Horner syndrome-A rare complication after thyroidectomy for benign thyroid swelling.

Horner syndrome occurring after thyroidectomy is a rare entity and most of the reported cases have happened after surgeries on malignant thyroid swellings. In the present report, we describe a 27-year-old female who developed ptosis, miosis, enophthalmos, and anhidrosis on the second post-operative day after thyroidectomy for benign goiter. Post-operative ultrasound, computed tomography of neck, nerve conduction study, and electromyography of brachial plexus were unremarkable. Patient was kept on conservative management. She was given short course of Prednisolone orally for 2 weeks and was discharged on 150 mcg thyroxine. She had significant improvement in ptosis, miosis, and enophthalmos after six months. Horner syndrome is a rare but an important complication after thyroidectomy which may lead to cosmetic disfigurement. Surgeons should be well aware of this possibility and its presentation for timely recognition and management postoperatively. Early intervention should be done for any reversible cause, i.e., hematoma and oral steroids should be initiated as early as possible.

Femoral pseudoaneurysm in drug addicts--excision without revascularization is a viable option.

PURPOSE: To present a series of patients presenting with femoral pseudoaneurysm. RESULTS: Seventeen patients who presented with a femoral pseudoaneurysm during a 1 year period were included in this study. Parenteral drug abuse was the most common aetiological factor. The femoral artery was most commonly involved at its bifurcation. Sixteen patients (94%) had excision of the pseudoaneurysm with ligation of vessel and debridement without any revascularization and one patient (6%) had reverse saphenous grafting after excision and ligation of vessels. Four amputations (23%) were performed. Three (17%) were major limb amputations, which included one above knee and two below knee amputations. Four patients (23%) developed intermittent claudication. CONCLUSION: Excision of the pseudoaneurysm with ligation of vessels and wide debridement without immediate revascularization in infected pseudoaneurysms is a safe and effective treatment.

Sequence analysis of gene 3, gene 4 and gene 5 of avian infectious bronchitis virus strain CU-T2.

We have previously reported the nucleotide sequences of gene 2 (spike (S) protein gene), gene 6 (nucleocapsid (N) protein gene), and the 3' end untranslated region of a novel avian infectious bronchitis virus (IBV) strain, CU-T2 [Jia et al. (1995) Arch. Virol. 140, 259 271]. In the present report we describe the sequences of the remaining genes of this strain (gene 3, 4 and 5) with the exception of gene 1 (RNA polymerase gene). Gene 3 contained three open reading frames (ORFs), 3a, 3b and 3c of 174, 195 and 282 nucleotides (nt), respectively. Gene 4 (membrane (M) protein gene) consisted of 749 nt with a single ORF of 687 nt. Gene 5 contained two ORFs, 5a and 5b, with 198 and 249 nt, respectively. Thus, in total, there were 7349 nt from the 5' end of S protein gene to the 3' end of the CU-T2 genome. The overall nt sequence homologies between gene 3, 4, and 5 of CU-T2 and those of other strains were between 84.1-90.8%, 85.8-88.8% and 90.4 96.4%, respectively. The predicted amino acid (aa) sequence homologies revealed that gene 3b and 5b were more conserved than 3a, 3c and 5a. Each individual gene of CU-T2 strain (with the exception of the RNA polymerase gene) had a different level of homology with the homologous gene of other strains, suggesting that the evolution of IBV strains in general has been a complex, and as yet, poorly understood process.

A novel variant of avian infectious bronchitis virus resulting from recombination among three different strains.

An antigenic variant of avian infectious bronchitis virus (IBV), a coronavirus, was isolated and characterized. This strain, CU-T2, possesses a number of unusual features, which have not been previously observed in IBV. The S1 glycoprotein of CU-T2 carries virus-neutralizing and serotype-specific epitopes of two IBV serotypes, Arkansas (Ark) and Massachusetts (Mass). Sequence analysis revealed that the virus, originally an Ark serotype, has acquired the Mass-specific epitope by mutation(s). This provides evidence that point mutations may lead to generation of IBV antigenic variants in the field. It was further observed that two independent recombination events involving three different IBV strains had occurred in the S2 glycoprotein gene and N protein gene of CU-T2, indicating that genomic RNA recombination in IBV may occur in multiple genes in nature. It was especially significant that a sequence of Holland 52 (a vaccine strain) had replaced half of the N gene of CU-T2. This proves that recombination among vaccine strains is contributing to the generation of IBV variants in the field. Based on these observations it is predicted that every IBV field isolate could have unique genetic nature. Therefore, several recently reported diagnostic and serotyping methods of IBV which are based on dot-blot hybridization, restriction fragment length polymorphism (RFLP), and polymerase chain reaction (PCR), may not reveal the true antigenic and/or genetic nature of IBV isolates, and may in fact yield misleading information.

Experimental induction of hemorrhagic-aplastic anemia in chickens. II. Serum protein changes.

The serologic response of chickens to infectious bursal disease virus (IBDV) and inclusion body hepatitis virus (IBHV) was analyzed. Inoculation at one day old with either IBDV or IBHV significantly (P less than 0.05) reduced levels of serum gamma-globulins at 4 weeks postinoculation. This response was not elicited by inoculation of IBDV together with IBHV. Birds with experimentally induced or naturally occurring hemorrhagic anemia syndrome (HAS) had serum proteins quantitatively and qualitatively changed from those of controls. Serum protein profiles did not coincide, however, in experimentally infected and naturally infected chickens. Among naturally infected chickens, those that were IBHV-positive upon culture had significantly (P less than 0.05) lower hematocrit values.

Experimental induction of hemorrhagic-aplastic anemia in chickens. I. Etiology.

Exposure to infectious bursal disease virus (IBDV) at 1 day old followed by inclusion body hepatitis virus (IBHV) inoculation at 36 days produced typical lesions of hemorrhagic-aplastic anemia syndrome (HAS). The lesions included severe anemia, widespread hemorrhages, and dermatitis. HAS could not be induced in the first 4 weeks of life in chickens inoculated at one day old with IBHV alone or in combination with IBDV. It was concluded that the immunosuppressive effects of IBDV failed to alter the pathogenicity of IBHV in chicks less than 4 weeks old. This resistance was considered to be age-related. Subcutaneous inoculation of day-old chicks with IBDV produced a more severe infection than did oral exposure. Serial passage of IBHV in day-old chicks had no significant effect on the viral pathogenicity.

Purification and concentration of viruses associated with transmissible (coronaviral) enteritis of turkeys (bluecomb).

Purification and concentration of viruses contained in pathogenic material was accomplished by sucrose density gradient centrifugation. Electron microscopy was also performed. Viruses recovered from intestinal preparations of both affected and unaffected turkey poults had a density of 1.16 to 1.17. The viruses resembled myxoviruses, paramyxoviruses, or oncornaviruses morphologically. In addition, preparations from bluecomb-affected poults were found to contain viruses indistinguishable from known coronaviruses. No such virus particles were seen in the control preparations. Data are presented to indicate an etiologic relationship between the coronavirus and transmissible enteritis of turkeys.