Long-term impact on a closed household of pet cats of natural infection with feline coronavirus, feline leukaemia virus and feline immunodeficiency virus

A closed household of 26 cats in which feline coronavirus (FCoV), feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) were endemic was observed for 10 years. Each cat was seropositive for FCoV on at least one occasion and the infection was maintained by reinfection. After 10 years, three of six surviving cats were still seropositive. Only one cat, which was also infected with FIV, developed feline infectious peritonitis (FIP). Rising anti-FCoV antibody titres did not indicate that the cat would develop FIP. The FeLV infection was self-limiting because all seven of the initially viraemic cats died within five years and the remainder were immune. However, FeLV had the greatest impact on mortality. Nine cats were initially FIV-positive and six more cats became infected during the course of the study, without evidence of having been bitten. The FIV infection did not adversely affect the cats' life expectancy.

Molecular basis of variant pseudo-hurler polydystrophy (mucolipidosis IIIC)

Mucolipidosis IIIC, or variant pseudo-Hurler polydystrophy, is an autosomal recessive disease of lysosomal hydrolase trafficking. Unlike the related diseases, mucolipidosis II and IIIA, the enzyme affected in mucolipidosis IIIC (N-Acetylglucosamine-1-phosphotransferase [GlcNAc-phosphotransferase]) retains full transferase activity on synthetic substrates but lacks activity on lysosomal hydrolases. Bovine GlcNAc-phosphotransferase has recently been isolated as a multisubunit enzyme with the subunit structure alpha(2)beta(2)gamma(2). We cloned the cDNA for the human gamma-subunit and localized its gene to chromosome 16p. We also showed, in a large multiplex Druze family that exhibits this disorder, that MLIIIC also maps to this chromosomal region. Sequence analysis of the gamma-subunit cDNA in patients from 3 families identified a frameshift mutation, in codon 167 of the gamma subunit, that segregated with the disease, indicating MLIIIC results from mutations in the phosphotransferase gamma-subunit gene. This is to our knowledge the first description of the molecular basis for a human mucolipidosis and suggests that the gamma subunit functions in lysosomal hydrolase recognition.

Exon-intron organization of the human gp130 gene

The exon-intron organization and sequences of the exon-intron boundaries of the human gp130 transmembrane receptor gene have been determined using genomic DNAs as samples. The gp130 gene comprises 17 exons and 16 introns. The positions of the exon-intron boundaries show good correlation to the functional/homology regions of gp130. Exons 3-17 code for the gp130 protein, and each subdomain of the receptor is encoded by a set of exons. The coding potential of exons and the intron phasing of the human gp130 gene conform to the patterns observed previously for other cytokine receptor genes. This supports the notions that the gp130 gene evolved from the same ancestral gene that gave rise to other members of the cytokine receptor family.

Detection of feline parvovirus in dying pedigree kittens

Feline parvovirus (FPV) was detected in the intestinal tract contents of 13 pedigree kittens which were fading or died suddenly by the use of a new chromatographic test strip for canine parvovirus (CPV) and FPV. The test appeared to be sensitive and specific for the detection of FPV and was a useful diagnostic aid. In three cases in which virus was grown in cell culture, the isolates were characteristic of FPV and not CPV. Cats in the households in which the kittens were reared were regularly immunised with FPV vaccines. The most likely explanation for the occurrence of FPV-associated disease was exposure of the young kittens to large doses of virus contaminating the environment.

Structural Organization of the WD repeat protein-encoding gene HIRA in the DiGeorge syndrome critical region of human chromosome 22

The human gene HIRA lies within the smallest critical region for the DiGeorge syndrome (DGS), a haploinsufficiency developmental disorder associated with instertitial deletions in most patients in a juxtacentromeric region of chromosome 22. The HIRA protein sequence can be aligned over its entire length with Hir1 and Hir2, two yeast proteins with a regulatory function in chromatin assembly. The HIRA transcription unit was found to spread over approximately 100 kb of the DGS critical region. The human transcript is encoded from 25 exons between 59 and 861 bp in size. Domains of highest conservation with Hir1 and Hir2 are encoded from exons 1-11 and 13-25, respectively. The amino- and carboxy-terminal regions of homology are separated from each other by a domain unique to HIRA that is encoded from a single exon. Seven WD repeats are conserved between yeast and man in the amino-terminal region of the HIR proteins. Individual repeats were found to be encoded from one, two, or three exons of the HIRA gene. End sequences have been obtained for all 24 introns, opening the way to PCR amplification of the entire coding sequence starting from genomic DNA. Point mutations can also be sought in 16 of the 24 introns that are readily PCR-amplifiable.

