French Otorhinolaryngology Society guidelines for day-case nasal surgery.

OBJECTIVES: The French Otorhinolaryngology Society (SFORL) set up a work group to draw up a consensus document on day-case surgery in four rhinologic procedures: endoscopic middle meatal antrostomy (French National Health Insurance (CCAM) code GBPE001), septoplasty (GAMA007), and reduction of nasal bone fracture using a direct approach (LAEA007) and using a closed technique (LAEP002). MATERIALS AND METHODS: Methodology followed the French Health Authority (HAS) "Methodological Bases for Drawing Up Professional Guidelines by Formalized Consensus" published in January 2006; the method chosen was the short version of the RAND/UCLA Appropriateness Method (without editorial group), as the work group topic was highly specialized, with few experts available. RESULTS: Ahead of any day-case sinonasal surgery, it is recommended that patient eligibility criteria be respected and hemorrhagic risk assessed; preference should be given to short procedures involving little variation in surgery time and minimizing blood-loss, and associated procedures (e.g., septoplasty+turbinectomy) should be avoided. The patient and family should be informed of specific hemorrhagic, orbital and/or neuromeningeal risks, onset of which may preclude discharge home. Uni- or bilateral postoperative nasal packing is not a contraindication to day-case management. CONCLUSION: All four procedures may be performed on a day-case basis. Eligibility criteria should be systematically respected, but hemorrhagic risk, which is very specific to the sinonasal organ, is to be assessed on a case-by-case basis, as it is a major issue in this kind of management for a non-negligible number of patients.

At least one class I gene in restriction fragment pattern-Y (Rfp-Y), the second MHC gene cluster in the chicken, is transcribed, polymorphic, and shows divergent specialization in antigen binding region.

MHC genes in the chicken are arranged into two genetically independent clusters located on the same chromosome. These are the classical B: system and restriction fragment pattern-Y (Rfp-Y), a second cluster of MHC genes identified recently through DNA hybridization. Because small numbers of MHC class I and class II genes are present in both B: and Rfp-Y, the two clusters might be the result of duplication of an entire chromosomal segment. We subcloned, sequenced, and analyzed the expression of two class I loci mapping to Rfp-Y to determine whether Rfp-Y should be considered either as a second, classical MHC or as a region containing specialized MHC-like genes, such as class Ib genes. The Rfp-Y genes are highly similar to each other (93%) and to classical class Ia genes (73% with chicken B: class I; 49% with HLA-A). One locus is disrupted and unexpressed. The other, YFV, is widely transcribed and polymorphic. Mature YFV protein associated with beta(2)m arrives on the surface of chicken B (RP9) lymphoma cells expressing YFV as an epitope-tagged transgene. Substitutions in the YFV Ag-binding region (ABR) occur at four of the eight highly conserved residues that are essential for binding of peptide-Ag in the class Ia molecules. Therefore, it is unlikely that Ag is bound in the YFV ABR in the manner typical of class Ia molecules. This ABR specialization indicates that even though YFV is polymorphic and widely transcribed, it is, in fact, a class Ib gene, and Rfp-Y is a region containing MHC genes of specialized function.

Effect of Cryptosporidium baileyi in specific pathogen free chickens vaccinated (CVI988/Rispens) and challenged with HPRS-16 strain of Marek's.

This study was performed to examine the effect of Marek's disease virus (MDV) serotype 1 vaccine (CVI988/Rispens) on the pathogenicity of Cryptosporidium baileyi , and to determine whether C. baileyi infection could prevent the development of vaccinal Marek's disease (MD) immunity in specific pathogen free (SPF) chickens. Sixty-eight SPF homozygous B13 White Leghorn chickens were divided into seven groups. C. baileyi was orally administered at 5 days of age (day 4) in chickens infected with Rispens vaccine at day 0 or at day 8 and challenged with HPRS-16 strain of oncogenic MDV at day 15. Relevant control groups were constituted. The chickens were kept in isolators until the end of the experiment at day 62. The parameters evaluated were clinical signs, kinetics of oocyst shedding, mortality, macroscopic and microscopic lesions, cryptosporidia location in various organs and serum anti- C. baileyi antibodies at days 42 and 62. Our results show that C. baileyi , which is considered to be non-pathogenic when inoculated orally, may become highly pathogenic. It induced severe mortality and developed in organs other than classical target sites when chickens were vaccinated with Rispens vaccine and challenged with the HPRS-16 strain of MDV.However,parasite infection does not prevent the induction of vaccinal immunity for MD. Our results also show that vaccination of B13 chickens at hatching induces higher protection against challenge with HPRS-16 MDV at day 15 than vaccination at day 8.

