Culex flavivirus isolates from mosquitoes in Guatemala

A new strain of Culex flavivirus (family Flaviviridae, genus Flavivirus, CxFV), an insect virus first described in Japan, was isolated from adult Culex quinquefasciatus Say (Diptera: Culicidae) collected in 2006 from Izabal Department on the Caribbean coast of Guatemala. Mosquito pools were assayed for flavivirus RNA by using flavivirus group-specific primers that amplified a 720-bp region of the nonstructural (NS) 5 gene by standard reverse transcriptase-polymerase chain reaction. From 210 pools (1,699 mosquitoes), eight tested positive, and six of these mosquito pools produced virus isolates in Aedes albopictus Skuse C6/36 cells. Nucleotide sequence comparison of the eight flavivirus RNA-positive pools showed that there was 100% identity among them, and phylogenetic analysis of the NS5 and envelope gene regions indicated that they represent a strain of the recently described CxFV from Japan. This is the first report of an insect flavivirus from Central America.

No evidence of HIV and SIV sequences in two separate lots of polio vaccines used in the first U.S. polio vaccine campaign

We obtained sealed vials of two different polio vaccine lots, expiration date 1955, which were used in the first U.S. polio vaccine campaign. These early lots were pulled from the market because they contained live infectious poliovirus which caused polio in some of the vaccines. Theoretically, these vaccines could have contained other infectious retroviruses, including HIV. No viral sequences were detected using RT-PCR analyses with primers capable of amplifying chimpanzee SIV and HIV-1-related viruses nor with primers for macaque SIV, sooty mangabey SIV, and HIV-2-related viruses. Poliovirus sequences were readily amplified by RT-PCR, suggesting that the technique used would have detected SIV or HIV sequences, if present.

Patient-blaming and representation of risk factors in breast cancer images

Media coverage of some cancers in the past often equated cancer with a death sentence. Breast cancer coverage in 1990s magazines, however, has become less fatalistic, more frequent, and discusses a broader range of issues than before. This study examined whether the visual images accompanying magazine articles about breast cancer have also evolved. We used Goffman's (1976) rituals of subordination to measure patient-blaming and subordinating, disempowering images. We also analyzed race/ethnicity, body type, and age of females in the images to gauge whether these demographic risk factors were represented in a random sample of images from nine magazines over a 30-year period. Magazines analyzed represented three genres-women's magazines, fashion/beauty, and general news. Findings suggest that patient-blaming images have decreased in some categories and women portrayed are slightly more representative of risk factors of age and race/ethnicity. Magazine images tended to reinforce stereotyped portrayals of femininity to the detriment of cancer patients. Fashion/beauty magazines, aimed at younger women, were most likely to portray breast cancer images in stereotyped, patient-blaming ways, with the least representative images of risk factors. The social construction of feminine beauty seems to overpower accuracy in creating these images.

SV40 and the pathogenesis of mesothelioma

Malignant mesothelioma, a tumor of the pleura, pericardium, and peritoneum, is presently a worldwide problem. Current therapy is ineffective in slowing the course of the disease, and median survival from the time of diagnosis is rarely greater than 1 year. While the tumor was almost unknown prior to the second half of the twentieth century, it is presently responsible for more than 2000 deaths per year in the US alone. Mesothelioma is frequently associated with exposure to asbestos, but the incidence of cases involving individuals with low levels of asbestos exposure is increasing. For this reason, there has been much interest in studying whether there are alternative factors that act alone or in conjunction with asbestos in producing this malignancy. In the last decade, simian virus 40 (SV40) has become the most notable suspected agent.

Framing women's health with a sense-making approach: magazine coverage of breast cancer and implants

This study examined how women's magazines framed breast cancer and silicone implants to determine whether they used a sense-making framework. Sense-making calls for existing gaps to be closed between what one group views as real and what another group experiences (Parrott, 1996). Analysis included 86 articles on cancer and implants published in four women's magazines from 1990 to 1997. Overall findings suggest that women's magazines used a sense-making approach to cancer coverage, framing the disease in terms of coping with its effects, personal experiences, and risk factors. Themes in implant articles pertained to economic concerns of the medical industry and media.

Human mesothelial cells are unusually susceptible to simian virus 40-mediated transformation and asbestos cocarcinogenicity

Mesothelioma, a malignancy associated with asbestos, has been recently linked to simian virus 40 (SV40). We found that infection of human mesothelial cells by SV40 is very different from the semipermissive infection thought to be characteristic of human cells. Mesothelial cells are uniformly infected but not lysed by SV40, a mechanism related to p53, and undergo cell transformation at an extremely high rate. Exposure of mesothelial cells to asbestos complemented SV40 mutants in transformation. Our data provide a mechanistic explanation for the ability of SV40 to transform mesothelial cells preferentially and indicate that asbestos and SV40 may be cocarcinogens.

