Absence of evidence for porcine circovirus type 2 in cattle and humans, and lack of seroconversion or lesions in experimentally infected sheep

No antibodies to porcine circovirus type 2 were detected in sera from cattle, sheep and humans. Experimental infection of lambs with this virus failed to produce lesions or seroconversion.

Preoperative sizing of meniscal allografts in meniscus transplantation

The purpose of this study was to determine the accuracy of radiographic and magnetic resonance imaging techniques in preoperative sizing for allograft meniscus transplantation. Twelve cadaveric knee specimens underwent sequential radiographs, magnetic resonance imaging scans, and arthrotomy. Meniscus dimensions were measured in multiple planes for the purpose of determining accuracy of imaging studies in comparison with actual meniscus dimensions. Overall, magnetic resonance imaging proved only slightly more accurate than conventional radiography. The mean difference between magnetic resonance imaging measurements and actual meniscus dimensions was 2.25 +/- 2.04 mm. The mean difference between radiographic measurements and actual meniscus dimensions was 2.35 +/- 1.79 mm. Neither imaging technique was accurate for measuring individual meniscus dimensions, with only 35% of images measuring within 2 mm of actual meniscus dimensions. Using less stringent criteria for accuracy (within 5 mm), radiography and magnetic resonance imaging were 79% and 83% reliable, respectively. Failure to obtain true anteroposterior or lateral images (15 degrees of external and internal rotation) increased measurement inaccuracy. Intraobserver agreement was significantly higher for magnetic resonance imaging than for radiography. Further research into the development of alternative techniques for more reliable meniscus sizing and better understanding of the tolerance for meniscus size mismatch is necessary.

Pulmonary pathology of harbour porpoises (Phocoena phocoena) stranded in England and Wales between 1990 and 1996

The pathological changes observed in the lungs of 197 freshly dead to moderately decomposed harbour porpoises (Phocoenaphocoena) stranded in England and Wales between October 1990 and December 1996 were reviewed. In 135 (69 per cent of the cases) macroscopic nematode infections of the bronchial tract with Pseudalius inflexus and Torynurus convolutus, either singly or in combination, were recorded, and 106 (54 per cent) also had P inflexus within the pulmonary blood vessels. All the macroscopically parasitised porpoises were adults or juveniles although two neonates had histological evidence of nematode infection. There were 62 cases of mild to severe, subacute to chronic bronchitis and bronchiolitis, 113 cases of mild to severe chronic granulomatous interstitial pneumonia, and 34 cases of mild to severe vasculitis or thrombovasculitis of pulmonary blood vessels attributable to these nematode infections. In 35 cases necropurulent or purulent (broncho)pneumonias were attributed either to secondary bacterial infections of the lungs or to septicaemias associated in seven cases with Streptococcus canis, in two cases with group B Salmonella species, in one case with Escherichia coli and in one case with Streptococcus lactis. The pulmonary lesions in 67 animals known or diagnosed to have been entrapped in fishing gear were non-specific and included persistent foam in the airways in 45 cases, diffuse congestion in 53, oedema in 50, and multifocal intra-alveolar haemorrhage in 33 cases. Seven cases of acute fibrinous or chronic fibrous pleuritis, seven cases of chronic necropurulent pneumonia associated with mycotic infections, four porpoises with traumatic lesions of the thorax and other parts of the body consistent with fatal attack from bottlenose dolphins (Tursiops truncatus), and one case of diffuse bronchointerstitial pneumonia associated with generalised morbillivirus infection were also recorded.

Causes of chronic pelvic pain

Chronic pelvic pain (CPP) is a common and debilitating condition, and yet remarkably little is known about what causes the pain. In this chapter we present a model of CPP which emphasizes the multifactorial nature of the problem. A range of physical causes are discussed, including endometriosis, pelvic inflammatory disease (PID), adhesions, irritable bowel syndrome, interstitial cystitis, musculo-skeletal factors and nerve-related pain. The role of the nervous system in the genesis and moderation of pain is explored. The importance of psychological factors is discussed, both as a primary cause of pain and as a factor which affects the pain experience. As with other chronic syndromes, the biopsychosocial model offers a way of integrating physical causes of pain with psychological and social factors.

