Search PubMed⌕ Search

Biomedical subjects

M Fiala

Publications and source records attributed to M Fiala.

At least 91 records · Page 5Linked to original sources
PubMed1978

Fever of undetermined origin: role of cytomegalovirus and Epstein-Barr virus.

Roles of various infections, neoplasms and granulomatous diseases in fever of unknown origin were studied in 22 patients. Bacterial infections were responsible in seven (32 percent), herpes viruses in five (23 percent), neoplasms in four (18 percent) and granulomata in two (9 percent) cases. Patients with herpes infections had initially no clinical or routine laboratory clues to viral involvement, and were given an intensive workup for 5 to 15 days. The diagnosis was made on the basis of cytomegalovirus or Epstein-Barr virus lgM antibody titers.

Adolescent↗
PubMed1977

Cytomegalovirus mononucleosis in a healthy adult: association with hepatitis, secondary Epstein-Barr Virus antibody response and immunosuppression.

A 35 year old previously healthy physician had clinical manifestations of a mononucleosis illness complicated by arthralgia, vesicular pharyngitis and hepatitis. Initially, the patient had cytomegalovirus (CMV) viremia (predominantly in polymorphonuclear leukocytes) followed by the presence of CMV in the urine, throat and semen. He also had an antibody response to the Epstein-Barr virus which appeared to be a secondary type. During the acute phase of illness, only 7 per cent of the patient's lymphocytes formed spontaneous T cell rosettes as compared to a normal value of 65 to 70 per cent. Concurrently, evidence of abnormal delayed hypersensitivity was manifested by the loss of reactivity to mumps skin test antigen. All clinical and laboratory abnormalities except for the persistence of CMV in the pharynx, urine and semen returned to normal after resolution of the clinical illness.

Adult↗
PubMed1977

Cytomegalovirus retinitis secondary to chronic viremia in phagocytic leukocytes.

We studied the relationship between the duration and intensity of cytomegalovirus viremia, cytomegalovirus complement fixing antibody, and cytomegalovirus retinitis in 61 renal transplant recipients. Five (8%) patients had chronic viremia which lasted more than six months. Two of the five developed typical cytomegalovirus retinitis and a severe fungal infection after intensive viremia of more than 11 months' duration. Retinitis did not develop in 22 patients with short-term viremia. Infectious cytomegalovirus was largely associated with polymorphonuclear leukocytes, but the virus was associated with monocytes during the immature granulocytic response accompanying one patient's terminal illness.

Adult↗
PubMed1977

Effect of cytosine arabinoside on Herpes virus infection in renal allograft recipients.

Cytosine arabinoside (Ara-C) was used for treatment of severe symptomatic cytomegalovirus (CMV)-herpes infections that were seen in nineteen of 174 renal allograft recipients. Ara-C was administered by continuous intravenous infusion at a mean dose of 35 mg/m2 daily for three to four days. Side effects were few and minor in nature. All cases of herpes simplex and herpes zoster, which usually have a prolonged and sometimes unfavorable course in immunosuppressed patients, cleared promptly with no recurrence. All nine patients, except one who had CMV infection with the symptom complex of fever and retinitis or pneumonitis, responded satisfactorily. In the three patients in whom the CMV titers were available, there was a significant decrease in titer within two weeks after treatment. This pilot study of Ara-C in treatment of CMV-herpes infections in immunosuppressed renal allograft recipients suggests a degree of efficacy and safety in the drug that would justify a carefully designed, controlled study.

Adult↗
PubMed1977

Extrinsic modulation of human T-lymphocyte E rosette function associated with prolonged hepatocellular injury after viral hepatitis.

Defective T-lymphocyte E rosette (ER) function associated with viral hepatitis A and B may be due to mechanisms extrinsic or intrinsic to the target lymphocyte. The extrinsic defect is induced by an immunoregulatory plasma lipoprotein (RIF) and has the capacity to regenerate ER function in vitro. The intrinsic defect is refractory to regeneration and is not associated with RIF. Although both mechanisms occur with high frequency during the acute phase of viral hepatitis they tend to segregate in accordance with progression of hepatocellular injury at later stages of the disease. The extrinsic defect was observed in 7 out of 8 patients with longstanding chronic active hepatitis and in 10 out of 10 patients with unresolved hepatitis 12 wk after the onset of jaundice. In contrast, none of nine patients with resolved hepatitis had extrinsically defective ER function 12 wk after the onset of jaundice whereas eight of them displayed an intrinsic defect of ER function at that time. Among the various viral and liver diseases studied RIF appeared to be specific for hepatitis A and B viral infections. None of 64 sera from a variety of viral infections including Epstein-Barr virus cytomegalovirus mononucleosis with associated hepatitis nor 15 sera from patients with several chronic nonviral liver diseases were positive for RIF. RIF and its associated extrinsic defect in ER function therefore appear to correlate with a particular type of hepatocellular injury initiated by the hepatitis A and B viruses that may have a propensity for persistence and(or) progression to an aggressive form of chronic hepatitis.

