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Biomedical subjects

H Masur

Publications and source records attributed to H Masur.

At least 253 records · Page 14Linked to original sources
PubMed1983

Multicentric Kaposi's sarcoma of the conjunctiva in a male homosexual with the acquired immunodeficiency syndrome.

A 38-year-old male homosexual with the new Acquired Immunodeficiency Syndrome (AIDS) had biopsy proven Kaposi's sarcoma of the right palpebral conjunctiva, extraocular mucocutaneous areas, and lymph nodes. Histologically, the palpebral tumor was characterized by atypical spindle cell proliferation and multiple slit-like vessels. Staining for Factor VIII-related antigen was positive in the cytoplasm of some tumor cells. Electron microscopy disclosed Weibel-Palade bodies in cells lining scattered slit-like vascular channels. The palpebral tumor mass was relatively nonadherent to its surrounding tissues and thus its simple excision was noteworthy; despite the prominent vascularity of the tumor, minimal bleeding was associated with its surgical resection. Any patient with AIDS should have all mucosal surfaces routinely examined for the presence of Kaposi's sarcoma lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Interleukin-2 enhances the depressed natural killer and cytomegalovirus-specific cytotoxic activities of lymphocytes from patients with the acquired immune deficiency syndrome.

The recently described acquired immune deficiency syndrome (AIDS) is characterized by the occurrence of severe opportunistic infections and an aggressive form of Kaposi's sarcoma. A variety of profound defects in cell-mediated immunity have been reported in association with the AIDS, including deficiencies in natural killer (NK) cell activity and cytomegalovirus (CMV)-specific cytotoxicity. In the present study, the in vitro effects of interleukin-2 (IL-2) and interferon beta (IFN Beta) on these abnormalities were examined to assess the potential use of these lymphokines in the immunotherapeutic treatment of this syndrome. The peripheral blood lymphocytes (PBL) from six male homosexuals with AIDS and an active CMV infection exhibited markedly depressed NK cell and CMV-specific cytotoxic lymphocyte responses compared with uninfected, heterosexual control subjects. Incubation of PBL with IFN Beta enhanced the NK cell activity and the CMV-specific cytotoxicity of only one of six and neither of two AIDS patients, respectively, while enhancing the NK cell activity of all six control subjects. In contrast, IL-2 dramatically enhanced both the NK cell and the CMV-specific cytotoxic lymphocyte activities of all of the patients. These results indicate that IL-2 can substantially potentiate the depressed cytotoxic effector functions of PBL from AIDS patients, while IFN Beta has little effect.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Pneumocystis carinii identified by gram stain of lung imprints.

The diagnosis of Pneumocystis carinii pneumonia conventionally depends on the time-consuming demonstration of the organisms in pulmonary secretions or lung tissue using toluidine blue 0, methenamine silver, or Gram Weigert stains that require special reagents. In 27 recent episodes of moderate to heavy pneumocystis infections, the cyst form and internal sporozoites of P. carinii could be readily identified on lung imprints using the conventional Gram stain. The Gram stain is unlikely to replace special stains for the diagnosis of pneumocystosis, but it does provide a rapid method to recognize moderate to heavy infections.

Female↗
PubMed1983

Unilateral cytomegalovirus retinochoroiditis and bilateral cytoid bodies in a bisexual man with the acquired immunodeficiency syndrome.

A 42-year-old bisexual man with the acquired immunodeficiency syndrome, cryptococcal meningitis, disseminated Mycobacterium avium-intracellulare with mycobacteremia, and oropharyngeal candidiasis developed unilateral retinitis and bilateral cotton wool patches. Histopathologic examination revealed unilateral necrotizing retinochoroiditis with virions in retinal and choroidal tissues. Postmortem cultures of retina and choroid were positive for cytomegalovirus.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Vancomycin serum levels and toxicity in chronic hemodialysis patients with Staphylococcus aureus bacteremia.

The pharmacokinetics and toxicity of six week courses of vancomycin were assessed prospectively in 12 chronic hemodialysis patients who had 17 episodes of Staphylococcus aureus bacteremia. Patients were treated with 1 gram doses of vancomycin at weekly intervals for six weeks. Peak serum vancomycin concentrations ranged from 5.5-40.0 micrograms/ml and trough concentrations were 1.0-12.0 micrograms/ml at the time of the second dose. No patients demonstrated important drug accumulation at the time of the fifth dose. Pure tone audiometry demonstrated no auditory toxicity. Flushing and pruritus (two patients) were only adverse effects noted. In 16 episodes blood cultures were sterilized within 48 hours of therapy. This investigation demonstrates that in chronic hemodialysis patients with S. aureus bacteremia vancomycin is a safe and microbiologically effective antimicrobial agent. Peak and trough serum concentrations vary widely when 1 gram doses are given at one week intervals, and thus it is recommended that concentrations be measured for each patient, particularly if the minimum bactericidal concentration of vancomycin for the clinical isolate is greater than 1.0 microgram/ml.

Chronic Disease↗
PubMed1982

Effect of hydrocortisone on macrophage response to lymphokine.

To define the suppressive effects of corticosteroids on mononuclear phagocyte antiprotozoal activity, normal resident peritoneal macrophages were exposed to hydrocortisone (HC) before, during, and after in vitro activation with cell-free supernatants (lymphokines). The presence of pharmacological concentrations of HC before or during lymphokine activation prevented normal macrophages from acquiring the capacity to either respond oxidatively to Toxoplasma gondii ingestion or to inhibit intracellular toxoplasma replication. HC had no effect, however, on the cells fully stimulated by lymphokine or on macrophages previously activated in vivo. These findings indicate that although HC does not impair the ability of activated macrophages to control intracellular protozoan infection, it does compromise the antimicrobial activity of the cell-mediated immune system by rendering normal macrophages unresponsive to lymphokine.