Viral wasting syndrome of swine: experimental reproduction of postweaning multisystemic wasting syndrome in gnotobiotic swine by coinfection with porcine circovirus 2 and porcine parvovirus

One-day-old gnotobiotic piglets were inoculated intranasally with in vitro passaged porcine circovirus 1 (PCV-1), PCV-2, and porcine parvovirus (PPV) alone or in combination (PCV-1/PCV-2, PCV-1/PPV, and PCV-2/PPV). Piglets were evaluated for 1) the development of porcine postweaning multisystemic wasting syndrome (PMWS), 2) distribution of viral antigens by immunochemistry, and 3) viremia and the presence of viral DNA in nasal and ocular secretions and feces. All single agent-infected piglets and piglets infected with PCV-1/PCV-2 or PCV-1/PPV were clinically asymptomatic. They were transiently viremic and seroconverted to homologous virus(es). At termination of the study on postinfection day (PID) 35, microscopic lesions were restricted to focal inflammatory cell infiltrates in livers and myocardia. One piglet given PCV-1/PPV was PPV viremic for 2 weeks after infection and had lymphangiectasia of the spiral and descending colon associated with granulomatous inflammation. All four PCV-2/PPV-inoculated piglets developed PMWS, characterized by sudden onset of depression and anorexia, icterus, and submucosal edema. One piglet became moribund on PID 27, and the remaining three piglets were euthanatized between PID 27 and PID 30 because of severe disease. Lymph nodes were small and the livers were mottled. Disseminated angiocentric granulomatous inflammation was present in all tissues examined except the brain. Multiple lightly basophilic intracytoplasmic inclusion bodies were identified in macrophages and histiocytes. PCV-2 antigen was widely distributed within macrophages; PPV antigen was sparse. Hepatocellular necrosis and bile retention were prominent. PCV-2 DNA was identified in ocular, fecal, and nasal secretions. Terminal sera contained antibodies to PPV (4/4) and PCV-2 (3/ 4). Production of PMWS in gnotobiotic swine appears to require PCV-2 and additional infectious agents such as PPV for full disease expression in gnotobiotic piglets.

Correlation of leukocyte adhesiveness, adhesion molecule expression and leukocyte-induced contraction following balloon angioplasty

1. The aim of this study was to examine the changes in leukocyte adhesion and leukocyte-induced contraction in balloon-injured rabbit subclavian artery and to correlate these changes with vessel morphology and expression of adhesion molecules on the injured arteries. 2. Rabbits were anaesthetized and their left subclavian arteries were injured by balloon inflation and withdrawal followed by sacrifice at 2, 24, 48 h or 8 days after injury. The left and right subclavian arteries were removed and leukocytes were isolated from autologous rabbit blood. Leukocyte-induced contraction was measured in 5-HT precontracted artery rings and leukocyte adhesion was measured using (51)Cr-labelled leukocytes. Immunocytochemistry using paraffin-embedded tissue was employed to detect changes in the expression of adhesion molecules on injured arteries. 3. Autologous leukocytes caused a contraction of rabbit subclavian artery rings, which was prevented by L-NAME (10(-3) M). Balloon-induced injury abolished the contractile response to leukocytes, which correlated with loss of carbachol-induced relaxation 4. Balloon injury markedly enhanced the adhesiveness of the subclavian artery for leukocytes, most notably at 24 and 48 h after injury (1.7 and 1.8 fold respectively). Increased leukocyte adhesion at these two time points correlated with an upregulation of E-selectin, P-selectin and VCAM-1 expression on the remaining endothelium of the injured artery. 5. Vessel morphology revealed that balloon inflation had induced an infiltration of inflammatory cells into the vessel wall, the greatest increase being seen at 24 h after injury. 6. It is concluded that an increase in the expression of E-selectin, P-selectin and VCAM-1 following balloon-induced injury leads to enhanced leukocyte adhesion and migration into the injured vessel.

A sequential study of experimental infection of pigs with porcine circovirus and porcine parvovirus: immunostaining of cryostat sections and virus isolation