Acute Disease↗
PubMed1977

Infectious mononucleosis and mononucleosis syndromes.

Infectious mononucleosis (IM) and cytomegalovirus (CMV) mononucleosis are caused by a primary infection with related viruses, Epstein-Barr virus (EBV) and CMV. Despite the similarity of clinical manifestations, basic differences exist: (1) The heterophil antibody (HA) response is absent in CMV mononucleosis, whereas it is present in IM. (2) In IM atypical lymphocytosis reflects proliferation of B cells early and of T cells later in the disease course; in CMV mononucleosis the situation appears complex. (3) In blood, EBV is restricted to B lymphocytes, whereas CMV is found in polymorphonuclear and mononuclear leukocytes. (4) Complications of CMV mononucleosis such as hepatitis and pneumonitis may be due to virus cytopathic effect in target organs. Prominent tonsillopharyngitis with adenopathy, and visceral complications of IM are related to lymphoproliferation which is self-limited except in males with a rare familial defect in defense against EBV. Immune complex-mediated pathology may occur in both diseases. (5) CMV is frequently transmitted to a fetus in utero or to an infant during or after birth, and this occasionally leads to severe cytomegalic inclusion disease; vertical transmission of EBV appears to be exceptional. (6) Secondary EBV infections are associated with certain malignancies whereas such an association has not been recognized in the case of CMV. Toxoplasma gondii is another cause of HA-negative mononucleosis. Its complications in the heart, in skeletal muscle and in the central nervous system are related to direct invasion by the parasite. Cellular immunity plays an important role in defense against all three agents.

Cytomegalovirus Infections↗
PubMed1976

Osteolytic lesion indicating Pseudomonas sternal osteomyelitis.

Two cases of osteolytic lesion of the sternum were caused by Pseudomonas aeruginosa. Both were in heroin addicts, and both occurred as a delayed reaction to injury in an automobile accident. Bony curettage and appropriate antibiotic therapy were sufficient for diagnosis and cure. Tobramycin sulfate (3 mg/kg/day), a new aminoglycoside, was successfully used in both instances. Excision of the sternum was not necessary.

Accidents, Traffic↗
PubMed1976

Cytomegalovirus proteins. I. Polypeptides of virions and dense bodies.

Cytomegalovirus virions and dense bodies were purified by sucrose velocity and equilibrium centrifugation from the medium of fibroblasts infected with the strain AD169. The final virus preparations were purified more than 228-fold with respect to cellular proteins as determined by double-isotopic labeling and at least 1,600-fold on the basis of changes in the ratio of total protein to virus particles. The protein content of purified particles approximated that found for purified preparations of other herpesviruses. Twenty polypeptides ranging from 22,000 to greater than 230,000 molecular weight were detected in purified virus preparations by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Polypeptides of virions and dense bodies were allocated on the basis of analyses of preparations containing differing percentages of virions and dense bodies. Six polypeptides were represented predominantly or exclusively in virions, and four polypeptides were represented predominantly or exclusively in dense bodies, whereas the remainder appeared to be shared by both types of particles. Four polypeptides were glycosylated, and at least three of these appeared to be shared by both particles. Four polypeptides were glycosylated, and at least three of these appeared to be shared by both particle types. The protein composition of cytomegalovirus differs profoundly from that of herpes simplex virus.

Cell Line↗
PubMed1976

Application of systolic time intervals to acute cardiomyopathy with echovirous 2.

The occurrence of echovirus type 2 myocarditis in an adult is reported. Myocarditis was substantiated by abnormal electrocardiograms. More important, a prolonged course and severe functional impairment was quantitatively assessed by serial systolic time intervals, even after the ECGs became normal. The patient also had meningitis, hemiparesis, and convulsions. Viral isolation was from the spinal fluid.

Adult↗
PubMed1975

Epidemiology of cytomegalovirus infection after transplantation and immunosuppression.

Viral infections and clinical complications were studied during hemodialysis and after renal transplantation. Active cytomegalovirus infection developed in 96% of patients after renal transplantation; reactivation of herpes simplex, varicella-zoster, and Epstein-Barr viruses was found in 35%, 24%, and 0% of patients, respectively. Cytomegalovirus viremia developed in 42% of patients an average of two months after renal transplantation, lasted 1.75 (+/- 1.5) months (except in one patient with chronic viremia), and was followed by chronic viruria. Higher titers of infectious cytomegalovirus were found in the polymorphonuclear than in the mononuclear leukocyte fraction. Reactivation of a latent infection and, less likely, respiratory infection appear to be the most probable mechanisms of cytomegalovirus infection after renal transplantation. One to three months after transplant, cytomegalovirus infection may be related to fever, arthralgia, pneumonitis, and leukopenia; three to four months after transplant, the virus may be related to hepatitis; and 12-30 months after transplant, it may be related to retinitis in patients with chronic viremia. Although other causes of these complications are possible, herpes simplex virus, Epstein-Barr virus, varicella-zoster virus, measles virus, adenovirus, hepatitis B virus, and Toxoplasma gondii appear to be of lesser importance than cytomegalovirus in this respect.

Adult↗