Evaluation of BioStar FLU OIA assay for rapid detection of influenza A and B viruses in respiratory specimens

BACKGROUND

Demand for the rapid diagnosis of influenza infections has increased with the advent of the availability of neuraminidase antiviral therapy for influenza A and B. Several rapid assays that detect both influenza A and B are now available.

OBJECTIVES

In this study we compared the performance of the BioStar FLU OIA assay to Bartels Viral Respiratory Screening and Identification Kit (Bartels Inc., Issaquah, WA), and cell culture.

STUDY DESIGN

A total of 145 patient specimens for influenza virus detection submitted in either viral transport medium or in sterile containers were evaluated by the three methods. Specimen types included nasal washings, nasal swabs, sputum, throat swabs, and bronchial alveolar lavage (BAL) fluids.

RESULTS

Fifty six positive specimens were identified based on culture and/or DFA. Of these, 30 specimens were positive by the OIA assay for an overall sensitivity of 54%. The OIA assay detected 48% (n = 21) of the 44 culture positive specimens and 81% (n = 29) of the 36 DFA positive specimens. Eighty six of the 89 culture/DFA negative samples were negative by the OIA assay (97% specificity). Analysis of the OIA assay sensitivity from samples submitted in M4 transport medium or in sterile containers revealed that M4 transport medium does not reduce the sensitivity of the OIA assay. Fifteen of the 27 positive samples submitted in M4 transport medium were positive by the OIA assay (56% sensitivity) compared to 15 of 29 positive samples transported in sterile containers (52% sensitivity). Twelve specimens were either culture and/or DFA positive for viruses other than influenza, but negative by the OIA assay, suggesting that there was no cross reactivity of the OIA assay with the other virus types recovered in this study.

CONCLUSIONS

The overall excellent specificity of the BioStar FLU OIA allows for treatment of positive patients for influenza, however, a negative result should be confirmed by DFA and culture.

Newspaper coverage of the breast implant controversy

Newspaper coverage of the silicone breast implant controversy from 1992 through 1996 was analyzed to determine whether women in the United States were provided with a fair and balanced account. The paper also addressed whether or not Dow Corning's public relations campaign impacted newspaper coverage. All stories from the New York Times, the Chicago Tribune and the Wall Street Journal were analyzed. Findings suggested that early coverage of the controversy focused on the health risks of silicone breast implants while later coverage focused on the financial situations of the implant manufacturers. The most-interviewed sources were spokespersons for the implant manufacturers, while the least-interviewed sources were women with implants. The findings suggested that reporting patterns were influenced by the public relations efforts of the implant manufacturer, raising questions concerning the coverage of health care controversies involving large corporations seeking refuge from litigation.

Surgical management of primary melanoma

A significant proportion of the general population is diagnosed with malignant melanoma each year, and more people die of melanoma now than at any time in the past. Consequently, treatment of melanoma at all stages of development is an important clinical issue. A variety of management options are discussed here, including biopsy techniques and treatment of the primary melanoma. The latter include lymphatic mapping and sentinel lymph node biopsy, hyperthermic isolated limb perfusion, and surgery for stage IV melanoma patients. Procedure-associated benefits and possible complications associated with each modality are also summarized.

Presence and expression of the simian virus-40 genome in human giant cell tumors of bone

SV40 DNA sequences have been found in human tumors, such as mesotheliomas, ependymomas, and bone tumors, suggesting that SV40 may be involved in their etiology. The FOS oncogene could play an important role in bone development because SV40 is able to induce FOS in cell culture. In this study, the presence of SV40 sequences, large T antigen (Tag), and FOS protein expression were investigated in 120 giant cell tumors (GCTs), moderately benign bone tumors that in some cases can progress to a malignant phenotype. Polymerase chain reaction (PCR), using primers that amplify the RB1 pocket binding domain and the intron of Tag, was used to analyze GCT for the presence of SV40 DNA. Tag and FOS protein expression was evaluated by immunohistochemistry. SV40 sequences were found in 30/107 GCTs, and of these, 22/30 samples expressed Tag protein (73%) and 15/30 overexpressed the FOS oncogene (50%). FOS was undetectable in 77 SV40-negative GCTs. Sequence analysis of the amplified DNAs confirmed that the amplified sequences corresponded to SV40 DNA. The correlation between FOS overexpression and SV40-positive GCTs was highly statistically significant (P < 0.001). These results show that SV40 DNA sequences and SV40 Tag are present in GCTs and might induce FOS activity. These data suggest that SV40 might play a role in the development and progression of some GCTs.

