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multiple sclerosis (MS) 515 mumps virus vaccine (live, injection)
to 99% of patients. IgG paraimmunoglobulin manifests
in 80% of myeloma patients, while 15% of the patients
manifest monoclonal IgA. A few cases of the IgD and
IgE types have been described. Homogeneous light chain
dimers identical to the corresponding light chain portions
of immunoglobulin in the blood appear in the urine. These
light chain dimers in the urine are called Bence–Jones
proteins. The segments of light polypeptide chains do not
represent degradation products of immunoglobulin, as they
are synthesized separately from it. The disease affects 3 in
100,000 persons, usually men over 50 years of age. Patients
develop anemia, anorexia, and weakness. The tumor
infiltrates the bone marrow cavities, ultimately leading to
erosion of the bone cortex. This may take years. Osteolytic
lesions are the hallmarks of multiple myeloma. The long
bones, ribs, vertebrae, and skull manifest diffuse osteoporosis,
which leads to the appearance of punched-out areas
and pathologic fractions. Tumor invasion of the marrow,
erosion of the cortex, and osteoclast-activating substances
produce the bone lesions. Lung or renal infections may also
occur. Hypogammaglobulinemia results from decreased
functioning of normal plasma cells and leads to diminished
antibody to combat infections. The malignant plasma cells
produce an excess of nonsense paraimmunoglobulin which
does not protect against infection. There is also defective
phagocytic activity. Patients may have altered B cell function
and increased susceptibility to pyogenic infections.
Some patients may develop myeloma kidney, signified by
proteinuria, followed by oliguria, kidney failure, and possibly
death.
PRE-
ALB.
Zone Electrophoresis
Patterns of Cerebrospinal Fluid
ALB.
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ALB.
α 1 α 2 β γ
ALB.
α 1 α 2 β γ
Multiple sclerosis (100× concentrate).
multiple sclerosis (MS)
A demyelinating nervous system disease of unknown
cause. It is most frequent in young adult females and has
an incidence of 1 in 2500 individuals in the United States.
MS shows a disease association with HLA-A3, B7, and
Dw2 haplotypes. Patients express multiple neurological
symptoms that are worse at some times than others,
together with inhibition of nerve impulse transmission.
They have paresthesias, muscle weakness, visual and gait
disturbances, ataxia, and hyperactive tendon reflexes.
Lymphocytes and macrophages infiltrate into the nervous
system which facilitates demyelination. Autoimmune
mechanisms mediated by T cells, which constitute the
majority of infiltrating lymphocytes, are involved. At least
20 viruses have been suggested to play a role in the etiology
of MS. Infected oligodendrocytes are destroyed by the
immune mechanism, and “innocent bystander” demyelination
may also occur. Antibodies against HTLV-I GAG
(p24) protein have been identified in the cerebrospinal
fluid of MS patients. HTLV-I gene sequences have been
identified in monocytes of MS patients. An oligoclonal
increase in cerebrospinal fluid IgG occurs in 90% of MS
patients. Inflammation, demyelination, and glial scarring
are observed. Paraventricular, frontal, and temporal
areas of the brain are first involved, followed by regions
of the brain stem, optic tracts, and white matter of the
cortex with patchy lesions of the spinal cord. Attempts
at treatment have included COP-1, a polypeptide mixture
that resembles myelin basic protein, and numerous other
agents.
multiplicity
The presence in the genome of numerous independent genes
that encode proteins that have the same function.
multivalent
Antibody or antigen molecules with a combining power
greater than two.
multivalent antiserum
An immune serum preparation containing antibodies
specific for more than two antigens. Multivalent means possessing
more than two binding sites.
multivalent vaccine
Refer to polyvalent vaccine.
mumps vaccine
A live attenuated immunizing preparation employed to
prevent mumps. It should be administered under the same
guidelines and restrictions that apply to live attenuated
measles virus vaccine.
mumps virus vaccine (live, injection)
For immunization of individuals over 12 months of age. Not
recommended for infants younger than 12 months because
of the possible presence of maternal mumps-neutralizing
antibodies that may interfere with the immune response.
Mumps is a common childhood disease induced by a
paramyxovirus that may lead to such serious complications
as aseptic meningitis, deafness, orchitis, and even death. As
proven in clinical trials, the vaccine is highly immunogenic
and well tolerated. A single injection can induce mumpsneutralizing
antibodies in 95% of susceptible children and
93% of susceptible adults. Even though the antibody level
is relatively lower than that following natural infection, it is
protective and of long duration. A few (1 to 5%) individuals
receiving the vaccine may fail to seroconvert following
primary immunization. Protective efficacy of mumps
vaccine has been established in controlled field trials.
Seroconversion has been shown to parallel protection from
the disease. Antibodies appearing following vaccination
may be assayed by neutralization, hemagglutination inhibition,
or ELISA techniques. Antibodies are often detectable
11 to 13 days after primary vaccination. Children vaccinated
at or after 12 months of age should be revaccinated
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