The sequential tissue distribution of virus was investigated using virus isolation and immunofluorescence tests in 1-day-old piglets inoculated with porcine circovirus 2 (PCV2) and/or porcine parvovirus (PPV). Enlarged mesenteric lymph nodes were seen in the pig inoculated with PCV2 alone and killed at 26 days post-inoculation (PI). One of the pigs inoculated with PCV2 and PPV and killed at 21 days PI had an enlarged liver. The pig killed at 26 days PI in this group had enlarged liver, kidneys and heart. Histopathological changes were seen in lymphoid tissues of the pigs inoculated with PCV2 alone and killed at 14 and 26 days PI. Similar, but more severe, lesions were observed in the pigs infected with PCV2 and PPV and killed from 10 days PI onwards. Histological lesions of nephritis, pneumonia and hepatitis were also apparent in these animals. Mild nephritis was also seen in the pigs infected with PPV alone and killed at 14 and 26 days PI. Moderate amounts of PPV antigen were detected in tissues from the pigs inoculated with PPV alone and killed at 14 days PI. Low levels of PCV antigen were detected, mainly in lymphoid tissues, in the pigs inoculated with PCV alone and killed at 14 days PI. Low to moderate amounts of PCV antigen were detected in a wider range of tissues in the pig in this group killed at 26 days PI. In the pigs inoculated with both viruses, PPV antigen was detected in tissues of pigs killed from 3 to 26 days PI with maximal amounts detected between 6 and 14 days PI. PCV2 antigen was detected in low to moderate amounts in the tissues of pigs killed at 14 days PI. Large amounts of PCV2 antigen were detected in most of the tissues from pigs in this group killed between 17 and 26 days PI. Virus isolation results for PCV2 generally correlated well with the results for immunofluorescent staining. PPV was isolated from almost all tissues from pigs inoculated with PCV2 and PPV, a much higher incidence of positive tissues than observed for immunofluorescent staining.

Neurohormonal responses to D-fenfluramine in healthy elderly subjects. A placebo-controlled study

Considering age-related changes in serotonin (5HT) function, we examined normative data of prolactin (PRL) and cortisol (CORT) responses to D-fenfluramine (D-FEN) in healthy elderly subjects. Twenty-three healthy male and female volunteers aged 60-86 participated in a single-blind, placebo-controlled, fixed-order, crossover-design challenge test. Two baseline PRL and CORT values and the responses of these hormones to 30 mg of oral D-FEN and placebo over a 4 h period were measured on two separate sessions. PRL and CORT responses were significantly greater following D-FEN than after placebo. Peak PRL responses (maximum change from baseline following D-FEN) were relatively robust compared to peak CORT responses. Peak PRL concentration was positively correlated with plasma D-nor-FEN concentration. Gender and aging had no effect on hormonal responses in the elderly. Although the weight adjusted dose used in this study was higher than the therapeutic dose of D-FEN, PRL responses were modest and only two participants experienced side effects. D-FEN is a safe serotonergic probe and PRL responsivity to D-FEN is a reliable index of central 5HT function in the elderly. An age-related decline in serotonergic function must be considered in determining the dose requirement for maximal hormonal responses to D-FEN challenge tests in the elderly.

Modern combined oral contraceptives for pain associated with endometriosis

BACKGROUND

Endometriosis is a major women's health-care problem. It causes pain and/or infertility, and affects millions of women worldwide. Endometriosis is defined according to histological criteria by the presence of tissue resembling endometrium in sites outside the uterus, most commonly the ovaries and peritoneum. The aim of treatment has been to remove the deposits of ectopic endometrium that are thought to be responsible for the symptoms of endometriosis. This can be achieved surgically by destroying or removing the implants; medical therapies induce atrophy within the hormonally-dependent ectopic endometrium. The duration of hormonal treatment may be limited by unwanted side effects. There is some evidence, however, from epidemiological research that current use of the combined oral contraceptive pill (OCP) is associated with a reduced incidence of endometriosis. The combined pill has the great advantage over other hormonal treatments that it can be taken indefinitely.

OBJECTIVES

The aim of this review was to establish the role of modern oral contraceptives in the management of painful symptoms ascribed to endometriosis.

SEARCH STRATEGY

The search strategy of the Menstrual Disorders Group was utilised to identify all randomised trials of the use of oral contraceptives in the treatment of symptomatic endometriosis. In addition a search of the Cochrane Controlled Trials Register was undertaken together with approaches to pharmaceutical companies.

SELECTION CRITERIA

All truly randomised controlled trials of the use of oral contraceptive pills in the treatment of women of reproductive age with symptoms ascribed to the diagnosis of endometriosis made visually at a surgical procedure, were included.

DATA COLLECTION AND ANALYSIS

Study quality assessment and data extraction was carried out independently by two reviewers. One of the assessors was an expert in the content matter.

MAIN RESULTS

Only one study was identified which satisfied the inclusion criteria. The oral contraceptive used in a conventional manner was less effective than a GnRH analogue in the relief of dysmenorrhoea. No significant difference was noted between the effectiveness of the oral contraceptive pill and a GnRH analogue in the relief of dyspareunia or non-menstrual pain. Headaches and weight gain were more commonly associated with oral contraceptive usage than with GnRH analogue usage whereas hot flushes, insomnia and vaginal dryness were less common.