SV40 can be reproducibly detected in paraffin-embedded mesothelioma samples

We studied tissue sections from 18 paraffin embedded mesothelioma specimens diagnosed by the Pathology Department of S. Chiara Hospital of Pisa. Using PCR analysis and Southern blot hybridization we examined the specimens for the DNA regulatory region of the virus. 10/18 (55.5%) of the samples tested contained SV40 DNA regulatory sequences, and of these positive samples, 80% were found to contain Tag sequences by PCR and Southern Blot hybridization. These results confirm that SV40 can be amplified and detected in paraffin embedded mesothelioma samples.

Unique strains of SV40 in commercial poliovaccines from 1955 not readily identifiable with current testing for SV40 infection

SV40 was first identified as a contaminant of poliovaccines used from 1955 until 1963. Recently, SV40 has been detected in several human tumors. The virus detected in human tumors often contained only one 72-bp enhancer in the regulatory region, in contrast to the SV40 originally isolated from poliovaccines, which contained two 72-bp enhancers. The origin of viruses with one 72-bp enhancer in humans was unknown, because it was thought that these viruses were not present in poliovaccines. It was also thought that all poliovaccine vials produced from 1955 until 1963 had been discarded, thus the possibility that one 72-bp virions contaminated those vials could not be tested. We unexpectedly obtained what appear to be the last available vials of poliovaccine produced in 1955. In these vials, we detected and sequenced SV40 containing only one 72-bp enhancer in the regulatory region. The tissue culture cytopathic test currently used in the United States to screen oral poliovaccines was designed to detect rapidly proliferating SV40 virions containing two 72-bp enhancers. We found that this test is not sensitive enough to detect low amounts of the slow-replicating SV40 virions containing one 72-bp enhancer. This virus was easily detected in the same cells by immunostaining and PCR. Twelve current vials of poliovaccines tested uniformly negative for SV40, suggesting that the precaution of preparing poliovaccines from kidneys obtained from monkeys bred in isolated colonies prevented SV40 contamination. Our data demonstrate that humans were exposed to SV40 viruses with both one 72-bp enhancer and two 72-bp enhancers SV40 through contaminated vaccines. Our data also suggest that instead of cytopathic tests, immunohistochemical and/or molecular studies should be used to screen poliovaccines for SV40 to completely eliminate the risk of occasional contamination.

Simian virus 40 is present in most United States human mesotheliomas, but it is rarely present in non-Hodgkin's lymphoma

Simian virus 40 (SV40) causes mesotheliomas, osteosarcomas, ependymomas, choroid plexus tumors, and lymphomas in hamsters. In humans, SV40 has been detected in tumors of the first four types. Using the polymerase chain reaction (PCR), we tested 29 non-Hodgkin's lymphomas (intermediate and high-grade), 25 posttransplant lymphoproliferative disorders, and 5 AIDS lymphomas for SV40 DNA. PCR analysis revealed that 3 of 29 lymphomas, 6 of 25 posttransplant lymphoproliferative disorders, and 2 of 5 AIDS lymphomas contained SV40 sequences corresponding to the retinoblastoma (RB)-pocket binding domain of SV40 tumor antigen (Tag). However, among positive samples, only one posttransplant lymphoproliferative disorder and one AIDS lymphoma contained the SV40 regulatory region, which suggest a higher viral load in these patients. In parallel experiments, 8 of 12 mesotheliomas tested positive for SV40 for both the RB-pocket binding domain of Tag and the SV40 regulatory region. These data confirm the presence of SV40 in most United States mesotheliomas and indicate that in human non-Hodgkin's lymphomas, the prevalence of SV40 is low.

Effect of music on state anxiety scores in patients undergoing fiberoptic bronchoscopy

OBJECTIVE

To study the effect of music on state anxiety levels in patients undergoing flexible fiberoptic bronchoscopy (FFB).

DESIGN

Randomized clinical trial using pretests, posttests, and two groups.

SETTING

Pulmonary special-procedures unit of a tertiary-care referral center.

PATIENTS

Sixty adult patients: 30 patients received music during bronchoscopy and 30 control subjects received no music.

