Fatal Candida esophageal abscess and sepsis complicating endoscopic variceal sclerosis.
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Biomedical subjects
Publications and source records attributed to R F Sprouse.
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Thirteen (65 per cent) of 20 horses subjected to carbohydrate overload developed Obel Grade 3 lameness within 56 h. Increases in plasma endotoxin from control levels of less than 0.1 ng/litre to values ranging from 2.4 to 81.53 ng/litre were measured in 11 (85 per cent) of 13 horses during the onset of Obel Grade 3 lameness. Obel Grade 3 lameness was associated with rises in plasma Gram-negative endotoxin levels in 11 (92 per cent) of 12 horses. Two peak increases separated by 16 h were verified in five (45 per cent) of 11 horses that exhibited both endotoxaemia and Obel Grade 3 lameness. The first peak occurred, on average, at 32 h and the second peak at 48 h post overload when only one peak was measured, this occurred in four horses at the average time of 24 h whereas in another three horses only a 48 h or 56 h peak was detected after carbohydrate overload.
The role of Campylobacter jejuni in the pathogenesis of proliferative ileitis in Syrian hamsters was evaluated with monoclonal antibodies of different specificities. Monoclonal antibodies were produced with two different specificities: one for all members of the genus Campylobacter tested (antibody 8322-2E6) and one for C. jejuni and Campylobacter coli (antibodies 841-2A11, 841-4C6, and 841-5B1). Heal sections from healthy hamsters, from hamsters with naturally occurring proliferative ileitis, and from hamsters with experimentally induced proliferative ileitis were examined by using fluorescein isothiocyanate-labeled, Campylobacter sp.-specific 8322-2E6 and tetramethylrhodamine isothiocyanate-labeled C. jejuni-C. coli-specific 841-2A11 for direct dual-labeling immunofluorescence. Organisms which stained with the C. jejuni-C. coli-specific monoclonal antibody were observed in the ileal lumens and along the distal tips of the villi of hamsters with either experimentally induced or naturally occurring proliferative ileitis. In contrast, organisms identified by the Campylobacter sp.-specific monoclonal antibody were present deep within the villus lumens and crypts and intracellularly within the apical portions of the epithelial cells. No organisms stained with the C. jejuni-C. coli-specific monoclonal antibody were observed in ileal sections from control hamsters; an occasional intracellular organism stained with the Campylobacter sp.-specific monoclonal antibody was observed in 2 of 10 control hamsters. Thus, at least two immunologically distinct patterns were identified in ileal sections from hamsters with proliferative ileitis. On the basis of these results, we conclude that the organism seen intracellularly in ileal sections from hamsters with proliferative ileitis is a member of the genus Campylobacter but that it probably is not C. jejuni or C. coli.
Systemic arterial hypertension is associated with equine laminitis, a disease precipitated by gross over-ingestion of carbohydrates. We examined the hearts from nine chronically hypertensive (161 +/- 11/99 +/- 6 mmHg) laminitic ponies and nine normotensive (128 +/- 2/76 +/- 3 mmHg) ponies postmortem for signs of left ventricular hypertrophy. The hypertensive ponies had hearts which were significantly larger (7.77 +/- 0.26 g/kg bodyweight (BW) vs. 5.67 +/- 0.22 g/kg BW), as well as increased combined left ventricle and septum weight (4.99 +/- 0.21 g/kg BW vs. 3.67 +/- 0.20 g/kg BW) and left ventricular free wall weight (3.71 +/- 0.23 g/kg BW vs. 2.62 +/- 0.19 g/kg BW) (p less than 0.05). The right ventricular free wall weights were not significantly different. Mean left ventricular free wall thickness was increased significantly in the hypertensive ponies compared to the normotensive group (26.1 +/- 0.4 mm and 22.5 +/- 1 mm, respectively), but neither septal nor right ventricular free wall thickness was different. These findings demonstrate that left ventricular hypertrophy accompanies equine laminitis-induced hypertension.
The morphologic and pathologic changes which occurred within the cecal mucosa of 4 horses during the onset of laminitis were determined from cecal biopsy materials obtained via a cecal fistula; the laminitis was induced with carbohydrate overload. The cecal epithelial mucosa specimens were obtained at 0 (base line), 24, 32, 48, and 72 hours after horses were given carbohydrate overload, and these were fixed and subsequently photographed. Changes in the cecal epithelium were examined by transmission electron and scanning electron microscopies. These histopathologic changes indicated that the mucosal barrier was substantially damaged by the carbohydrate overload.
Patients infected with Histoplasma capsulatum exhibit protean clinical manifestations and similarly express variable humoral immune responses. Therefore, the specific goals of this study were to more clearly define host immune responses by determining the concentrations of total and H. capsulatum-specific immunoglobulins in sera from patients with acute or chronic pulmonary and disseminated histoplasmosis. H. capsulatum-specific (AS) IgG, IgA and IgM, and total IgE were determined by radioimmunoassays while total IgG, IgA, and IgM were quantitated by laser nephelometry. In general, total IgG and IgA were elevated, while IgM and IgE were either decreased or normal for the three clinical forms of histoplasmosis studies. Antigen-specific IgG and IgA were markedly elevated in all classes of disease, whereas AS-IgM was only slightly increased. Total and AS-IgG were elevated in the sera of chronic patients directly proportional to the number of demonstrable precipitin bands.
A patient with renal failure secondary to amyloidosis and undergoing continuous ambulatory peritoneal dialysis had fungal peritonitis due to Trichoderma viride, an organism ubiquitous in the soil. Tissue invasion by this species has not previously been reported. In vitro susceptibility of the organism suggests that such infections may respond to amphotericin B or ketoconazole although our patient died before a response to therapy could be evaluated.
