Infectious DNA of the human spumaretrovirus

An infectious molecular clone (pHSRV) of the human Spumaretrovirus (HSRV) was constructed using viral DNA and cDNA clones. The infectivity of pHSRV was proven by transfection of cell cultures and subsequent infection of susceptible cultures with cell free transfection derived virus. pHSRV derived virus produced foamy virus typical cytopathic effects in susceptible cultures. Infected cells could be stained specifically with foamy virus antisera by means of indirect immunofluorescence. Radioimmunoprecipitation revealed the presence of characteristic HSRV structural proteins in pHSRV infected cultures. By cotransfection of pHSRV and an indicator plasmid it was found that pHSRV is able to transactivate the viral LTR. Viral transcripts were found to be approximately 200 bases longer in pHSRV infected cultures compared to wildtype infected cultures. This difference is most likely due to an insertion of DNA of non-viral origin in the U3 region of the 3'LTR of the infectious clone.

Staphylococcus aureus septicaemia: the initial presentation of polyarteritis nodosa

A 51-year-old man presented with Staphylococcus aureus septicaemia. He improved initially but died suddenly on day 8 of his hospital admission. Post-mortem examination revealed multiple lesions of polyarteritis nodosa which were the cause of death. We are unaware of any other case of polyarteritis nodosa that presented with Staphylococcus aureus septicaemia. These two conditions have a number of similar clinical characteristics and are difficult to distinguish unless the association is considered.

Genomic organization of the human spumaretrovirus and its relatedness to AIDS and other retroviruses

The human spumaretrovirus (HSRV) isolated from a nasopharynx carcinoma patient 17 years ago has a RNA genome 11 kb in size. It encodes besides the gag, pol, and env genes several novel genes (S1 and bel 1, 2, and 3) that are comparable to the regulatory genes R, X, tat, art, and 3'-orf of the human (HIVs) and simian immunodeficiency viruses (SIVs) with respect to genomic location and to sizes of the putative gene products. A comparison between the HIV protein sequences of the pol and the novel genes to the corresponding gene product sequences of HSRV revealed that HSRV is related to the lentiviruses but occupies a distinct phylogenetic placement of its own. A detailed analysis of the reverse transcriptase domain allows the construction of a phylogenetic tree for the known retroviral subfamilies and/or groups, including the oncoviruses, the lentiviruses, the spumaviruses, the HLTV-BLV group, and the D-type viruses. Regions of the putative novel HSRV gene products with segmental protein sequence homology to the regulatory protein of other human retroviruses are discussed. The results strengthen the view that HSRV and its novel genes should be studied in comparison to the new genes of acquired immunodeficiency syndrome (AIDS) viruses and human T cell leukemia viruses (HTLV).

Functional assessment of patients treated with permanent dual chamber pacing as a primary treatment for hypertrophic cardiomyopathy

Patients with severe hypertrophic cardiomyopathy pose a difficult management problem. Between 1984 and 1986, 11 such patients have been treated by dual chamber pacing. (DDD). Subjectively all patients improved and objectively there was an increase in exercise tolerance during paced rhythm.

Analysis of the primary structure of the long terminal repeat and the gag and pol genes of the human spumaretrovirus

The nucleotide sequence of the human spumaretrovirus (HSRV) genome was determined. The 5' long terminal repeat region was analyzed by strong stop cDNA synthesis and S1 nuclease mapping. The length of the RU5 region was determined and found to be 346 nucleotides long. The 5' long terminal repeat is 1,123 base pairs long and is bound by an 18-base-pair primer-binding site complementary to the 3' end of mammalian lysine-1,2-specific tRNA. Open reading frames for gag and pol genes were identified. Surprisingly, the HSRV gag protein does not contain the cysteine motif of the nucleic acid-binding proteins found in and typical of all other retroviral gag proteins; instead the HSRV gag gene encodes a strongly basic protein reminiscent of those of hepatitis B virus and retrotransposons. The carboxy-terminal part of the HSRV gag gene products encodes a protease domain. The pol gene overlaps the gag gene and is postulated to be synthesized as a gag/pol precursor via translational frameshifting analogous to that of Rous sarcoma virus, with 7 nucleotides immediately upstream of the termination codons of gag conserved between the two viral genomes. The HSRV pol gene is 2,730 nucleotides long, and its deduced protein sequence is readily subdivided into three well-conserved domains, the reverse transcriptase, the RNase H, and the integrase. Although the degree of homology of the HSRV reverse transcriptase domain is highest to that of murine leukemia virus, the HSRV genomic organization is more similar to that of human and simian immunodeficiency viruses. The data justify classifying the spumaretroviruses as a third subfamily of Retroviridae.