A prospective risk analysis of contemporary thoracic surgery

OBJECTIVE

The results of surgical therapy can only be accurately judged if the patients' characteristics and their impact on the outcome are known. The purpose of this study was to identify the risk factors of contemporary thoracic surgery, which could serve as a basis for a risk-matched comparison of different surgical techniques.

METHODS

The data of 15 patients' undergoing thoracic surgery were prospectively documented. The outcome of the various operative procedures applied was statistically correlated with the access procedure, sex, age, body mass, dignity of underlying disease and six concomitant diseases.

RESULTS

Four patients died within 30 days of surgery (mortality: 2.6%). Morbidity comprising all complications (class I) and morbidity comprising only complications of consequence for postoperative therapy (class II) rose with the number of concomitant diseases (50%/0% with no concomitant disease, 89%/33% with more than three concomitant diseases). Univariate testing identified malignant disease (P = 0.002), male sex (P = 0.003), body mass index of less than 20 and more than 27 kg/m of the expected level according to the Quetelet rule (P = 0.013) and a combination of concomitant respiratory and cardiocirculatory disease (P = 0.022) as being associated with class I morbidity. Male sex was significantly coincident with class II morbidity (P = 0.020). Logistic regression analysis demonstrated that these characteristics also had independent influence on class I morbidity (P = 0.022, P = 0.001, P = 0.023, P = 0.028).

CONCLUSION

It is concluded that these characteristics are important predictors of morbidity of thoracic surgery. If a non-randomized comparison of the outcome of thoracic operations or different access strategies like thoracotomy or thoracoscopy is intended, at least these patient features should be documented and used as a basis for matching pairs.

Risk of feline infectious peritonitis in cats naturally infected with feline coronavirus

A longitudinal survey of 820 cats in 73 households was conducted over a period of 6 years to establish the fate of pet cats that were seropositive after natural exposure to feline coronavirus (FCoV). In particular, their risk of developing feline infectious peritonitis (FIP) was determined. The seropositive cats were assigned to 1 of 3 groups: cats from households in which FIP had recently been diagnosed; cats from households in which FIP had not been diagnosed, but from which kittens had been relocated and subsequently died of FIP; and cats from households in which FIP had not been diagnosed. Cats in the first group were not at greater risk of developing FIP than were cats in the other 2 groups. Consequently, any household in which seropositive cats live must be considered a potential source of FCoV that can cause FIP. There was no evidence that the enhanced disease, which has been described after experimentally induced infection of seropositive cats, exists in nature. Thus, analysis of the survival of the seropositive cats over periods of up to 36 months indicated that their risk of developing FIP decreased with time, suggesting the development of immunity rather than increased susceptibility to disease. In addition, of 56 cats deemed to have been naturally reinfected because their anti-FCoV antibody titers decreased and subsequently increased, only 3 developed FIP.

Thoracoscopic treatment of recurrent pneumothorax by pleurabrushing and argon beam coagulation

There is no consensus in treating relapsing pneumothorax and pleural effusion. Various types of treatment exist. While open chest surgery with mechanical pleurodesis or pleurectomy is effective, with a recurrence rate close to zero, for patients in poor conditions this treatment may be disadvantageous because of its invasiveness. Therefore minimally invasive techniques using antibiotics, fibrin glue, talcum, kaolin, blood and silver nitrate have been described. Several side effects accompany these agents, and the recurrence rate is between 5-39%. New video-assisted thoracoscopic techniques have enabled surgeons to combine the effectiveness of pleurectomy with minimal invasiveness. Results using these techniques are encouraging. As with open pleurectomy, bleeding complications have been reported, Further disadvantages have to be considered, such as the effect of destroying the parietal layer of the pleura, which may complicate subsequent operations in the thoracic cavity. A technique for avoiding this pleural injury, while maintaining the same efficiency as open pleural abrasion and coagulation is described below.

An aggressive philosophy in controlled ovarian stimulation cycles increases pregnancy rates

To assess the effect of timing of human chorionic gonadotrophin (HCG) administration in ovarian stimulation cycles, the serum oestradiol concentration and follicle profile were compared with the clinical pregnancy rate in 582 ovarian stimulation-intra-uterine insemination (OS-IUI) cycles and 3917 in-vitro fertilization-embryo transfer (IVF-ET) cycles. The pregnancy rates increased exponentially with increasing oestradiol in both OS-IUI and IVF-ET cycles (R2 = 0.720, P < 0.001) but then decreased in OS-IUI cycles when the oestradiol concentration exceeded 5000 pmol/l (R2 = 0.936, P < 0.004) at HCG administration. In OS-IUI cycles the percentages of cycles with three or more mature follicles (> or = 18 mm diameter) increased up to an oestradiol concentration of 5000 pmol/l then declined, mirroring the pregnancy rate (R2 = 0.900, P = 0.01). The exponential increase in pregnancy rate with increasing oestradiol concentration in IVF-ET cycles suggests that high oestradiol concentration does not have a deleterious effect on endometrial receptivity. The decrease in pregnancy rate in OS-IUI cycles when oestradiol concentration exceeded 5000 pmol/l reflected fewer mature follicles, resulting from premature administration of HCG to avoid severe ovarian hyperstimulation syndrome (OHSS). We recommend that HCG administration be delayed until multiple follicles have reached maturity, and reducing the risk of severe OHSS by converting high risk OS-IUI cycles to IVF-ET, or if funds or facilities are unavailable, transvaginally draining all but four or five mature follicles.