Renal Cryptosporidiosis (Cryptosporidium baileyi) in specific-pathogen-free chickens experimentally coinfected with Marek's disease virus.

Renal Cryptosporidiosis was experimentally induced during a study to investigate the pathogenicity of Cryptosporidium baileyi in specific-pathogen-free (SPF) chickens coinfected with Marek's disease virus (MDV). Cryptosporidium baileyi was administered orally at 4 days of age to chickens previously infected at hatching (day 0) with the HPRS 16 strain of oncogenic MDV. Three control groups received MDV at hatching, C. baileyi on day 4, or placebo consisting of distilled water. Renal cryptosporidiosis lesions were induced in the group coinfected with MDV and C. baileyi. The kidneys were markedly swollen and pale, with visible urate crystals in the ureters and surface tubules. Oocysts of C. baileyi were demonstrated in six of seven cases tested by a scoring method with modified Sheather's sugar solution on renal tissue scrapings and were confirmed in three cases by histologic examination of paraffin-embedded kidney sections. Histologic study also revealed subacute interstitial nephritis, acute ureteritis, and attachment of cryptosporidia on the epithelial cell surface of the ureters and collecting ducts, collecting tubules, and distal convoluted tubules. Various developmental stages of the parasite were present in the kidney sections. To our knowledge, this is the first report of experimentally induced renal cryptosporidiosis in SPF chickens coinfected with MDV.

Intratesticular inoculation of avian leukosis virus (ALV) in chickens--production of neutralizing antibodies and lack of virus shedding into semen.

In order to investigate the possibility of producing transgenic chickens by injection of avian leukosis virus-based vectors into testis, we have analyzed the infection rate of testicular cells following inoculation of Rous-associated virus type 1 (RAV-1) into the gonads of adult and 1-wk-old brown leghorn males. Viroproduction, neutralizing antibody production, and vital DNA presence in testis, blood, muscle, and semen were analyzed at various times after infection. Inoculation of RAV-1 into the gonads of adult males resulted in a low level of viroproduction in testis and blood, followed by the appearance of neutralizing antibody 2 or 3 wk later. Neither viroproduction in semen nor viral DNA presence in sperm were detected even though the infected chickens were found to produce RAV-1 in testis. One week after intratesticular inoculation of 1-wk-old males with RAV-1, a high level of viroproduction was found in blood and testis, and viral DNA was detected in gonadal cells. Further, by 6 wk after inoculation, the production of virus decreased in all tissues, viral DNA could not longer be detected in the testis, and neutralizing antibodies appeared in blood. All together these data show that it is possible to infect testicular cells by direct inoculation of RAV-1 in the testis, and that the immune response of both adult and young chickens seems to reduce this infection. Moreover, no evidence of spermatozoa infection was found; this result suggests that RAV-1 inoculation into testis may not induce genetic transmission of virus, and consequently would not be useful in the production of transgenic chickens.

Occupational exposure to poultry and prevalence of antibodies against Marek's disease virus and avian leukosis retroviruses.

