Laguna Negra Virus Infection Causes Hantavirus Pulmonary Syndrome in Turkish Hamsters (Mesocricetus brandti).

Laguna Negra virus (LNV) is a New World hantavirus associated with severe and often fatal cardiopulmonary disease in humans, known as hantavirus pulmonary syndrome (HPS). Five hamster species were evaluated for clinical and serologic responses following inoculation with 4 hantaviruses. Of the 5 hamster species, only Turkish hamsters infected with LNV demonstrated signs consistent with HPS and a fatality rate of 43%. Clinical manifestations in infected animals that succumbed to disease included severe and rapid onset of dyspnea, weight loss, leukopenia, and reduced thrombocyte numbers as compared to uninfected controls. Histopathologic examination revealed lung lesions that resemble the hallmarks of HPS in humans, including interstitial pneumonia and pulmonary edema, as well as generalized infection of endothelial cells and macrophages in major organ tissues. Histologic lesions corresponded to the presence of viral antigen in affected tissues. To date, there have been no small animal models available to study LNV infection and pathogenesis. The Turkish hamster model of LNV infection may be important in the study of LNV-induced HPS pathogenesis and development of disease treatment and prevention strategies.

Virology. Mutation rate and genotype variation of Ebola virus from Mali case sequences.

The occurrence of Ebola virus (EBOV) in West Africa during 2013-2015 is unprecedented. Early reports suggested that in this outbreak EBOV is mutating twice as fast as previously observed, which indicates the potential for changes in transmissibility and virulence and could render current molecular diagnostics and countermeasures ineffective. We have determined additional full-length sequences from two clusters of imported EBOV infections into Mali, and we show that the nucleotide substitution rate (9.6 × 10(-4) substitutions per site per year) is consistent with rates observed in Central African outbreaks. In addition, overall variation among all genotypes observed remains low. Thus, our data indicate that EBOV is not undergoing rapid evolution in humans during the current outbreak. This finding has important implications for outbreak response and public health decisions and should alleviate several previously raised concerns.

Age factor relevant to the development of radiation pneumonitis in radiotherapy of lung cancer.

The significance of age factor for the development of radiation pneumonitis is evaluated in 62 patients with lung cancer between 1977 and 1985. The younger group consists of those less than 70 years old and the elderly group of those 70 years old or more. Radiation doses ranged from 1.5 to 2 Gy, 3 to 5 times per week, therefore the delivered doses were converted to nominal single doses (rets dose). Severe radiation pneumonitis was more often observed in the elderly than in the younger regardless of radiation field size and chemotherapy (n.s.). The onset of radiation pneumonitis occurred earlier in a field size of 90 sq cm or more than in that of less than 90 sq cm in both age groups; there was no significant difference between the two age groups in each field size. The pneumonitis was more frequently noted with increasing rets dose in both age groups (n.s.) regardless of field size and chemotherapy. It is concluded that there is no significant difference in the development of radiation pneumonitis between the younger group and the elderly group, but the pneumonitis is inclined to be more severe in the latter.

Pressor response to microinjection of clonidine into the hypothalamic paraventricular nucleus in conscious rats.

We have reported that intracerebroventricular (i.c.v.) injection of clonidine causes pressor response in conscious rats. To determine the effective brain site, cardiovascular responses induced by unilateral microinjection of clonidine into various hypothalamic nuclei of conscious rats were studied. Microinjection of clonidine (5-20 micrograms/0.5 microliter) into the paraventricular nucleus (PVN) of conscious rats dose-dependently produced a long-lasting pressor response with a decrease in heart rate, which mimicked the response to i.c.v. injection of clonidine. However, clonidine (10 micrograms) injection into various hypothalamic nuclei (anterior, posterior, ventromedial and dorsomedial nucleus) caused a small or no pressor response. In anesthetized rats, clonidine injected into the PVN induced a long-lasting depressor response concomitant with bradycardia. PVN pretreatment with the alpha 2-adrenoceptor antagonist, yohimbine (1 and 10 micrograms), dose-dependently inhibited the pressor response to PVN injected clonidine, but the alpha 1-adrenoceptor antagonist, prazosin (1 microgram), had no significant effect. Central (i.c.v.) pretreatment with the vasopressin (AVP) V1-receptor antagonist, [d(CH2)5Tyr(Me)]-AVP (0.5 and 2.0 micrograms), dose-dependently inhibited the pressor response to PVN injection of clonidine (10 micrograms), while systemic (i.v.) and local (intra-PVN injection) pretreatments with V1-receptor antagonist (2.0 micrograms) had no effect. These results suggest that the pressor response to microinjection of clonidine into the PVN of conscious rats is mediated by endogenous brain AVP, which is released by activation of alpha 2-adrenoceptors. It is also suggested that the PVN is a possible brain site for the pressor response to i.c.v. injected clonidine.

Metabolism and pulmonary toxicity of intratracheally instilled cupric sulfate in rats.

