Experimental Nipah virus infection in pteropid bats (Pteropus poliocephalus).

Seventeen grey-headed fruit bats (Pteropus poliocephalus) were inoculated subcutaneously with an isolate of Nipah virus derived from a fatally infected human. A control group of eight guinea-pigs was inoculated intraperitoneally with the same isolate in order to confirm virulence. Three of eight infected guinea-pigs developed clinical signs 7-9 days post-inoculation. Infected fruit bats developed a subclinical infection characterized by the transient presence of virus within selected viscera, episodic viral excretion and seroconversion. A range of histopathological changes was observed within the tissues of infected bats. Nipah virus was excreted in bat urine while neutralizing antibody was present in serum. This intermittent, low-level excretion of Nipah virus in the urine of bats may be sufficient to sustain the net reproductive value of the virus in a species where there is regular urine contamination of the fur, mutual grooming, and where urine droplets are a feature of the environment.

A new DNA binding assay to study subclasses of SV40 large T antigen binding to individual binding sites on the SV40 DNA.

SV40 large T antigen interacts specifically with three different sequences, termed sites I, II or III, within the control region of the SV40 DNA to regulate transcription as well as the initiation and progress of SV40 DNA replication. We have biotinylated three different DNAs containing either site I, II or III and immobilized these constructs on a streptavidin agarose matrix. All three immobilized DNAs were shown to bind T antigen from a total cell extract of SV40 infected monkey cells although with different affinities. Pulse chase experiments revealed that newly synthesized T antigen bound efficiently to all three binding sites whereas mature T antigen bound only to site I and site III DNA. The analysis of non-binding and DNA-bound T antigen on sucrose density gradients showed that only low molecular weight forms of T antigen were bound to all three immobilized DNAs. However, incubation of T antigen in the total cell extract with site I DNA resulted in high molecular weight forms of T antigen, indicating that the presence of site I DNA influences the quaternary structure of T antigen which might result in a detachment from the DNA.

Pyriformis syndrome in a 10-year-old boy as a complication of operation with the patient in the sitting position.

We present a case of sciatic neuropathy due to the pyriformis syndrome after operation in the sitting position. Neither sciatic nerve injury nor the pyriformis syndrome has been reported after operation in the sitting position, although a low incidence of common peroneal nerve injury has been reported as a complication of operation on patients who are in the sitting position. The clinical findings of sciatic neuropathy, external rotation of the ipsilateral foot in the position of comfort, and a therapeutic response to local anesthetic injection into the pyriformis muscle are diagnostic of the syndrome. Nerve conduction studies should be performed to aid in the differentiation between a common peroneal and sciatic neuropathy. The syndrome may occur because of extreme flexion of the hips and prolonged pressure while in the sitting position, leading to pyriformis muscle trauma, resultant spasm, and sciatic compression. The prognosis is for complete recovery after symptomatic treatment with nonsteroidal antiinflammatory medication and physical therapy.

Immunohistochemistry in the identification of a number of new diseases in Australia.

Immunohistochemistry plays an important part in the diagnosis of some viral diseases. Demonstration of viral antigen in a lesion is an important contribution to diagnosis, either at the time of investigation or retrospectively. At the CSIRO Australian Animal Health Laboratory, the most frequent use of immunohistochemistry has been in the diagnosis of the important avian diseases, highly pathogenic avian influenza and Newcastle disease. The technology took key roles in the diagnoses of Hendra virus infections, and, later, an immunoperoxidase test gave the first indication of the existence of Australian bat lyssavirus. The test can often confirm that a virus isolated in an animal is the actual virus causing disease and not a coincidental isolation. Good examples of that in some more new diseases were the association of Wallal virus with blindness in kangaroos, and of the new porcine Menangle virus in natural and experimental cerebral disease in foetal piglets.

Cerebral perfusion pressure monitoring in premature newborns.

Cerebral perfusion pressure (CPP), believed to be a major determinant of neurologic outcome, was monitored at the bedside of high-risk premature newborns during the first few days of life. Intraventricular hemorrhage was presumed to have occurred in only one of the seven infants and was associated with ventriculomegaly and early death. The other infants had good neurologic outcomes at age 18 months despite low mean CPPs (less than 30 mm Hg). These low CPPs were determined to be dependent on mean arterial blood pressures and not on intracranial pressures which were low in all infants (and even lower in more premature infants with apnea). Methylxanthine treatment of apnea of prematurity did not apparently change CPP, despite hypothetical effects on cerebral and peripheral vascular tone. Although fairly low CPP can be associated with good neurologic outcome, it may not be useful in monitoring newborn infants.

The jittery newborn and infant: a review.