OBJECTIVES: To compare the prevalence of antibodies against Marek's disease herpes virus (MDV) and against avian leukosis viruses type C (ALV) in groups of workers exposed to poultry and in unexposed groups. METHODS: Antibodies directed against avian viral proteins were detected by enzyme linked immunosorbent assay in 549 subjects. Exposure to chickens was high in two subgroups: farmers on intensive chicken farms and workers at chicken slaughterhouses. One subgroup, traditional farmers on dairy or pig farms with poultry, had moderate exposure to poultry. Another subgroup, farmers and slaughterhouse workers on quail farms, had high exposure to quails. Three subgroups were not exposed to chickens: farmers on dairy or pig farms without poultry, workers at cattle slaughterhouses, and white collar workers. Also, MDV antibodies were tested after serum sample adsorption with chicken antigens in 134 serum samples. RESULTS: The prevalence of antibodies against MDV was significantly higher in the exposed subgroups than in unexposed groups (odds ratio (OR) 6.17; 95% confidence interval (95% CI) 3.91-9.75). No association was found between seroprevalence and age. However, higher prevalence was found among women and was related to duration of exposure to chickens. The concentration of antibodies from a few subjects remained very high after adsorption. Significant differences between the men and women were found for the prevalence of antibodies for ALV but were not related to exposure to chickens. CONCLUSIONS: The prevalence of antibodies against MDV was significantly higher among workers exposed to chickens and was related to sex and duration of exposure. The higher prevalence of antibodies against avian oncogenic viruses found among women compared with men may be induced by differences in exposure or by genetic factors. The meaning of these high titres could be related to the presence of MDV in humans. Because the involvement of animal oncogenic viruses in human cancer is indicated by epidemiological and some experimental studies, the integration of viral DNA in human cells needs to be investigated.

The tetrapeptide AcSDKP, a negative regulator of cell cycle entry, inhibits the proliferation of human and chicken lymphocytes.

The tetrapeptide AcSer-Asp-Lys-Pro (AcSDKP) is a physiological negative regulator of hematopoiesis in mammals. It acts by blocking the cell cycle entry of quiescent stem cells and progenitors. In the present study we report that AcSDKP blocks the proliferation of human as well as chicken lymphocytes. It inhibits by 25 to 40% the polyclonal mitogen- (phytohemagglutinin (PHA), pokeweed mitogen (PWM), or concanavalin A) or mixed lymphocyte reaction-induced proliferation of chicken lymphocytes. A comparable degree of inhibition was observed in human whole blood cultures stimulated by "T" (PHA) or "T and B" (PWM) mitogens. Our results obtained on two phylogenetically distant species show that AcSDKP reduces the lymphocyte proliferation probably by blocking or retarding entry into the cell cycle as previously demonstrated for hematopoietic progenitors and hepatocytes. Therefore, this endogenous, non-species-specific tetrapeptide may be involved in the regulation of immune response.

The tetrapeptide AcSDKP, a physiological inhibitor of normal cell proliferation, reduces the S phase entry of continuous cell lines.

The tetrapeptide AcSer-Asp-Lys-Pro (AcSDKP), a physiological negative regulator of cell proliferation, inhibits the progression of normal quiescent cell to the S phase of the cycle, while it is inactive in the proliferation of permanent cell lines and of freshly isolated leukemic cells. It protects normal hematopoietic stem cells and progenitors from the toxic effects of anticancer drugs. We studied the effects of AcSDKP on the S phase entry of mouse and chicken continuous cell lines MS-K, 3T3, MDCC-PA9, and MDCC-MSB1 lines when they are cultured under these defined conditions. They show that AcSDKP acts on cells previously partially synchronized by culture under conditions of low serum concentrations or serum starvation. Our results demonstrate that AcSDKP reduces the proliferation of these cell of continuous cell lines as it does on hepatocytes or hematopoietic cells in vivo or on freshly isolated cells in vitro, by blocking or retarding their entry into S phase from early G1.

Germline transmission of exogenous genes in chickens using helper-free ecotropic avian leukosis virus-based vectors.

We have used vectors derived from avian leukosis viruses to transduce exogenous genes into early somatic stem cells of chicken embryos. The ecotropic helper cell line, Isolde, was used to generate stocks of NL-B vector carrying the Neo(r) selectable marker and the Escherichia coli lacZ gene. Microinjection of the NL-B vector directly beneath unincubated chicken embryo blastoderms resulted in infection of germline stem cells. One of the 16 male birds hatched (6.25%) from the injected embryos contained vector DNA sequences in its semen. Vector sequences were transmitted to G1 progeny at a frequency of 2.7%. Neo(r) and lacZ genes were transcribed in vitro in chicken embryo fibroblast cultures from transgenic embryos of the G2 progeny.

