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Biomedical subjects

T M Daniel

Publications and source records attributed to T M Daniel.

At least 91 records · Page 5Linked to original sources
PubMed1988

The detection by immunoassay of antibody to mycobacterial antigens and mycobacterial antigens in bronchoalveolar lavage fluid from patients with tuberculosis and control subjects.

Bronchoalveolar lavage (BAL) samples from patients with pulmonary tuberculosis and from control subjects were studied using direct and inhibition enzyme-linked immunosorbent assay (ELISA) for the detection of IgG and IgA antibody to Mycobacterium tuberculosis culture filtrate and purified antigen 5 and for the detection of mycobacterial antigens. The IgG and IgA antibodies were found in the majority of samples from tuberculous patients. The IgG titers were higher than were IgA titers. Substantial nonspecificity was observed for antibodies to crude M tuberculosis culture filtrate. Antibodies to purified M tuberculosis antigen 5 were more specific. The detection of antibody in BAL did not offer advantages over previously described serodiagnostic assays. Antigen was found in some BAL samples from tuberculous patients. Greater specificity was observed with an assay based on purified antigen 5 than on crude mycobacterial culture filtrate.

Adult↗
PubMed1987

Characterization of Mycobacterium tuberculosis antigen 5 epitopes by using a panel of 19 monoclonal antibodies.

Antigen 5 is a 35,000-dalton protein which has been purified from culture filtrates of Mycobacterium tuberculosis and shown by immunoprecipitation to be restricted in distribution to M. tuberculosis and M. bovis among 14 mycobacterial species studied. We raised 19 antigen 5-reactive monoclonal antibodies and used them to characterize epitopes of this antigen by enzyme-linked immunosorbent assay and immunoabsorbent affinity chromatography. Fifteen monoclonal antibodies, all immunoglobulin M (IgM), cross-reacted in two major patterns with culture filtrates from five species of mycobacteria and with purified mycobacterial arabinomannan and arabinogalactan. All 15 monoclonal antibodies also reacted with M. tuberculosis antigen 6. Immunoabsorbent affinity columns prepared with these antibodies yielded principally arabinomannan and arabinogalactan. Four monoclonal antibodies, three IgG2a and one IgM, reacted by enzyme-linked immunosorbent assay with antigens 5 and 6 exclusively and not with mycobacterial culture filtrates or polysaccharides. All four monoclonal antibodies yielded antigen 5 and small amounts of antigen 6 when used for immunoabsorbent affinity chromatography. We conclude from these studies that antigen 5 has two nonspecific epitopes, possibly carbohydrate in nature, and one apparent species-specific epitope which is shared with antigen 6.

Antibodies, Bacterial↗
PubMed1987

Esophageal anastomotic leaks: preliminary results of treatment with balloon dilation.

Disruption of a cervical esophagogastric or esophagocolonic anastomosis shortly after surgery is a common complication, and fistula drainage from the leaking anastomosis may be prolonged. Narrowing of the anastomosis apparently contributes to the development and maintenance of the fistula. Fluoroscopically guided balloon dilation of anastomotic strictures was performed in three patients with anastomotic leaks. Preliminary results suggest that the procedure is safe and promotes healing of the fistula.

Adult↗
PubMed1986

The clinical outcome of needle aspirations of the lung when cancer is not diagnosed.

One hundred thirty-two of 397 consecutive percutaneous fine needle aspirations done at the University of Virginia between January, 1979, and December, 1984, for pulmonary lesions showed no evidence of cancer on cytological examination. We reviewed the presenting symptoms, radiographic findings on the day of needle aspiration, and the descriptive cytological terms to determine if it was possible to distinguish benign from malignant disease in these 132 patients. We found a specific benign diagnosis in only 16 (12%) of the 132 patients, and 1 of them ultimately was found to have cancer. In the remaining 116 patients, analysis of age, sex, smoking history, presenting symptoms, radiographic findings at the time of needle aspiration, and cytological terms other than malignancy did not enable distinction of benign from malignant disease as the cause of the radiographic finding. In the group of 132 patients without suggestion of cancer on initial cytological study, 38 (29%) were subsequently found to have a malignant process.

Adolescent↗
PubMed1986

Isolated injury of the proximal vertebral artery associated with blunt chest trauma.

A patient who had sustained blunt trauma of the chest was admitted for evaluation and treatment. A thoracic aortogram was obtained to exclude mediastinal vascular injury, and an incomplete intimal disruption of the proximal left vertebral artery was found. Transient visual disturbances developed after admission, and the patient was treated by operation and vein patch angioplasty. He recovered without additional neurologic symptoms. The vertebral artery can be divided descriptively into four sections, and each section is commonly associated with particular types of injuries. This is the first reported case of an isolated injury to the proximal extraosseous portion of the vertebral artery caused by distant blunt trauma.

Adult↗
PubMed1986

Evaluation of adenosine deaminase activity and antibody to Mycobacterium tuberculosis antigen 5 in cerebrospinal fluid and the radioactive bromide partition test for the early diagnosis of tuberculosis meningitis.