Conditional expression and oncogenicity of c-myc linked to a CD2 gene dominant control region

Over-expression of the c-myc gene is widely implicated in the genesis of lymphoid neoplasia, including tumours of the T-cell lineage. To study the effects of deregulated c-myc expression on T-cell development and oncogenesis, we sought to generate a transgenic mouse model in which c-myc expression was targeted specifically to the T-cell lineage. A plasmid construct containing a dominant control region (DCR) from the human CD2 locus linked 5' to the human c-myc gene was used to generate 2 lines of transgenic mice. Both strains developed thymic lymphoma at low frequency, but thymic development and peripheral T-cell numbers were otherwise apparently normal. Low tumour penetrance was consistent with the observed lack of stable CD2-myc transgene mRNA in tissues of healthy transgenic mice. In contrast, transgene RNA was detected in all malignant tumours as well as in early lymphomatous lesions. RNase protection analyses confirmed these findings and showed that the PI human c-myc promoter was active in all neoplastic tissues but not in the thymus or other tissues of healthy transgenic mice. Despite the low spontaneous tumour incidence, the presence of the transgene markedly and uniformly accelerated the onset of tumours after neonatal infection with Moloney murine leukaemia virus. All tumours were rearranged for T-cell receptor beta-chain genes and were of T-cell origin from their surface phenotype (Thy-1+, CD3+, CD4+/-, CD8+, sIg-). Virus-accelerated tumours contained clonal integrations of Moloney murine leukaemia virus, suggesting that proviral insertional mutagenesis may have played a role in tumour development. Analysis of several candidate myc-cooperating genes failed to reveal any rearrangements apart from a low frequency involving proviral insertion at the pim-1 locus. The CD2-myc mouse should therefore be a valuable system in screening for novel myc-collaborating genes involved in T-cell lymphoma.

Subtentorial subdural empyema: Case report

We present a case of an extensive subtentorial subdural empyema of otorhinological origin. Although 3%-6% of all intracranial suppurations are infratentorial, there is no report on extensive multiloculated subtentorial empyema so far.

Developmentally programmed induction of differentiation inhibiting activity and the control of stem cell populations

Differentiation inhibiting activity/leukemia inhibitory factor (DIA/LIF) is a glycoprotein that controls differentiation of pluripotential stem cells. Alternative transcription generates both diffusible and matrix-associated forms of DIA/LIF. Transcriptional analysis using a sensitive ribonuclease protection assay revealed that the two messages are expressed independently, consistent with the proposition that the two forms of DIA/LIF have distinct biological roles. DIA/LIF expression was found to be activated early during differentiation of embryonic stem (ES) cells, providing a mechanism for feedback regulation of stem cell renewal. Expression of DIA/LIF by mesenchymal cells was shown to be controlled in a paracrine manner by polypeptide regulatory factors. Specific expression of the two forms of DIA/LIF was also demonstrated in the egg cylinder-stage mouse embryo. The combination of cell type-specific and signal-specific regulation enables very precise control over DIA/LIF expression and may represent an important component of the regulatory networks that govern stem cell proliferation and differentiation during mammalian development.

Differentiation inhibiting activity is produced in matrix-associated and diffusible forms that are generated by alternate promoter usage

The differentiation of embryonic stem (ES) cells is controlled by the regulatory factor differentiation inhibiting activity/leukemia inhibitory factor (DIA/LIF). Examination of feeder cell-mediated suppression of ES cell differentiation revealed that DIA/LIF is produced both as a diffusible protein and in an immobilized form associated with the extracellular matrix. This alternative localization arises from the expression of alternate transcripts that diverge throughout exon 1. The effect of alternate first exon usage is to change the amino terminus of the primary translation product and to direct incorporation of mature, biologically active DIA/LIF into the extracellular matrix. The production of a potent regulatory factor in both diffusible and immobilized forms may be an important element of developmental control mechanisms.