Though copper (Cu)-handling workers are known to be at risk to develop metal fume fever and acute respiratory failure, very little is known about the metabolic fate and pulmonary toxicity of Cu compounds deposited in the lung. We have investigated time-course and dose-related changes in Cu contents, the production of metallothionein (MT) and inflammatory responses in the rat lung following intratracheal instillation of cupric sulfate (CuSO4). Intratracheally instilled Cu was cleared rapidly from the lung with a half-time of 7.5 h. Copper-binding MT was induced in the lung tissue following Cu instillation and the amount of MT increased with the dose of CuSO4. However, the production of MT contributed little to the accumulation of Cu in the lung. The pulmonary toxicity of CuSO4 was evaluated by examining time-course and dose-effect profiles of cytological and biochemical inflammatory indices (enzymes, protein and elements) retrieved in bronchoalveolar lavage fluids. These results revealed that the inflammatory indices reached maximum values in their activities and contents at 12 h to 3 days after instillation and a dose of 5 micrograms Cu/rat was sufficient to produce acute inflammatory responses in the rat lung.

Catheter-induced spasm during spontaneous attack of variant angina.

The simultaneous occurrences of spontaneous spasm and catheter-induced spasm during coronary angiography were obtained in 3 patients. Catheter-induced spasm was seen in the right coronary artery in 3 patients: 1 patient had spontaneous spasm in the distal right coronary artery and 2 patients had spontaneous spasm in the proximal left anterior descending coronary artery. These findings suggest that patients with variant angina may be susceptible to mechanical induction of spasm.

Recurrence of coronary artery spasm after successful percutaneous transluminal coronary angioplasty.

A 47-year-old man presented with angina, and coronary angiograms showed a significant organic stenosis with spasm in the left anterior descending coronary artery. Percutaneous transluminal coronary angioplasty was successfully performed for the organic lesion in the left anterior descending coronary artery. Symptom of angina due to coronary artery spasm recurred, even without restenosis at the site of successful angioplasty.

Recurrence of myocardial infarction related to different vessels in a patient with diffuse coronary artery spasm without underlying severe organic stenosis.

A 59-year-old man had a first myocardial infarction in the right coronary artery, followed by an another infarction in the left anterior descending coronary artery. Coronary thrombolysis for both occasions of acute myocardial infarction was successfully performed without severe residual stenosis. In the chronic phase after the second myocardial infarction, ergonovine test showed diffuse coronary artery spasm. The etiology of myocardial infarction is briefly discussed.

Multiple coronary thrombosis in a patient with thrombocytosis.

A 59-year-old woman was admitted with acute inferior myocardial infarction. Cardiac catheterization revealed total occlusion in the right coronary artery and thrombus-like filling defect in the left anterior descending coronary artery. With simultaneous intracoronary urokinase infusion to the right and left coronary arteries, the right coronary artery became patent and the thrombus in the left anterior descending coronary artery was released to the distal coronary artery. Thrombocytosis was disclosed by laboratory examination. The relationship between myocardial infarction and thrombocytosis is discussed.

Prediction of degree of residual stenosis in coronary thrombolysis.

In order to predict the residual stenosis in coronary thrombolysis, the factors easily obtained from clinical history--age, gender, history of angina before acute myocardial infarction (AMI), family history, hypertension, diabetes, hypercholesterolemia, smoking, and interval between onset of AMI and recanalization--were observed in 114 patients with successful coronary thrombolysis. In 55 patients with angina before AMI, 29 patients had residual stenosis greater than or equal to 75% and 26 patients had residual stenosis less than 75%. In 59 patients without angina before AMI, 15 patients had residual stenosis greater than or equal to 75%, and 44 patients had residual stenosis less than 75%. The presence or absence of angina before AMI was the main variable that discriminated the groups of residual stenosis of more or less than 75%, which was the only significant independent variable to predict the residual stenosis. These data suggest that the presence of angina pectoris before AMI is likely to be associated with a significant degree of residual stenosis after thrombolysis.

A case of cardiac amyloidosis presenting with symptoms of exertional syncope.

A 54-year-old man presented with symptoms of exertional syncope. Cardiac amyloidosis was diagnosed by endomyocardial biopsy. Exercise tolerance test revealed a failure of increased heart rate followed by sinus arrest, associated with syncope. Autopsy revealed amyloid deposits in the sinoatrial node.

V-Y advancement flaps in the reconstruction of skin defects of the posterior heel and ankle.

A V-Y advancement pedicle flap including fascia has been used for reconstruction of soft-tissue defects of the posterior heel and ankle region. This flap has been used to cover 17 defects in 16 patients ranging in age from 4 to 58 years, and results have been good. We limited this application to patients without systemic disease and under 60 years of age and did not apply it to the elderly, debilitated, or systemic vascular damaged patients. There were no complications or loss of overlying skin, with the exception of one superficial tip necrosis of the flap. The results indicate the reliability and usefulness of this procedure in coverage of the posterior heel and ankle regions. It is a relatively quick and simple procedure that is without a free skin graft, and it involves only one stage that adequately corrects the skin defect at the posterior heel and ankle without prolonged splintings and results in negligible deformity of the donor site.