Jitteriness is an involuntary movement that is particularly frequent in the newborn. Its hallmark is tremor. The pathogenesis is poorly understood. Jitteriness is often accompanied by other signs of central nervous system excitation, such as hypermotility, hypertonicity, and ease of startle. It must be differentiated from myoclonus and seizure, although they may coexist. Jitteriness can be caused by a variety of pre-, peri-, and postnatal insults, and it is the nature and treatability of these, rather than the tremor itself, that are the major determinants of the ultimate prognosis. "Coarse" tremor is probably more often abnormal than "fine" tremor, and appears to bear some relationship to the later development of a choreiform syndrome. The evaluation of the jittery infant must be individualized and management aimed at reversing any remediable causes.

Experimental Nipah virus infection in pigs and cats.

A human isolate of Nipah virus from an outbreak of febrile encephalitis in Malaysia that coincided with a field outbreak of disease in pigs was used to infect eight 6-week-old pigs orally or subcutaneously and two cats oronasally. In pigs, the virus induced a respiratory and neurological syndrome consistent with that observed in the Malaysian pigs. Not all the pigs showed clinical signs, but Nipah virus was recovered from the nose and oropharynx of both clinically and sub-clinically infected animals. Natural infection of in-contact pigs, which was readily demonstrated, appeared to be acute and self-limiting. Subclinical infections occurred in both inoculated and in-contact pigs. Respiratory and neurological disease was also produced in the cats, with recovery of virus from urine as well as from the oropharynx. The clinical and pathological syndrome induced by Nipah virus in cats was comparable with that associated with Hendra virus infection in this species, except that in fatal infection with Nipah virus there was extensive inflammation of the respiratory epithelium, associated with the presence of viral antigen. Viral shedding via the nasopharynx, as observed in pigs and cats in the present study, was not a regular feature of earlier reports of experimental Hendra virus infection in cats and horses. The findings indicate the possibility of field transmission of Nipah virus between pigs via respiratory and oropharyngeal secretions.

Patterns of dysphoria in a Puerto Rican urban community.

This study was undertaken to explore the prevalence of perceived dysphoria in a poor, urban, predominantly Puerto Rican community. A cross-sectional sample of 704 adult respondents were asked a single validated question, with a five-item Likert scale response, about their level of perceived dysphoria. Chi-squared analysis and Spearman's correlation coefficients were used to assess the association of level of dysphoria with social characteristics, barriers to health care, health status, and substance use. Linear regression modeling was used to control for confounding variables. Twenty percent of the respondents were dysphoric. Respondents with no health insurance or no source of health care were least likely to be dysphoric. Persons who perceived distance to the hospital and the doctor, and understanding language of the doctor and office staff as barriers to care were more likely to be dysphoric. Ethnicity was not correlated with level of perceived dysphoria; however, age, gender, and health status were found to be associated with level of dysphoria after controlling for other correlated variables. These results indicate that the psychological needs of communities need to be understood and interventions that are appropriate for the population need to be devised.

Occupational therapy management of the acute spinal cord-injured patient.

This report describes an occupational therapy program for the patient with an acute spinal cord injury. The program includes guidelines for evaluation and treatment, criteria for early orthotic selection, and psychological considerations. The program was developed by the occupational therapy staff at Northwestern Memorial Hospital, Chicago, in conjunction with a medical team and occupational therapy staff from the Rehabilitation Institute of Chicago. The intent of the program is to implement rehabilitation in the acute care environment immediately.

[Effect of high doses of retinol acetate on the 3-beta-ol-steroid dehydrogenase and alkaline phosphatase content in mouse ovaries]. / Vliianie vysokikh doz retinola atsetata na soderzhanie 3-beta-ol-steroiddegidrogenazy i shchlochnoi fosfatazy v iaichnikakh myshei.

The author reports on the effects of different doses of retinol acetate on ovarian steroidogenesis. Two groups of CBA/C57BL mice with a mean body weight of 18-20 g received 3.44% oily retinol acetate per os in daily doses of 50 000 and 80 000 IU for 10 days. After completion of the experiments the quick-frozen sections of the ovaries were subjected to a histochemical assay for the content of 3-beta-ol-steroid dehydrogenase and alkaline phosphatase. Administration of 50 000 IU vitamin A was found to stimulate ovarian steroidogenesis. The effect of vitamin A was the most demonstrable in the interstitial tissue, atretic corpora, and, in the internal theca of the follicles. Administration of 80 000 IU retinol acetate inhibited ovarian steroidogenesis. The estrous cycle in animals ceased. Administration of vitamin A (80 000) primarily affected the follicular apparatus of the ovaries, namely the epithelium of the follicles and yellow bodies. At the same time secretory function of atretic corpora and interstitial tissue remained within normal, which was regarded as a compensatory-adaptive mechanism under toxic hypervitaminosis A.

[Effect of different doses of retinol acetate on the RNA and total protein content of rodent ovaries and endometrium]. / Vliianie razlichnykh doz retinola atseta na soderzhanie RNK i obshchego belka v iaichnikakh i éndometrii gryzunov.