The 3'-orf protein of human immunodeficiency virus 2 shows sequence homology with the bel3 gene of the human spumaretrovirus

The primary amino acid sequence within a domain of 89 residues of the central part of the 3'-orf protein (p27 3'-orf) of human immunodeficiency virus (HIV-2) shares homology with the middle and carboxy-terminal portion of the bel3 gene product of human spumaretrovirus (HSRV). In addition, a limited region of the tat protein of HIV-2 but not HIV-1 shows a 28% degree of homology to the deduced protein sequence of the bel1 gene product of HSRV. Comparison between the viral sequences suggests that the 3'-orf and bel1 gene product of HSRV could serve similar functions to those in HIV-2.

Nucleotide sequence analysis of the env gene and its flanking regions of the human spumaretrovirus reveals two novel genes

Recombinant clones that represent the 3' part of the genome of the human spumaretrovirus (foamy virus) were established from viral DNA and from DNA complementary to viral RNA. The recombinant clones were characterized by blot hybridizations and nucleotide sequence analysis. The deduced protein sequence of the clones at their 5' ends was found to be homologous to the 3' domain of retroviral reverse transcriptases. Downstream of a small intergenic pol-env region a long open reading frame of 985 amino acid residues was identified that according to its genomic location, size, glycosylation signals, and hydrophobicity profile closely resembles the lentiviral env genes. The spumaretroviral env gene is followed by two open reading frames, termed bel-1 and bel-2 which are located between env and the long terminal repeat region. The long terminal repeat of 1259 nucleotides is preceded by a polypurine tract and contains the canonical signal sequences characteristic for transcriptional regulation of retroviruses. The provisional classification of the spumaretrovirus subfamily is discussed.

Nucleotide sequence analysis of a cloned DNA fragment from human cells reveals homology to retrotransposons

During molecular cloning of proviral DNA of human spumaretrovirus, various recombinant clones were established and analyzed. Blot hybridization revealed that one of the recombinant plasmids had the characteristic features of a member of the long interspersed repetitive sequences family. The DNA element was analyzed by restriction mapping and nucleotide sequencing. It showed a high degree of amino acid sequence homology of 54.3% when compared with the 5'-terminal part of the pol gene product of the murine retrotransposon LIMd. The 3' region of the cloned DNA element encodes proteins with an even higher degree of homology of 67.4% in comparison to the corresponding parts of a member of the primate KpnI sequence family.

Molecular cloning of the genome of human spumaretrovirus

DNA of human spumaretrovirus (HSRV) was cloned from both cDNA and from viral DNA into phage lambda and bacterial plasmid vectors. The recombinant plasmids harboring viral DNA were characterized by Southern blot hybridization and restriction mapping. Physical maps were constructed from cDNA and found to be colinear with the restriction maps obtained from viral DNA. The recombinant clones isolated contained viral DNA inserts which range in size from 2.2 kb to 15.4 kb. The recombinant clones allowed to construct a physical map of the complete HSRV provirus of 12.2 kb.

[Differential arthrographic diagnosis of the painful shoulder joint]

60 arthrograms of the shoulder were explored under morphologic and pathologic-anatomic aspects. Differentiation was made between acute and chronic pain. The possible findings in leaking of the contrast material out of the joint capsule are shown and discussed. Signs are quoted of degeneration of soft tissue and bone. The findings in patients with rheumatoid arthritis and a history of shoulder dislocation are summarised. Distension of the joint capsule without shoulder dislocation is described. Filling of the periarticular lymphatics is mentioned in different cases.