Performance test of PDM-101 electronic pocket dosimeters using a 60Co source.

The performance tests of one type (named PDM-101) of silicon semiconductor dosimeter were carried out by using a 60Co point source (approximately 500 kBq). The dosimeter responds to dose equivalents on the order of 0.02 microSv although measured data show a large error for values < 0.08 microSv. The deviation of measured dose equivalents from calculated ones was < 10% in the region > or = 0.08 microSv. The deviation of measured dose equivalent rates from calculated ones was generally < 10%. The average value of measured dose equivalents for 31 directional exposures without underside exposure was 0.92 +/- 0.06 of the calculated value. The difference of measured data for the front and back exposure was < 10%. The background and noise level of the dosimeter was 0.092 +/- 0.005 microSv h-1. All measured data showed that dosimeter response for radiation was symmetric between the front (left) and the back (right) sides of the dosimeter within 10% tolerance.

[Study on middle ear ventilation using positional tympanometry--normal ear].

The middle ear is a cavity surrounded by solid bones, lined with mucosa, which has a gas-filled lumen. Cavernous organs such as the ear should have their own ventilation system under atmospheric pressure. The mechanism of ventilation in the middle ear has not been sufficiently clarified. Ventilation performed in the middle ear may be classified into two types: 1) passive ventilation via the Eustachian tube, required in cases of abnormal pressure and 2) unique physiological active ventilation of the middle ear performed under atmospheric pressure and not involving the Eustachian tube. The purpose of the present study is to prove the existence of this active ventilation under atmospheric pressure. The subjects were 50 normal ears and elevation of middle ear pressure in the lateral position (determined by positional tympanometry) was studied. The change in the peak level, on tympanometry, was used as an index. The results were continuously recorded every 12 seconds. The following results were obtained. 1. Middle ear pressure was elevated by changing from the sitting to the lateral position. Venous pressure was regarded as a causative factor in this pressure elevation. 2. The elevated middle ear pressure in the lateral position suggested gas production from mastoid cells of the middle ear. The observation that the middle ear pressure was stabilized with the increase in pressure, up to a level of 85-90 mm H2O, indicated the existence of gas leakage from the Eustachian tube and a mechanism for controlling gas production from the mastoid cells of the middle ear.

[Study on middle ear ventilation using positional tympanometry--post mastoidectomy ear].

The middle ear is a cavity surrounded by solid bone, lined with mucosa with a lumen filled with gas. To examine this unique ventilation system under atmospheric pressure, the middle ear pressure of 50 normal ears was previously examined. Positional tympanometry, whereby the middle ear pressure is increased as the subject assumes the lateral position under atmospheric pressure was used. As a result, (1) The middle ear pressure was elevated by the change from the sitting position to the lateral position. Venous pressure was regarded as causative factor of this pressure elevation. (2) The elevation of the middle ear pressure in the lateral position suggested gas production from the mastoid cells of the middle ear. In this study, a proportion of the mastoid cells were removed to resect a tumor of the internal acoustic meatus in conjunction with resection of an acoustic tumor. After resection the area was filled with fascia and fatty tissue. The middle ear pressure of each subject was monitored to determine the effect of a decrease in the mastoid cell volume on middle ear pressure. The results were continuously recorded every 12 seconds for the lower ear when the subjects were in the lateral position. The following results were obtained. (1) The elevation of the middle ear pressure due to positional change among subjects which had had acoustic tumors resected was noticeably greater than the elevation in normal ears. This is thought to have been the result of an elevation in cerebrospinal fluid pressure attributable to positional change, along with an elevation in intravenous pressure. (2) We made comparisons of increases in middle ear pressure 10 minutes after assuming the lateral position in 14 ears after acoustic tumor resection and in 21 normal ears. No noticeable differences were found in the middle ear pressure increases between the two groups despite the fact that the volume of the mastoid cells in the group that had tumors resected had been greatly reduced.

[A case of radiation myelitis following radiotherapy in lung cancer].

A case of radiation myelitis developed 1 year and 5 months after radiotherapy for lung cancer is reported. A 75-years old male was given a dose of 70 Gy to the tumor with a fraction dose of 2 Gy, 5 times per week. He developed the weakness and disturbance of sense in bilateral lower extremities, which gradually worsened in spite of a variety of treatment. Some discussions on tolerance dose, fraction dose and fraction number are made as well as technique of irradiation.

Complete genome sequences of three ebola virus isolates from the 2014 outbreak in west Africa.

Here, we report the complete genome sequences, including the genome termini, of three Ebola virus isolates (species Zaire ebolavirus) originating from Guinea that are now being widely used in laboratories in North America for research regarding West African Ebola viruses.