corynebacterium parvum and Aristolochia acid were less protective; other immunostimulants were ineffective.
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The effect of X-irradiation on experimental vaccinia infection of BALB/c mice was studied. As compared with nonirradiated controls, the X-irradiated animals exhibited (i) a time lag in virus replication (delayed, but protracted replication); (ii) a delayed and repressed immune response: (iii) more severe acute cytocidal infection of leptomeninges, choroid plexus, ependyma, and vessels, with extensive damage to the brain-barrier system; and (iv) noncytocidal, latent infection of glial cells and neurons. Several animals developed acute or subacute demyelination disease, resembling experimental allergic encephalomyelitis or postinfectious encephalomyelitis.
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Adenine arabinoside monophosphate (ARA-AMP) is a new antiviral agent with significant activity against DNA viruses of the herpes group. It appears to be superior to cytosine arabinoside and iodoxuridine in severe herpes simplex infections. Unlike cytosine arabinoside and idoxuridine ARA-AMP has only minimal myelosuppressive and immunosuppressive properties. The original compound, adenine arabinoside (ARA-A) which has been used in the United States in the last years had the disadvantage of poor solubility and tissue penetrance. Compared to adenine arabinoside the monophosphate ester of this compound has the advantage of better solubility and is more slowly metabolized in humans. In eight children with virus induced encephalitis ARA-AMP was well tolerated, we could not observe any severe side effects. A case of herpes simplex encephalitis showed a complete recovery. However it has to be pointed out that in herpes simplex encephalitis ARA-AMP should be given early in the course of infection to have a beneficial effect, therefore an early diagnosis is of utmost importance. A case of generalized herpes zoster healed up within about a week. Of course these are very preliminary results which must be confirmed by further experiences.
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Adenine arabinoside (Ara-A), a synthetic nucleoside, is an antiviral agent, which is effective against poxviruses and viruses of the herpes group. The monophosphate (Ara-AMP) has the great advantage of better solubility, compared to the parent compound. Experimental studies show the outstanding effect of Ara-AMP on the encephalitis by vaccinia-virus in white mice. Even after immunesuppression by total body irradiation, the survival rate of the Ara-AMP treated animals was significantly higher compared to the untreated controls. In experimental vaccinia-virus infections in rabbits, who had undergone total body irradiation. Ara-AMP has a favourable influence upon the course of the disease and the prognosis. Some clinical observations in children with immunesuppression, who suffered from generalized zoster of varicella-infections, are reported. Furthermore in cases of viral encephalitis Ara-AMP was successful. Controlled studies of a greater number of patients on the therapeutic value of Ara-AMP in infections with DNS-viruses are needed.
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It is estimated that every year about 500 000 people around the world are bitten by poisonous snakes. Between 30 000 to 50 000 persons die due to snake-bites; the highest frequency is reported from Southern Asia. Clinically three types of snake-bites can be distinguished: 1. Bites with local damage (extreme pain, edema, necrosis), 2. Bites followed by generalized hemorrhagic symptoms and 3. bites with neurotoxic effects of the poison (no local pain, paralysis of cerebral nerves, coma). For tropical snake-bites snake-venom is live-saving. As in many cases the biting animal cannot be identified it is advisable to use polyvalent sera. These are heterologous sera which contain antitoxins against several poisonous snakes of a certain area. Often there is some delay until the snake-venom becomes available. Therefore local and symptomatic treatment is valuable: cleaning of the wound, superficial incision to remove poison, venous congestion, oral and intravenous fluid-therapy, antihistaminic drugs, steroids and prophylaxis of shock. Tourists are only rarely endangered by poisonous snakes, they do not need to carry anti-snake venom; this is recommended for scientific excursions in areas with dense vegetation and for persons living in warm countries.
In an epidemiological survey the serum cholesterol levels of 3057 persons belonging to the middle or lower socioeconomic groups were checked. None of these persons suffered from any disease that might affect the lipid metabolism. The values varied according to the age: in children and adolescents 133.46 mg/dl (3.45 mmole/liter); in adults 160.82 mg/dl (4.15 mmole/liter); in persons over 50 years of age 181.02 mg/dl (4.68 mmole/liter). No differences were found between the sexes. Three smaller, highly selected groups showed higher levels. Among 324 obese persons the mean values appeared around 20 mg/dl higher per age group. 168 individuals from higher social classes had readings between 204.25 to 232.85 mg/dl (5.29 to 6.03 mmole/liter), depending on the age. In 311 patients with diseases of the cardiovascular system the mean cholesterol levels were 215.45 mg/dl (5.58 mmole/liter). The average caloric intake per day of the population of Punjab is highest all over India (2500 cal). Most of the calories derive from wheat and cereals, only 20 to 25% from milk and milk products. This, and the fact, that most people have normal weight, might explain why the serum cholesterol levels in the population of Punjab do not differ much from findings in other, less developed state of India.
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Inspite of a high standard of hygiene, infections due to salmonellae are increasing in the highly developed countries. In the Federal Republic of Germany 36 000 cases were reported in 1976; the number of unreported cases is probably five times higher. Practical and clinical aspects make it necessary to differentiate between typhoidal, systemic infections and enteric salmonellosis, which normally remains localized in the gut. In the treatment of typhoid fever, co-trimoxazole seems to be a potent drug which can replace chloramphenicole. In cases of enteritis due to salmonellae the most important therapeutic aim is to replace the loss of fluid. This can be achieved in most cases by an oral glucose-electrolyte-solution. Antibiotics are of no value in these cases. The treatment of prolonged excretion of salmonellae with the stool remains a problem. Antibiotics usually fail. Some authors have tried drugs which tend to normalize the bacterial flora of the gut; there are no controlled studies about the effectiveness of this kind of treatment.