Biochemical and functional characterization of an avian homolog of the integrin GPIIb-IIIa present on chicken thrombocytes.

We have analyzed the reactivity of a new mouse monoclonal antibody (mAb), 11C3, which identifies a cell marker detected on the surface of chicken thrombocytes. Tissue distribution studies have shown that only cells of the thrombocytic lineage in blood, spleen, and bone marrow are stained by 11C3. However, it does not react with other species such as quail, mouse, and man. The 11C3 mAb immunoprecipitates an heterodimeric molecule made of two bands with an apparent molecular weight of 112 and 90 kDa under nonreducing conditions and 112 and 26 kDa following reduction. This pattern of migration is similar to the one observed for members of the integrin family of cell adhesion molecules. We have used the previously described mAb AP-2, which is specific for the human platelet integrin GPIIb-IIIa and cross-reacts with chicken thrombocytes. We have shown that it immunoprecipitates two bands with an identical electrophoretic mobility. Cross-inhibition and immunodepletion studies reveal that the two antibodies recognize two different isoforms or two conformational variants of the same molecule. Moreover, our data demonstrate that in contrast with AP-2, 11C3 is a potent inducer of thrombocyte activation measured by cell aggregation, chemiluminescence, or release of [3H]serotonin. It also inhibits the adhesion of thrombin-activated thrombocytes to fibrinogen and, to a lesser degree, to fibronectin, in a dose-dependent manner. Altogether, these results indicate that this antibody identifies the avian homolog of the mammalian platelet integrin and fibrinogen receptor GPIIb-IIIa.

Analysis of B complex polymorphism in Rous sarcoma progressor and regressor chickens with B-G, B-F, and B-L beta probes.

Molecular polymorphism of the B complex was studied in serologically defined B19 haplotypes by use of class I, class II, and class IV probes in Southern blot experiments in chickens. All chickens studied shared identical class IV restriction patterns. In contrast, class I and class II probes revealed six and five subtypes of B19 haplotype, respectively. These subtypes may be resolved in three homozygous genotypes and their corresponding heterozygous combinations. Previous genetic selection allowed us to distinguish two subpopulations in these B19 chickens with regard to the fate of Rous sarcoma virus (RSV)-induced tumors. Molecular genotyping was applied to B19 chickens challenged with RSV in order to determine whether there is a correlation between one of the molecularly defined subtypes and the progressor/regressor phenotypes of the chickens. None of the molecularly defined subtypes correlated with the progressor or regressor phenotype of the challenged birds.

Differentiation of an epiperiosteal sheath in avian hyperostosis induced by myeloblastosis associated virus MAV-2 (0).

If myeloblastosis associated virus MAV-2(0) is injected in chick embryos, it causes a severe, irreversible and generalized hyperostosis which subsequently follows a chronic course. An epiperiosteal sheath forms at the site of the lesion, whose development follows that of the hyperostosis. The sheath contains not only cell infiltrates, blood vessels and myoblasts, but also highly specialized cells such as Pacinian corpuscles. The structural lesions are absolutely different from these described in human, mammal or avian spontaneous or induced osteopetrosis. Our initial description of the "hyperostosis" is confirmed by observation of this sheath surrounding the pathological bone: it is a monodermic, mesenchymal, pluritissular tumor. The role of the virus is discussed: it probably acts early, when mesenchymal stem cells differentiate.

Effect of a preliminary infection of ducks with EDS-76 virus on the Derzsy's disease pathology.

The aim of this work was to investigate the role of a non pathogenic adenovirus (EDS-76, strain A-127), frequently isolated from ducklings on the infection by a pathogen agent (such as the parvovirus responsible for Derzsy's disease, DDV). Three groups of ducklings were respectively infected with A-127 alone, at day old, DDV alone at day 10th, A-127 at day old plus DDV at day 10th. The infected groups and a control one were raised under similar conditions. Pathological signs were observed and body weights recorded. Sera were collected weekly and analysed for DDV and A-127 antibodies. In addition, in vitro assays of the multiplication of these viruses and studies on cytopathic effects on duck embryo fibroblasts were conducted. The humoral response did not appear to be influenced by dual infection. No differences in cytopathogenic effects were detected in vitro between single and dual infection. On the other hand, in ducklings, dual infection increased the mortality rate and depressed the body weight gain, as compared to infection with either virus alone. The drastic effect on the body weight gain of the EDS-76 virus in the presence of DDV clearly shows a synergic role of this virus on the course of Derzsy's disease.