REVIEWER'S CONCLUSIONS

There is a paucity of data relating to the use of oral contraceptive preparations in the treatment of symptomtic endometriosis. The data such as it is supports the common practice of the use of the oral contraceptive pill as a first line therapy but further research is required to fully evaluate its role in the management of endometriosis.

Mass die-Off of Caspian seals caused by canine distemper virus

Thousands of Caspian seals (Phoca caspica) died in the Caspian Sea from April to August 2000. Lesions characteristic of morbillivirus infection were found in tissue specimens from dead seals. Canine distemper virus infection was identified by serologic examination, reverse transcriptase- polymerase chain reaction, and sequencing of selected P gene fragments. These results implicate canine distemper virus infection as the primary cause of death.

Reproduction of lesions of postweaning multisystemic wasting syndrome by infection of conventional pigs with porcine circovirus type 2 alone or in combination with porcine parvovirus

Post-weaning multisystemic wasting syndrome (PMWS) has recently emerged as an important disease of pigs in North America, Europe and Asia. Porcine circovirus type 2 (PCV2) and porcine parvovirus (PPV) have been isolated from affected pigs. To investigate the pathogenicity of these isolates, groups of colostrum-deprived conventional pigs were inoculated with PCV2 alone (n=4), PPV alone (n=3) or dually with PCV2 and PPV (n=7) and examined post mortem between 21 and 26 days post-infection (dpi). Two control pigs were inoculated with an uninfected cell culture lysate. All pigs that received both viruses became dull at approximately 10-12 dpi and six of these animals subsequently developed jaundice. Hepatomegaly and enlarged kidneys were prominent post-mortem findings in these animals. Histopathological examination revealed severe macrophage infiltration, syncytia formation and numerous cytoplasmic and nuclear amphophilic inclusion bodies in lymphoid tissues. Granulomatous lesions were apparent in liver, lung, kidney, pancreas, myocardium, intestines, testis, brain and salivary, thyroid and adrenal glands. Abundant PCV2 antigen was detected in affected tissues. Only one of the four pigs inoculated with PCV2 alone developed clinical signs, but they all had histopathological lesions which, although less severe, were similar to those in the dually infected animals. The control pigs and those infected with PPV alone remained clinically normal and did not have gross lesions. The only histopathological lesion seen in these animals was mild interstitial nephritis in the pigs infected with PPV alone. These results indicate that lesions of PMWS can be induced by inoculating pigs with PCV2 alone, thereby fulfilling Koch's postulates. Concurrent infection with PPV increased the severity of the lesions, suggesting that co-factors are important in the pathogenesis of PMWS.

Ovarian response to repeated controlled stimulation in in-vitro fertilization cycles in patients with ovarian endometriosis

In-vitro fertilization (IVF) is an effective infertility treatment for women with endometriosis, but most women need to undergo several cycles of treatment to become pregnant. This case-control study was designed to assess how consistently women with ovarian endometriosis respond to ovarian stimulation in consecutive treatment cycles compared to women with tubal infertility. We compared outcome measures in 40 women with a history of surgically confirmed ovarian endometriosis and 80 women with tubal infertility, all of whom had at least three IVF treatment cycles. The groups were matched for age and early follicular follicle stimulating hormone (FSH) concentration at their first IVF cycle. Outcome measures included number of follicles, number of oocytes, peak oestradiol concentration and number of FSH ampoules required per follicle. Cumulative pregnancy and live birth rates were calculated in both groups. The ovarian endometriosis group had a significantly poorer ovarian response and required significantly more ampoules of FSH per cycle, a difference that became greater with each subsequent cycle. However, cumulative pregnancy (63.3 versus 62.6% by fifth cycle) and live birth (46.8 versus 50.9% by fifth cycle) rates were similar in both groups. In conclusion, despite decreased ovarian response to FSH, ovarian endometriosis does not decrease the chances of successful IVF treatment.

Toxoplasmosis in beluga whales (Delphinapterus leucas) from the St Lawrence estuary: two case reports and a serological survey

Toxoplasmosis was diagnosed in two free-ranging beluga whales from the St Lawrence estuary, Quebec, Canada, in 1988 and 1998. Histologically, tachyzoites and bradyzoites were present in the brain, spleen, lymph nodes, adrenals and lungs of both animals, and in the thymus of one. These organisms were readily labelled by an indirect immunohistochemical method for Toxoplasma gondii antigens. In the lymph nodes, spleen and lungs the organisms were associated with histiocytic infiltration. In the brain of one animal they were associated with mild multifocal gliosis and haemorrhages. There was no evidence of concomitant morbillivirus infection. Serum samples were collected from 22 beluga whales stranded between 1995 and 1998 on the shores of the St Lawrence Estuary and examined for antibodies to T. gondii by the modified agglutination test. Antibody titres of s25 were found in six (27%) of the animals. This is the first confirmed report of toxoplasmosis in beluga whales.