Supernatant culture media obtained from adherent spleen cell preparations of mice experimentally infected with Histoplasma capsulatum yeast cells suppressed in vitro growth of human myeloid cells. This suppression was significantly greater than that obtained when splenocytes from normal mice or those inoculated with killed yeast cells were used. The use of indomethacin partially blocked this suppressive effect. A direct relationship was observed between the levels of prostaglandin E (PGE) per 10(6) adherent cells in the splenocyte preparations and the degree of in vitro myelosuppression. These findings suggest a possible mechanism for the leukopenia frequently observed in disseminated histoplasmosis.
Factors modulating host resistance to Histoplasma capsulatum are only partially understood. The role of iron-binding proteins in infectious diseases has been an area of recent in-depth investigation. The present study reaffirmed the necessity of iron for growth of H. capsulatum. Transferrin saturation was found to be of importance in withholding iron, and antigen-specific antibody had no added effect. Serums of patients with various clinical classes of histoplasmosis were found to exhibit abnormalities in iron metabolic parameters. However, based on transferrin saturation data, iron withholding by transferrin does not appear to be a significant host defense mechanism in vivo. Further studies presented herein suggest a protective effect of phagocytosis and sequestration by the macrophage-phagocyte system.
A radioimmunoassay was developed to discriminate immunoglobulin (Ig) classes specific for the J-5 mutant of Escherichia coli (serotype O:111-B4). Adult horses were periodically inoculated IM with a nonviable suspension of the J-5 mutant emulsified in Freund's incomplete adjuvant. Before and after the horses were inoculated, sera were collected sequentially and examined by radioimmunoassay. Rabbit anti-(horse) Ig and [125I]protein A served as the indicator system. Antigen-specific IgM, IgG, and IgA were observed to follow a classic immune response. The radioimmunoassay offers a valuable tool for the discrimination of circulating, antigen-specific Ig in the horse.
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A radioimmunoassay for determination of human immunoglobulin G, A, and M class antibodies to Histoplasma capsulatum is reported. Yeast-phase antigen from H. capsulatum was adsorbed onto polyvinyl chloride microtiter plates as the solid phase. Human antibodies were allowed to react with this antigen, followed by addition of rabbit anti-human alpha- or mu-heavy chain sera. 125I-labeled staphylococcal protein A was then added and allowed to bind the human and rabbit immunoglobulin G. With this technique, it is possible to evaluate individual human serum samples for antigen-specific classes of antibodies. This assay may be useful for monitoring the immune response in histoplasma infections.
Cecal fluid from two adult horses was assayed by the limulus amebocyte lysate system for endotoxin before and after carbohydrate overload of the gastrointestinal tract. There were increases in cecal fluid endotoxin concentrations at the 3-, 6-, and 12-hour samplings when compared with base-line values. Concomitant cecal fluid lactate concentrations and pH values increased and decreased, respectively. Both horses subsequently developed clinical signs of acute laminitis.
Caecal fluid samples collected 8 and 24 hours after carbohydrate overload were quantitatively compared to control samples in terms of aerobic and anaerobic bacteria. Concomitant increases in lactic acid-producing bacteria and decreases in Gram negative bacteria were substantiated during the onset of acute laminitis. Progressive decreases in caecal fluid pH were also quantitated. Although endotoxin assays of caecal fluid and blood were not done, the caecal flora changes suggest its presence during the onset of acute laminitis.
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A purified component designated HPD (histoplasmin-purified derivative) dII was isolated from two different cru-e histoplasmin lots by a combination of gel filtration and polyacrylamide disc electrophoresis (Sprouse, 1969). A 0.05-mug portion of HPD dII was reactive and specific in detection of delayed hypersensitivity in guinea pigs experimentally infected with Histoplasma capsulatum. The objective of this study was to characterize this skin test-reactive component for (i) homogeneity, (ii) molecular weight, (iii) isoelectric point, and (iv) composition. Sephadex chromatography, polyacrylamide disc electrophoresis, sucrose density gradient ultracentrifugation, acid and heat denaturation, and immunoelectrophoresis indicate that HPD dII is (i) homogeneous, (ii) of approximately 12,000 molecular weight, and (iii) a glycopeptide of approximately 60% carbohydrate and 40% proteinaceous composition. The marked acid and heat stability exhibited by the compound probably is attributable to the prominent carbohydrate moiety in the molecule. Isoelectric focusing indicated an isoelectric point of 5.68. This would suggest that dII is an acidic compound with either predominance of acidic amino acid residues in the molecule or, more probably, an abundance of electron donors in the carbohydrate moiety. In summary, HPD dII appears to be a glycopeptide of approximately 12,000 molecular weight, reactive in elicitation of delayed hypersensitivity of histoplasmosis.
This investigation examined the theoretical and practical parameters requisite to preparatory istachophoretic separation of blastomycin purified derivative. It resulted in a relatively simple, two-step procedure for preparation of blastomycin antigens in milligram quantitites that exhibited sensitivity and specificity in experimentally infected guinea pigs. Analysis of the nine isotachophoretic fractions for skin test sensitivity and specificity provided some insight into the generally accepted unreliability of blastomycin when used for immunological evaluation.
Preparative polyacrylamide gel electrophoresis was used to isolate individual components of an alkaline-soluble-water-soluble fraction of the cell wall of Blastomyces dermatitidis yeast phase. One component isolated demonstrated exceptional specificity and reactivity when tested on guinea pigs infected with B. dermatitidis. This component displayed no cross-reactivity when tested on animals infected with Histoplasma capsulatum. The significance of isolation of a purified, specific antigen is discussed.