The identification and management of drug-seeking behavior in a medical center

We describe the development of a quality assurance program that monitors prescription medication misuse in a medical setting. The program focuses on patient activities that influence physician prescribing of abusable medications. Seven defining criteria have been developed to judge the presence of drug seeking by patients. When appropriate, a drug-seeking label is attached to the patient's chart and the hospital computer information system. The warning informs the physician and protects the patient from excessive medications.

The rhythmic properties of the motor system

The resonance properties of the motor control circuits are basic features of the motor system. From our results, it can be concluded that, when the normally existing suppression mechanism weakens, external stimuli or internal impulses may elicit oscillations in the circuits according to the resonant frequency, and tremor will appear. It seems that the resonant frequency is between 5 and 8 Hz, as demonstrated by rhythmic voluntary movement, rhythmic elicited reflex movement and rhythmic modulated voluntary movement modulated by the stimulation of the central motor system.

Separation of the tumor and brain surface by "water jet" in cases of meningiomas

In the surgery of meningiomas one of the most delicate problems is the separation of the tumor from the brain surface. The authors generally recommend microsurgery to preserve the brain surface anatomically and functionally. For this purpose we have developed a new surgical technique according to our concepts of tissue care. After excavating the tumor from inside the tumor brain surface was separated by repeated "water jets" into the tumor arachnoideal space. The "water jet" was produced by an ordinary bulb syringe. The front pressure of the jets was 300-1000 mm of water and the side pressure 100-300 mm of water. In the tumor-arachnoideal space the spreading water (phys. NaCl) separates the brain from the tumor with utmost care. We operated on 55 meningiomas of different types with the "water jet" technique. The immediate results were anatomically excellent. Intraoperative and postoperative acute and late edemas appeared only in a few cases. The functions of the nearby brain were generally preserved. The surgery was uneventful when the tumor surface was smooth and the tumor was spherical. When the tumor surface was uneven, one part of the tumor extended under the dura as a thin layer or the tumor was multilobulated with expanded vessels between the lobules, more microseparation was necessary. We compared the results of the "water jet" technique with the results of the "pre-water jet" series. The surgery with the "water jet" technique was much shorter and its results were better than those of microsurgery alone.

Prevalence of positive epicutaneous tests among infants, children, and adolescents

We studied 314 otherwise healthy children younger than 18 years of age with epicutaneous testing, and found that 20% of those tested had at least one positive epicutaneous test result. Neomycin, nickel, and potassium dichromate were the most prevalent allergens detected in our study group. We found that sensitization occurred at less than 5 years of age for all but fragrance allergens. Aluminum chambers and the American Academy of Dermatology Patch Test Kit were found to be safe for use in infants, children, and adolescents.

Therapist's management of tendon transfers

Rehabilitation of the tendon transfer patient is a challenge to the hand therapist, given the variety of transfers performed and the level of skill, knowledge, and creativity needed to treat them adequately. Careful preoperative evaluation and treatment increase the prospects for a successful result. The postoperative care of the tendon transfer is a team effort by the surgeon, therapist, and patient; each must have a clear understanding of the goals and precautions of each stage of treatment. Restrictions are initially placed upon the patient's mobility to allow healing; these are then reduced as he activates the transfer and then begins to incorporate the new motion into daily activity. Resistance is added gradually to the patient's tolerance, and care is taken throughout the rehabilitation process not to overwork the muscle in its new function. Tendon transfer is never completely restorative, but often makes a striking difference in the patient's functional abilities. The outcome can be very gratifying for the patient and for those who collaborate in his treatment.

Interaction between feline leukaemia virus subgroups in the pathogenesis of erythroid hypoplasia

The interaction of feline leukaemia virus (FeLV) of subgroups A and C in the pathogenesis of erythroid hypoplasia in cats was studied. Weanling kittens infected with FeLV-A became permanently viraemic but remained haematologically normal over a period of 36 weeks. Similar kittens inoculated with FeLV-C, which produces erythroid hypoplasia when administered to newborn kittens, neither became viraemic nor developed the disease. However, weanling kittens inoculated with a mixture of FeLV-A and C became viraemic, first with FeLV-A and then additionally with FeLV-C, and the emergence of FeLV-C into the blood coincided with the advent of erythroid hypoplasia. When FeLV-C was inoculated into five older cats which had been viraemic with FeLV-A for several months previously, it appeared in the plasma of three of the cats and erythroid hypoplasia was diagnosed in two of these, 16-20 weeks after infection with FeLV-C. These results show that FeLV-A enhances the growth of FeLV-C in cats and overcomes their age-related resistance to FeLV-C. Also, the appearance of FeLV-C in the plasma of cats viraemic with FeLV-A indicates that erythroid hypoplasia will subsequently occur rapidly. These findings are relevant to the origin of FeLV-C isolates and their occurrence in nature.