Extended half-life and elevated steady-state level of a single-chain Fv intrabody are critical for specific intracellular retargeting of its antigen, caspase-7

8 h) and high steady-state levels of protein accumulation, while the H2 intrabodies had a half-life of 2 h and less protein at steady state. These results suggest that the choice of sFv as an intrabody depends critically on the intracellular sFv protein having an extended half-life and elevated steady-state level. Thus, extended half-life must be considered together with sFv antibody specificity and affinity when choosing an optimal sFv intrabody for functional studies of cellular proteins.

Lipopolysaccharide potentiates the effect of hepatocyte growth factor on hepatocyte replication in rats by augmenting AP-1 activity

The liver regenerates by replication of differentiated hepatocytes after damage or removal of part of the liver. Although several growth factors and signaling pathways are activated during regeneration, it is unclear as to which of these are essential for hepatocyte replication. We show here that low- (1 mg/kg) and high- (10 mg/kg) dose hepatocyte growth factor (HGF) induced replication of 2.1% and 11.1% of hepatocytes in rats, respectively. Lipopolysaccharide (LPS), an inducer of the acute phase response, augmented hepatocyte replication in response to low- and high-dose HGF by 4- and 2-fold, respectively. HGF alone induced moderate levels of c-Jun-N-terminal kinase (JNK) and p44/p42 mitogen-activated protein kinase (MAPK), resulting in moderate levels of AP-1-DNA binding activity. The combination of LPS + HGF increased JNK and AP-1-DNA binding activity more than levels seen with LPS or HGF alone. The activation of Stat3 that was observed after administration of LPS + HGF, but not HGF alone, could contribute to increased transcription of AP-1 components. Because phosphorylation of the c-Jun component of AP-1 by JNK increases its ability to activate transcription, the AP-1 in hepatocytes from animals treated with LPS + HGF may be more active than in rats treated with LPS or HGF alone. LPS may contribute to hepatocyte replication by potentiating the effect of HGF on the activation of both AP-1-DNA binding and transcriptional activity.

Spinal anesthesia with 0.5% S(-)-bupivacaine for elective lower limb surgery

BACKGROUND AND OBJECTIVES

This study examines the clinical effects of the subarachnoid administration of levobupivacaine, the S(-)-enantiomer of racemic bupivacaine.

METHODS

An open, noncomparative study was performed on 20 patients undergoing elective lower limb surgery. Three milliliters of a plain solution of 0.5% S(-)-bupivacaine ( 15 mg) was administered via the L2 or L3 interspace with the patient in the sitting position. Following injection, the patients were immediately placed supine. Spread of sensory analgesia, degree of motor block, and hemodynamic parameters were recorded.

RESULTS

Satisfactory surgical anesthesia was achieved in 18 patients. The median time to onset of analgesia was 2 minutes (ranging 2-10 minutes) and the median duration of analgesia was 388 minutes (range, 295-478 minutes). This group of patients achieved complete motor block, with a median onset time of 5 minutes (2-10 minutes) and duration of 266 minutes (range, 170-415 minutes). Sensory block height was inadequate for surgery in 2 patients, who received supplemental anesthesia.

CONCLUSIONS

The results suggest that S(-)-bupivacaine can provide satisfactory surgical anesthesia, but the spread of the plain solution is unpredictable.

Economic consequences of comorbid depression, anxiety, and allergic rhinitis

The present study extends prior work on the association between allergic rhinitis (AR) and common mental disorders by testing three related hypotheses: 1) that AR is associated with increased rates of depression and anxiety disorders in a large insured population, 2) comorbid AR, depression, and anxiety are associated with increased health and mental health expenditures, and 3) allergy treatment moderates the association between increased expenditures and comorbid AR, depression, and anxiety. Data are from MARKETSCAN, a large health care claims database of over 600,000 privately insured persons. Results indicate that AR is associated with higher rates of depression and anxiety disorder. Outpatient health care expenditures were increased by an average annual amount of $207 when AR and anxiety disorder were comorbid and $363 when AR and depression were comorbid. Finally, prescription treatment of AR moderated the increased expenditures associated with comorbidity.