RESULTS

The study population had baseline state anxiety levels similar to those previously reported in surgical patients (42.6 +/- 13 vs 42.7 +/- 14; p value, not significant [NS]) and higher than those reported in normal working adults (42.6 +/- 13 vs 34.4 +/- 10; p < 0.001). Experimental and control groups were similar in patient and procedure-related characteristics and baseline pre-FFB state and trait anxiety scores. Although trait anxiety scores decreased significantly after the procedure (pooled post-FFB scores of 32.6 +/- 10 vs pre-FFB scores of 35.5 +/- 11; p < 0.001), no reductions were noted in state anxiety (pooled post-FFB scores of 42.8 +/- 13 vs pre-FFB scores of 42.6 +/- 13; p value, NS). More importantly, playing music through headphones during FFB did not result in a statistically or clinically significant reduction in either state or trait anxiety when compared to control subjects.

CONCLUSION

Relaxation music administered through headphones to patients during flexible bronchoscopy does not decrease procedure-related state anxiety.

New molecular and epidemiological issues in mesothelioma: role of SV40

Mesotheliomas are malignant tumors usually associated with occupational asbestos exposure. Simian virus 40 (SV40) is a DNA tumor virus that preferentially causes mesotheliomas when injected intracardially and/or intrapleurally into hamsters. SV40 also transforms human cells in tissue culture, and these cells contain extensive DNA damage. In the United States, at least 60% of human mesotheliomas contain and express SV40. In these tumor cells, the SV40 tumor antigen binds and inhibits the cellular tumor suppressors p53 and Rb. These findings suggest that SV40 may contribute to the development of those human mesotheliomas that occur in people not exposed to asbestos. SV40 may also facilitate asbestos-mediated carcinogenicity. The epidemiological data available are insufficient to address the role that SV40 may have played in contributing to the increased incidence of mesothelioma in the second half of this century.

The biological activities of simian virus 40 large-T antigen and its possible oncogenic effects in humans

Simian virus 40 (SV40) is an oncogenic virus which induces tumors in hamsters and transforms human cells in tissue culture. Between 1955 and 1963, polio vaccines and adenovaccines were contaminated with SV40; therefore, millions of people were exposed to this oncogenic virus. The SV40 proteins responsible for in vivo oncogenesis and in vitro cell transformation are encoded by the early region of the virus. These proteins are called T (tumor) antigens (Tags), because animals with tumors induced by SV40 have antibodies against these viral proteins. Recently, we and other research laboratories have found SV40 in specific types of human tumors: mesothelioma, ependymoma and choroid plexus tumors, osteosarcoma and sarcoma. The same tumor types will develop in hamsters which have been injected systemically with SV40. SV40 causes cell transformation in tissue culture and tumors in animals, because SV40 Tag binds and inactivates the cellular tumor suppressor gene products, Rb and p53. We found that SV40 Tag binds p53 and Rb in human mesotheliomas, possibly contributing to the malignant phenotype.

The detection of simian virus 40 in human tumors by polymerase chain reaction

Simian virus (SV) 40 is a deoxyribonucleic acid (DNA) virus that induces mesotheliomas, ependymomas, bone tumors, and lymphomas in hamsters. In recent years SV40 sequences have been detected in approximately 60% of mesotheliomas and ependymomas, in 33% of bone tumors and sarcomas, and in 13% of lymphomas. Because the amount of human specimens available for molecular studies is usually minimal, the method most commonly used to demonstrate SV40 in human specimens is the polymerase chain reaction (PCR). PCR is a highly sensitive and useful technique. In the PCR reaction, different sets of primers are used for targeting different regions of DNA. The regions of the SV40 genome targeted by PCR include the large T-antigen, the small t-antigen, the origin of replication, and viral protein-1 capsid protein. The use of these different sets of primers to test human tumor specimens for SV40 produce a different percentage of positive results. This is because these experiments revealed that some primers are more specific than others which may also detect sequences belonging to other DNA papovaviruses. Therefore, the combined use of different sets of primers is recommended when it is important to distinguish SV40 from other related papovaviruses such as BK and JC, which can also be occasionally present in human cells. Furthermore, these experiments demonstrated that polymerase chain reaction analyses for simian virus 40 can be performed better and easier when using deoxyribonucleic acid extracted from fresh and/or frozen tissue. Deoxyribonucleic acid from paraffin embedded specimens should not be used routinely for simian virus 40 testing because of the high risk of obtaining false negative results. However, these paraffin derived deoxyribonucleic acids can be used reliably in molecular laboratories specialized in these type of analyses. This paper describes the methods that we have developed to test simian virus 40 in human specimens.