[Neuroinfections in childhood].
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Biomedical subjects
Publications and source records attributed to J Budai.
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The clinical course, serological changes and the development of the specific cell-mediated immune response to Epstein-Barr-Virus (EBV), measured in terms of leukocyte migration inhibition, were followed in 40 children suffering from an EBV infection. The patients were followed for between six and 24 months. Although the majority of the children were under six years of age, they presented a typical clinical course; heterophil antibodies could only be demonstrated in 60% of the cases. Anti-VAC-IgM and IgG antibodies were found in all patients during the acute phase, but no anti-EBNA could be demonstrated. In children under three years of age, no antibodies against the D component of the early antigen were found; this antibody was found in 50% of the adolescents. An antibody against the R component of the early antigen could be demonstrated in 73% of the children five to six months after the onset of the disease. Specific leukocyte migration inhibition was present only during convalescence or later. A relationship between the appearance of anti-EBNA and the development of specific leukocyte migration inhibition has been established.
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Ninety children, most under 6 years of age, 73 of whom were suffering from a disease suspect of infectious mononucleosis, were examined serologically for EBV infection. Acute EBV infection was demonstrated in 40 cases. These children were followed up until the end of the second year by examining serum samples taken every month of every third month for anti-VCA-IgM, anti-VCA-IgG, anti-VCA-IgA anti-EBNA, and for the specific antibodies to the components D and R of the early antigen. Heterophil antibodies were examined by agglutination of sheep and horse erythrocytes. The temporal course of the antibody response was similar to those reported in adults while anti-EA-D and heterophil antibodies were demonstrated less frequently.
A six-month-old male infant, whose elder brother had died of progressive vaccinia due to combined immunodeficiency, contracted varicella-zoster infection, and died of disseminated varicella ten days after onset of the disease. As with his elder brother, the blood levels of immunoglobulins were normal, and specific varicella antibodies appeared in his serum, although in low concentrations. His T-lymphocytes, although their number was subnormal, could be stimulated with phytohaemagglutinin, and production of migration inhibitory factor could also be demonstrated. The necropsy confirmed thymic dysplasia. In addition to histological changes, severe combined immunodeficiency and foci of malignant lymphoma were present. On this basis the disease was classified, according to the WHO recommendations, as severe combined immunodeficiency with B lymphocytes, complicated by malignant lymphoma.
Germfree and conventional mice responded similarly to pertussis vaccine treatment. In both groups, lymphocytosis and splenomegaly developed in a similar proportion. The formalin stress reaction of germfree and conventional mice with hypertrophic lymphoid organs induced by pertussis vaccine differed from that of untreated mice: the treated germfree and conventional mice showed a acute increase of lymphocytosis without an significant change in splenomegaly.
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Progressive vaccinia is a rare and serious complication of smallpox vaccination. Depressed immune function can generally be found as an underlying disorder; thus adequate immuno-correction may be expected to be therapeutically effective. Humoral and cell-mediated immunity was repeatedly examined in one case throughout the course of the disease. Results indicated partial deficiency of cell-mediated immunity. No therapeutic effect was achieved by using human antivaccinia immunoglobulin and N-methylisatin beta-thiosemicarbazone. Transfer factor therapy was also attempted. Treatment with a non-specific transfer factor preparation was followed by a transitory clinical improvement. A specific transfer factor preparation given during the last month of life, however, had no therapeutic effect. The patient died on the 145th day after vaccination. Autopsy findings pointed to combined immune deficiency.
During a two-year period, 2411 faecal specimens and 514 throat swabs were cultured from 1674 persons, mainly infants and children. Of 31 Escherichia coli serogroups considered to represent facultatively enteropathogenic agents, the following were encountered: O4, O18a,b, O18a,c, O19, O20, O25, O28a,b, O32, O51, O53, O75, O78, O79, O105, O112a,c, O114, O115, O117, O129, O143, O145, O148. There was no significant difference in the incidence of the organisms and their serogroup distribution between patients with enteritis, patients with extraintestinal diseases and healthy individuals. A rise of antibody titre in some of the patients indicated an association with enteritis in case of serogropus O4, O18a,c, O19, O25, O75, O78 and O117. It has been assumed that the presence in faeces of a facultatively pathogenic E. coli serogroup does not necessarily prove its aetiological relationship to the disease.
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