The effects of different doses of retinol acetate (RA) on protein synthesis by the hamster ovaries and endometrium were studied. Two groups of CBA/C57BL mice aged 3-4 months were given 3.44% oily RA per os on a daily basis for 10 days. After completion of the experiments the paraffin sections 6 micron m thin were subjected to a histochemical assay for the content of RNA and total protein in the ovaries and endometrium. RA (50 000 IU) was found to stimulate RNA and protein synthesis in all the ovarian structures and endometrium. In the ovaries, vitamin primarily affected the follicular epithelium and internal the-ca of the follicles. Administration of RA in a dose of 80 000 IU inhibited protein synthesis in the ovaries and endometrium. As for the ovarian structures the greatest changes under toxic hypervitaminosis A (80 000 IU) were experienced by the follicular epithelium and ovocytes.

[Histofunctional state of mouse ovaries in normal conditions and during hypervitaminosis A]. / K voprosu o gistofunktsional'nom sostoianii iachnikov myshei v norme i pri gipervitaminoze A.

Morphometry was used to analyze different histofunctional structures of mouse ovaries (follicles of varying maturation grades, yellow and atretic bodies, interstitial tissue) in health and hypervitaminosis A (80 000 IU). It was noticed that in the ovaries of female mice in health, there occurred consistent cyclic processes marked by the changes in the number and size of the morphofunctional structures during different stages of the estrous cycle. In hypervitaminosis A, female mice had no estrous cycle. The ovaries showed the impairment of the growth of the follicles and enhancement of atresia. As a result, the follicles did not reach the final stages of development, which led to the cessation of ovulation and formation of yellow bodies.

An aberrant right hepatic artery from the right renal artery: anatomical vignette.

The vascular supply of the liver is variable. An unusual aberrant right hepatic artery arising from the right renal artery is described. The embryologic derivation and clinical relevance are discussed.

Contralateral loop snare removal of a ruptured and entrapped angioplasty balloon.

We describe a technique that extracted a ruptured angioplasty balloon which had become entrapped by a calcified left common iliac artery stenosis. The balloon catheter had been advanced crossover from the right and could not be retracted directly into a sheath across the aortic bifurcation. Therefore, a guidewire was inserted through the balloon catheter and captured by a loop snare advanced from the left femoral artery. The loop snare was also used to free the balloon wings from the stenosis. The balloon was then pulled into a 10 Fr sheath and removed as a unit with the sheath.

Lung cancer in patients seropositive for human immunodeficiency virus.

The authors describe the clinical and radiographic findings of lung carcinoma in six patients infected with the human immunodeficiency virus (HIV). These patients were in a younger age group than is commonly associated with lung cancer. The radiographic findings included mediastinal adenopathy (n = 5), hilar masses with distal atelectasis (n = 3), parenchymal masses (n = 3), pleural effusions (n = 2), and pleural thickening (n = 1). Recognition of any of these findings should raise the diagnostic possibility of lung cancer in this group of younger patients.

Percutaneous cholecystostomy for the diagnosis and treatment of acute calculous and acalculous cholecystitis.

PURPOSE: To determine the safety, efficacy, and diagnostic utility of percutaneous cholecystostomy in patients with suspected calculous or acalculous cholecystitis. PATIENTS AND METHODS: Percutaneous cholecystostomy guided with ultrasound (US) was performed in 58 consecutive hospitalized patients with suspected acute cholecystitis (28 with calculous, 30 with acalculous disease) who were not surgical candidates. RESULTS: The gallbladder was successfully catheterized in all 58 patients; 48 patients (83%) had a final diagnosis of acute cholecystitis. Clinical benefit was seen in 26 of 28 patients (93%) with calculous cholecystitis and in 16 of 20 patients (80%) with acalculous disease. The six patients who did not respond had pathologic evidence of transmural inflammation, and five had a gangrenous wall. The gallbladder was excluded as the source of sepsis in 10 patients with suspected acalculous cholecystitis. These patients' conditions did not improve after percutaneous cholecystostomy. Of the 48 patients with cholecystitis, 18 underwent cholecystectomy, 25 recovered and had their catheters removed, and five died of other causes with their catheters in place. There was one major complication, and seven minor complications. CONCLUSION: Percutaneous cholecystostomy is efficacious in both calculous and acalculous cholecystitis, but it may be most useful in the diagnosis of acalculous cholecystitis.

Radiographic appearance of intrathoracic complications of pregnancy.

The authors reviewed all chest radiographs obtained for pregnant women at a university hospital over a 15-year period to determine the intrathoracic complications of pregnancy and diseases occurring during pregnancy. The characteristic physiologic changes seen on chest radiographs during normal pregnancy are reviewed. Examples of intrathoracic diseases that may occur in pregnant patients include pulmonary embolism, amniotic fluid embolism, beriberi, aspiration pneumonia, community-acquired pneumonia, viral pneumonia, asthma, systemic disease, trophoblastic disease and peripartum pulmonary edema. The authors discuss the radiation biology implications of performing chest radiography during pregnancy and conclude that the benefit that the fetus receives from diagnosis and treatment of the mother's disease may be greater than the risk of radiation exposure.