Bi-atrial myxomas presenting as recurrent pulmonary emboli in a girl

A 14-year-old girl whose sole presenting features were symptoms of pulmonary embolism, was found to have bi-atrial myxomas. The diagnosis was made preoperatively, and the patient had a successful outcome following elective surgery. The absence of other features such as systemic embolism, atrioventricular valvular obstruction, fever and constitutional symptoms makes this a most unusual case. Right atrial myxoma should be considered in any patient presenting with pulmonary embolism for which there is no obvious source.

Pseudomonas streptomycin resistance transposon associated with R-plasmid mobilization

Plasmid pMG1 encodes resistance to gentamicin, streptomycin, sulfonamides, and mercuric ions and also mobilizes pRO161, a transfer-deficient plasmid derived from RP1. Upon mobilization, pRO161 acquires streptomycin resistance (Smr) and can subsequently be remobilized by pMG1 at significantly higher frequencies than pRO161 itself. Both the initial acquisition of Smr and the subsequent mobilization of the transfer-deficient plasmid are recA independent: thus, the Smr determinant appears to be located on a transposon, disignated Tn904. Tn904 transposes to a variety of other plasmids, including RP1, FP2, R388, K, pRO1600, and pBR322, and in some cases the acquisition of this transposon accompanied deletions in the target plasmid. When no deletion occurred, target plasmids gained 5.2 kilobase pairs of DNA and new restriction endonuclease cleavage sites for AvaI, BglII, PstI, SmaI, and SstI. Physical analysis of such plasmids showed that the Tn904 termini are inverted repeat DNA sequences of approximately 124 base pairs. After cloning into vector pRO1723, a single site for restriction endonuclease AvaI was identified within the Smr determinant of Tn904. In Escherichia coli, but not in Pseudomonas aeruginosa. Tn904 shows a gene dosage-dependent expression of streptomycin resistance.

Q fever endocarditis

Despite a worldwide distribution of Coxiella burnetii, only single cases of Q fever endocarditis have been reported outside Great Britain and Australia. We present 10 patients; five were female, only four had a history of environmental exposure, and the mitral valve was involved as commonly as the aortic stenosis, and three patients had a prosthetic valve. We confirm the importance of hepatic involvement, thrombocytopenia and hypergammaglobulinemia as diagnostic features. Diagnosis was established by finding and elevated complement-fixing antibody to Phase I C. burnetii antigen. Tetracycline, with or without lincomycin or cotrimoxazole, was used in nine patients, and one patient received cotrimoxazole as as the sole antibiotic agent. Optimal duration of therapy is unknown. In one patient, relapse followed when treatment was stopped after 18 months. Valve replacement was necessary in five patients, because of hemodynamic problems. Five patients died, and the means survival is 36 months with a range of five to 66 months. We suggest that Q fever endocarditis is frequently missed, and we recommend clinicians to consider the diagnosis in all cases of culture-negative endocarditis.

[Diagnostic laparotomy in Hodgkin's disease: indication, management, results (author's transl)]

Till December 31st 1976, diagnostic laparotomy was carried out in 58 patients with Hodgkin's disease. Of these, 23 cases (40%) revealed abdominal involvement. The tumor stage found by conventional diagnostics before surgical treatment had to be altered in 16 patients (27%). It had to be increased in ten and lowered in six cases. Of 13 splenic Hodgkin infiltrations twelve had not been supposed preoperatively; four out of 43 sound organs had been suspected preoperatively because of splenomegaly. Subdiaphragmatic histological findings involving a rather unfavorable prognosis were seen in nine patients (16%). In Hodgkin's disease, risk groups cannot be selected with confidence, as no definite correlation between the frequency of subdiaphragmatic affection and the primary manifestations, histology or general symptoms was observed. Since operation risk of diagnostic laparotomy is low, operable stage I-III cases with Hodgkin's disease should undergo diagnostic laparotomy prior to treatment planning.

[Extraperitoneal endometriosis in a kidney (author's transl)]

A case of extraperitoneal, isolated, intrarenal endometriosis observed by the author is described. The diagnostic problems are discussed; usually these concern complaints related to menstruation.