Animals↗
PubMed1982

Opportunistic infection in previously healthy women. Initial manifestations of a community-acquired cellular immunodeficiency.

Opportunistic infections and unusual tumors have been reported in an unprecedented outbreak of community-acquired cellular immune deficiency among homosexual and drug-abusing men. We report five women with the same syndrome. The women were residents of metropolitan New York City closely associated with drug abuse either by personal use (our patients) or close sexual contact with an abuser (one patient). One patient was bisexual. All five patients developed Pneumocystis carinii pneumonia as well as combinations of other opportunistic infections including oral candida, disseminated mycobacteria, and ulcerative herpes simplex infections. All patients had marked depression of cellular immune function. Three patients died. The appearance of this syndrome in women has important implications with regard to the epidemiology and etiology of this emerging syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Mycobacterium avium-intracellulare: a cause of disseminated life-threatening infection in homosexuals and drug abusers.

Five men developed disseminated infection with Mycobacterium avium-intracellulare. These patients all lived in the New York City area and presented with their illnesses between January 1981 and September 1981; four were homosexual and one was an intravenous drug abuser. Four patients died. All five patients had defects in the cell-mediated immune response. The infections were characterized histopathologically by poor or absent granulomatous tissue reaction. Clinical isolates of M. avium-intracellulare from all five patients agglutinated commonly used antimycobacterial drugs. The spectrum of opportunistic infections among populations of homosexuals and drug abusers should be expanded to include disseminated disease due to M. avium-intracellulare.

Adult↗
PubMed1982

Complications of Staphylococcus aureus bacteremia. Occurrence in patients undergoing long-term hemodialysis.

Since staphylococcus aureus bacteremia continues to be a common occurrence in patients with arteriovenous fistulas who are undergoing long-term hemodialysis, the complications and outcome of 37 episodes of bacteremia were examined. Systemic complications included pulmonary emboli, empyema, persistent bacteremia, and endocarditis. Such events were rarely life threatening--three of the 34 episodes involving patients without severe concurrent medical problems resulted in death. Local complications at the fistula site were common; however, thrombosis, hemorrhage, impending rupture, and persistent bacteremia caused loss of fistula in 13 of the 22 episodes seen with fistula inflammation. Results of this study demonstrate that, although loss of vascular access was an important problem, particularly in patients with prosthetic grafts, patients with S aureus bacteremia who were undergoing long-term hemodialysis had a favorable prognosis for survival, particularly when they were compared with other patients not undergoing hemodialysis.

Adolescent↗
PubMed1981

An outbreak of community-acquired Pneumocystis carinii pneumonia: initial manifestation of cellular immune dysfunction.

Eleven cases of community-acquired Pneumocystis carinii pneumonia occurred between 1979 and 1981 and prompted clinical and immunologic evaluation of the patients. Young men who were drug abusers (seven patients), homosexuals (six), or both (two) presented with pneumonia. Immunologic testing revealed that absolute lymphocyte counts, T-cell counts, and lymphocyte proliferation were depressed, and that humoral immunity was intact. Of the 11 patients, one was found to have Kaposi's sarcoma, and another had angioimmunoblastic lymphadenopathy. Eight patients died. In the remaining three, no diagnosis of an immunosuppressive disease was established, despite persistence of immune defects. These cases of pneumocystosis suggest the importance of cell-mediated immune function in the defense against P. carinii. The occurrence of this infection among drug abusers and homosexuals indicates that these groups may be at high risk for this infection.

Adult↗
PubMed1980

Serologic diagnosis of acute lymphadenopathic toxoplasmosis.

The diagnosis of acute toxoplasmosis usually depends on serology, yet little data are available to compare the relative usefulness of various serologic tests after the onset of illness. The Sabin-Feldman dye test (DT), the IgM immunofluorescent antibody (IgM-IFA) test, the soluble antigen complement-fixation (CF) test, and the indirect hemagglutination (IHA) test were performed on serial serum specimens from 27 previously healthy patients, each of whom could identify the date of onset of illness within two weeks. IgM-IFA titers of greater than or equal to 1:160 were the best indicators of infection acquired in the past two to four months. The DT was useful for screening, but two-tube rises in titer were rarely documented, and absolute titers were imprecise indicators of the recentness of infection. Although two-tube rises in titer in CF and IHA tests could be seen in the majority of patients, the rises were so slow that both tests were less useful than the IgM-IFA test in documenting the diagnosis of acute toxoplasmosis.

Acute Disease↗
PubMed1980

Prosthetic valve endocarditis.

The diagnosis, therapy, and complications of prosthetic valve endocarditis (PVE) in 48 patients seen between 1962 and 1978 are reviewed. Staphylococcus epidermidis and diphtheroids were the most common causes of both early and late PVE. These microorganisms were frequently resistant to the penicillins and cephalosporins but were uniformly sensitive to vancomycin. The mortality rate in this series was 69%, with 20% of the deaths attributed to central nervous system emboli and the remainder to cardiac causes. The mortality rate exceeded 75% in patients with any of the following findings: aortic valve infection, nonstreptococcal infecting microorganism, new or increased regurgitant murmurs, or significant congestive heart failure (CHF). The mortality rate was lowest in streptococcal PVE (29%) and in mitral valve PVE (49%). The unacceptably high mortality rate suggests that early replacement of infected prostheses should be considered in all patients except those with uncomplicated streptoccal or mitral valve PVE.

Bacterial Infections↗