Chicken thymocyte-specific antigens identified by monoclonal antibodies: characterization and distribution in normal tissues and in tumoral tissues from Marek's disease chicken.

Monoclonal antibodies (MAbs) were obtained against purified thymocyte membrane extracts. Five MAbs TA3, TB1, TB6 (IgG1), TC4, and TA1 (IgG2a), were tested by immunofluorescence and by immunoperoxidase tests against normal cells from different organs, Marek's disease (MD) cell lines, and MD tumoral cells from chickens. Three of them, TA3, TB1, and TB6, reacted exclusively with lymphoid cells in both cortical and medullary areas of the thymus and with less than 8% bursa cells. They identified a protein of apparently 40 kD. The other two revealed antigenic determinants on most medullar thymocytes and some cortical thymocytes, and on some splenic and peripheral blood lymphocytes. They were positive with MD cell lines and cells deriving from MD tumors. TC4 and TA1 detected molecular masses of about 110 kD and 16 kD, respectively. No MAbs reacted with erythrocytes, bone marrow, liver, brain, and skin cells. Not all of the tested cells were stained after contact with an anti-chicken immunoglobulin serum. In this paper, we determine a specific antigen restricted to T cells from thymus and different markers belonging to the mature T cells. The latter are also present on MD cell lines and MD tumoral cells.

Protein concentrations and immunosuppressive properties of serum in chickens experimentally infected with avian tumor viruses.

Sera from chickens affected by Marek's disease or developing Rous sarcoma were investigated. There were changes in the protein fractions, and the amount of alpha and beta fractions was consistently increased. At the same time, immunosuppressive factors were found to inhibit the number of plaque-forming cells in the spleen of mice immunized with sheep red blood cells.

[The periosteum in experimental avian hyperostosis induced by MAV 2-0 myeloblastosis virus. Differential diagnosis from osteopetrosis]. / Le périoste dans l'hyperostose aviaire expérimentale induite par le virus myéloblastique mav 2-0. Diagnostic différentiel de l'ostéopétrose.

Diaphyseal tibial bones of 11-14-17 th day-old hatched chicks infected with retrovirus myeloblastic MAV 2-0 were examined by conventional optical microscopy. The characteristic lesion is osteoblastic hyperplasia with the development of spongious bone. The new formed bone contains abnormal chondroid tissue. The relation between osseous and cartilaginous tissues in this experimental model is discussed. As connective tissue took part in the constitution of this hyperostosis, this osteopathy may be considered as an hyperplastic, monodermic mesenchymatous, pluritissular tumour. The numerous works concerning the "avian hyperostosis osteopetrosis" are commented.

[Influence of B locus on avian viral induced tumours]. / Influence du locus B sur les tumeurs virales aviaires.

Since early in the century Avian Cancers were described as induced by viruses which later were known of DNA and RNA types. The susceptibility of birds was found different according to the genetic lines of the chickens and specially to the B locus blood group. Since the B locus of birds was strongly associated with the Major Histocompatibility Complex (MHC) it was of interest to review the last reports on the influence of the B locus on viral induced tumours. In Marek's Disease due to a DNA virus (Herpes type) the B21 allele expresses the greater resistance compared with other B alleles although non-B factors could be involved as demonstrated with the lymphocyte factor Ly-4. The possible mechanisms of the influence of B locus on the resistance against Marek's Disease are discussed. The tumours induced by RNA viruses (Avian Leucosis Sarcomas) develop or regress following genetic characters closely related to MHC. Differences of resistance exist between B alleles. Complementary genes should be present to fully express the resistance. The relationship between MHC-B locus and resistance to tumors stimulates the actual assays. Since a number of parameters remain still unknown further researches should be done in order to evidence the involved mechanisms of the resistance.