John R. Montgomery

Optic nerve manifestations of human congenital cytomegalovirus infection

A Latin American male and a white female infant who had a cytomegalovirus infection on the first day of life had unilateral optic nerve hypoplasia. A white male infant who had cytomegalovirus isolated at 5 weeks of age had a unilateral partial coloboma of the optic nerve. A 4-month-old black infant with cytomegalovirus infection diagnosed at 2 days of age had a unilateral complete coloboma of the optic nerve associated with microphthalmia. Optic nerve involvement was an important manifestation of this disease.

Rejection of the Transplanted Human Heart

Abstract The human heart is highly vulnerable to rejection. In 16 patients with 17 allografts rejection progressed relentlessly in histocompatibility matches of C and D grades. Only three patients ...

Cytotoxic and soluble mediator responses by complement (C3) receptor-bearing lymphocytes from patients with B-cell immunodeficiency diseases

Abstract Peripheral blood lymphoid subpopulations from congenital (X-linked) agammaglobulinemic and selective IgA-deficient patients were assessed for nonspecific cytotoxicity and lymphotoxin (LT) effector responses. Complement receptor-bearing lymphocyte-mediated cytotoxicity and culture supernatant LT responses were quantitated using 51 Cr-labeled human melanoma target cells. All patients appeared to have normal numbers of T and B cells as defined by E and EAC rosetting while agammaglobulinemic patients were deficient in cells bearing surface membrane-associated immunoglobulin (SmIg). T cells and enriched B cells obtained by T-cell depletion gave negligible nonspecific cytolytic responses. In contrast, complement (C3) receptor-bearing lymphocytes (CRL) from B-cell-immunodeficient patients and normal donors gave significant cytolytic and supernatant lymphotoxin responses when activated by EAC rosetting. Evidence is presented that CRL from immunodeficient patients with total or partial B-cell deficiencies can still express C3 receptor-induced nonspecific cytotoxicity and lymphotoxin effector responses. The absence of serum and membrane-associated immunoglobulins did not impair the expression of C3 receptor-induced responses.

Cord serum IgA in congenital cytomegalovirus infection

EVALUATION of cord serum concentrations of IgM has been reported as a useful but a nonspecific aid in the diagnosis of congenital infections caused by the TORCH agents (Toxoplasma, Rubella virus, Cytomegalovirus, Herpes virus)? Melish and Hanshaw ~ reported that five of 19 (26%) infants with culture proved congenital cytomegalovirus infection had elevated cord IgM levels. It has been suggested that infants with congenital CMV infection may produce small amounts of IgA in response to antigenic stimulus by the virus2 McCracken and Shinefield a studied eight infants two to 11 days of age with clinical signs of CMV infection and found IgA present in all of the patients whereas age and weight-matched, noninfected control infants did not have detectable lgA. The concentrations of IgA and IgM in cord serum in congenitally infected and noninfected infants entered in a prospective study of congenital CMV infection are presented here.

HEMOLYTIC REACTION AFTER NOVOBIOCIN THERAPY.

A SIX-year-old girl was seen at the United States Army Hospital, Fort Rucker, Alabama, with a chief complaint of mild jaundice and dark urine present for one day. The child had previously been seen...

Medical Management of Cardiac Transplant Patients

The most perplexing problems encountered in the medical management of heart transplant patients are recognition and management of rejection. In addition the immunosuppressive therapy given can make infection hard to recognize. In the series of 16 heart transplantations on which this report is based, eight of the 14 deaths can be attributed to rejection and four to infection. Current challenges are the clear identification of biologic mechanisms involved in rejection and the understanding of the immune mechanisms.

Medical Management of Cardiac Transplants.

Excerpt Transplantation of the human heart is now a A possible means of therapy for those patients with advanced heart disease that is not amenable to other forms of therapy. This paper is based on...

32 Defective Lymphocyte Response to PHA in Congenital Rubella

Persistent viral carrier state in congenital rubella remains an enigma. Defective cellular immune mechanisms may play a role in this persistence. To investigate this possibility the response of leukocytes to phytohemagglutinin (PHA) was studied. 2 × 106 peripheral leukocytes were cultured in routine media. PHA was added to achieve a concentration of 0.025 ml/ml of media. Quadruplicate cultures were incubated at 37° C for 72 h and treated with C14 labeled thymidine for 5 h prior to termination. Cellular response was estimated by measuring the cellular content of C14 in a standard liquid scintillation system. A decreased PHA responsiveness of leukocytes was demonstrated in 8 of 14 congenital rubella patients studied, despite evidence in these patients of normal delayed hypersensitivity. PHA response returned to normal later in the course of each patient. To test whether this lack of responsiveness is due to an intrinsic defect in lymphoid cells from these patients or to direct effects of rubella virus, a normal adults leukocytes were cultured with rubella virus. PHA response was dramatically reduced in every experiment; this effect could be eliminated by pretreatment of the virus preparation with rubella neutralizing antibody. Inhibition was also produced when Newcastle disease virus was substituted for rubella virus. These studies indicate that leukocytes from some congenital rubella patients show a defective response to PHA. The defective response can be reproduced in normal leukocytes by the addition of rubella virus or Newcastle disease virus in vitro. The prolonged persistence of virus and the defective reactivity to PHA in babies with congenital rubella may be interrelated. (SPR)