A number of different biochemical and serological tests have been described recently for the early and accurate diagnosis of tuberculous meningitis. None of these tests has yet gained widespread acceptance in clinical medicine or in microbiology laboratories. To investigate this problem we evaluated adenosine deaminase activity (ADA), an enzyme linked immunosorbent assay (ELISA) that detects antibody to antigen 5 of Mycobacterium tuberculosis, and the radioactive bromide partition test (BPT) in the cerebrospinal fluid (CSF). Cerebrospinal fluid specimens from children with tuberculous, pyogenic, and viral meningitis as well as from patients with pulmonary tuberculosis without meningitis and from controls with normal CSFs were included inn the study. In addition, we estimated ADAs in serum samples from selected children in these groups. The sensitivity and specificity of the three tests evaluated in the CSF were: ADA assay 73% and 71%; BPT 92% and 92%; and ELISA for antibody to antigen 5, 53% and 90%, 40% and 94%, and 27% and 100%, respectively, at tires of more than or equal to 1:20, 1:40, and 1:80. The serum ADA was lower (11.0 +/- 6.15 IU/l) in children with tuberculous meningitis when compared with those with pulmonary tuberculosis alone (25.8 +/- 20.9 IU/l). The BPT was found to be the most reliable test in the early differentiation of tuberculous from other causes of meningitis and remained abnormal for a period of up to five months after the beginning of treatment. Accordingly, we believe that the BPT should be used in conjunction with bacterial and fungal antigen detection systems for the initial differentiation of clinically suspicious tuberculous meningitis from Gram or culture negative cases, or both, of bacterial and fungal meningitis.

Adenosine Deaminase↗
PubMed1986

Field evaluation of enzyme-linked immunosorbent assay for the serodiagnosis of tuberculosis.

An enzyme-linked immunosorbent assay (ELISA) was evaluated as a serodiagnostic test for active tuberculosis in La Paz, Bolivia. ELISA was compared with sputum smear in 277 persons presenting to the Instituto de Torax and was used for screening in 1,458 military personnel. The test was performed under field conditions on 4-microliter samples of capillary blood obtained by finger prick. ELISA was found to have a sensitivity of 69% and a specificity of 88%. Sputum smear had a sensitivity of 79% and a specificity of 100%. ELISA was found to have undiminished sensitivity and specificity in patients who were sputum-negative, and the two tests could be combined to achieve a sensitivity of 92% and specificity of 88%. Positive and negative predictive values were highest for populations with tuberculosis prevalences in the range of that seen among patients presenting to the Instituto de Torax in Bolivia, but ELISA also led to the diagnosis of tuberculosis in 5 of 1,458 soldiers tested in the screening program.

Adolescent↗
PubMed1986

Enzyme-linked immunosorbent assay using Mycobacterium tuberculosis antigen 5 for the diagnosis of pulmonary tuberculosis in China.

Measurement of serum IgG antibody to Mycobacterium tuberculosis antigen 5 by enzyme-linked immunosorbent assay was evaluated as a serodiagnostic test for pulmonary tuberculosis in China. The test was 89% sensitive and 94 to 100% specific with high accuracies of prediction. Among 82 tuberculous patients, antibody titer was related to the extent of pulmonary disease. Among control subjects, false positive tests were encountered among 5 of 52 persons with other pulmonary disease and not among 30 healthy subjects. The characteristics of this test compare favorably with those reported for sputum smear examination.

Antibodies, Bacterial↗
PubMed1985

Enzyme-linked immunosorbent assay using Mycobacterium tuberculosis antigen 5 and PPD for the serodiagnosis of tuberculosis.

Enzyme-linked immunosorbent assays (ELISA) of immunoglobulin G antibody to Mycobacterium tuberculosis antigen 5 and tuberculin purified protein derivative (PPD) were assessed for the serodiagnosis of tuberculosis in 41 patients with active tuberculosis, 19 patients with inactive tuberculosis, and 59 healthy control subjects. Patients with active tuberculosis were studied serially at monthly intervals following the initiation of therapy. When contrasted with our earlier studies of sera from patients in Bolivia and Argentina, serum titers in Cleveland patients with active tuberculosis were somewhat lower. Geometric mean titer in patients with active tuberculosis was 1:68 with antigen 5 and 1:46 with PPD. Titer was correlated with patient age, male sex, extent of tuberculosis, and history of prior tuberculosis. However, these associations were not statistically significant. During monthly follow-up for 16 months after the initiation of therapy, ELISA titers remained essentially stable. Thus, no convincing evidence was acquired to support the hypothesis that higher titers in sera from South American patients related to more chronic or more extensive disease. Receiver operating characteristics of ELISA with antigen 5 were better than those obtained using PPD and were similar to those reported by others for sputum smear. In a situation where tuberculosis screening is warranted, ELISA with antigen 5 might have a place if it recognizes a different population than does sputum smear.

Adult↗
PubMed1985

Demonstration of a shared epitope among mycobacterial antigens using a monoclonal antibody.

An IgM monoclonal antibody designated TB-C-1 which is broadly reactive with mycobacteria has been studied to characterize the antigens with which it reacts. Enzyme linked immunosorbent assay (ELISA) demonstrated reactivity not only with culture filtrates of several mycobacterial species but with several purified antigens of Mycobacterium tuberculosis, including protein antigens 5 and 6 and polysaccharides arabinogalactan and arabinomannan. Immunoblotting demonstrated reactivity with four distinct components of M. tuberculosis. Reactions with components of similar mol. wt were demonstrated for several other mycobacterial species, although fewer components bound with TB-C-1 in these other mycobacteria than in M. tuberculosis. Immunoabsorbents were prepared from TB-C-1 and used to isolate antigens with which the antibody reacted. Multiple antigens were identified in the eluates from M. tuberculosis, including protein antigens 6 and 7, arabinomannan, and arabinogalactan. Fewer components were recovered from other species of mycobacteria. Affinity of binding of immunoabsorbents was similar for all antigens bound. These results indicate that a common epitope is widely shared among antigens of M. tuberculosis and other mycobacteria and they suggest that species specificity of mycobacterial antigens may rest with individual epitopes rather than intact antigenic molecules.

Animals↗