眶内眼神经的断层解剖学研究及其临床意义

目的：为影像检查和眶内手术提供断层解剖学资料。方法：应用50侧成人头颅湿标本制成0．5mm的火棉胶连续切片，对额神经、鼻睫神经、泪腺神经的位置、走行和毗邻进行观测。结果：眼神经的分支额神经、鼻睫神经和泪腺神经均经眶上裂人眶。额神经发出滑车上神经和眶上神经内外支，鼻睫神经与眼动脉伴行，泪腺神经在外直肌上方前行。结论：火棉胶连续切片能够准确显示眶内眼神经的分支、走行，对影像诊断和避免手术损伤均有重要参考价值。     

眶上裂区及其穿经结构的薄层冠状断层解剖学

目的：探讨眶上裂区及其穿经结构的薄层冠状断层解剖,为临床眶上裂区疾病的影像诊断提供形态学依据。方法：采用火棉胶切片技术对5例(10侧)成人眶上裂区标本进行连续薄层冠状断层解剖学观察。结果：眶上裂被Zinn腱环分为外侧区、中央区和内侧区,内有第Ⅲ、Ⅳ、Ⅴ_1、Ⅵ对脑神经及其分支和眼上静脉通过,未见眼下静脉。视神经由颅内的横椭圆形逐渐变为眶内的圆形;眼动脉在视神经管颅口、中部和眶口处分别位于视神经的内下方、正下方和外下方。结论：冠状断层对于眶上裂区及其穿经结构显示效果良好,应作为该区影像诊断的基本层面。火棉胶包埋结合滑动式切片机薄层连续切片技术是研究眶上裂区断层解剖学的一种简便适用、定位准确的方法。     

眶尖区的断层解剖学研究及临床意义

目的　为眶尖区影像诊断提供断层解剖学资料。方法　应用 5 0侧成人头颅湿标本制成 0 5mm的火棉胶连续切片 ,用计算机图像分析系统对 3 6侧冠状位标本上的眶尖结构进行测量。结果　视神经管眶口处面积最小 ,管内段视神经从颅端到眶端逐渐变细 ,眼动脉进入神经经管从视神经内下方向外下方走行 ,眶上裂被Zinn腱环分为外侧区、中央区、下区 3部分。结论　冠状位是观测眶尖结构的理想层面 ,对眶尖部病变的诊断具有重要意义。     

前列腺解剖带区的断层切片与MRI图像对照研究

目的　探讨前列腺各带区在解剖断层切片的形态学表现,及其与MRI断层图像的对应关系,确定前列腺各带区MRI影像的解剖学基础。 方法　利用MRI技术对6具成人尸体及576例健康成人的前列腺进行扫描,观察尸体及活体前列腺带区MRI表现,然后采用火棉胶包埋技术把标本制成前列腺区薄层连续切片,并与MRI图片进行对照研究。 结果　尸体断层解剖切片可根据尿道、精阜、射精管识别外周带、中央带、移行带、尿道周围组织及前列腺肌肉基质区的大体位置,但其间未见明显界限。尸体标本及活体MRI图像表现基本一致,即T1WI上整个前列腺呈略低信号;T2WI上前列腺外周带呈高信号表现,中央区呈低信号;薄层切片与MRI图像有良好的对应关系。 结论　MRI检查时,横断面、冠状面及矢状面扫描相结合,才能完整显示前列腺各带区的结构特点,进而有利于对前列腺内的病灶进行准确地MRI定位诊断。     

额神经末支解剖特点及其在前额除皱术中的意义

目的：为了前额除皱术切口位置和分离平面的选择提供解剖学依据。方法：对18例成人头部标本进行大体和显微解剖研究以及组织切片观察。结果：（1）眶上神经绕过眶上缘后分为溶，浅二支，浅支位额肌深面并穿过该肌分布于额部皮肤，深支行于额肌，帽状腱膜与骨膜之间直达人字缝；（2）滑车上神经在皱眉肌外侧和穿经皱眉肌后穿过额肌到达头皮，结论：（1）前额除皱术中冠状切口应尽量靠近人字缝，并在骨膜下剥离皮瓣，以避免损伤眶上神经，（2）切断皱眉肌时宜在直 下仔细操作以减少对滑车上神经的损伤。     

视神经的断层解剖学研究及其临床意义

目的：为视神经的影像检查提供断层解剖学资料。方法：应用50侧成人头颅湿标本制成0.5mm的火棉胶连续切片，用计算机图像分析系统对36侧冠状位标本上的视神经进行测量。结果：视神经分颅内段、管内段、眶内段和球内段四部分。管内段从视神经管颅口到眶口逐渐变细，眶内段中点最细。结论：视神经的测量可在冠状面上进行，眶内段中点可作为测量标准。     

眼动脉的变异报告

在一具男性成人尸体的右侧眶标本上发现眼动脉的少见变异。眼动脉起自颈内动脉硬膜下段,动脉发育较差,外径仅0.8 mm(对侧2.0 mm)。在视神经的外下侧入眶。至总睫环下方分为内、外二支。外侧支分为二小支睫状动脉,与睫状神经件行,围绕视神经的下、外侧穿巩膜筛板进入眼球;内侧支在总腱环前8.0 mm处向外发出视网膜中央动脉,自视神经下方入视神经。主干继续前行,分为上、下二支。上支与来自硬膜中动脉的副眼动脉吻合;下支与睫状神经伴行,在视神经内侧向前穿巩膜筛板进入眼球,亦为睫状动脉。硬膜中动脉前支的眶支与泪腺动脉的硬膜返支的吻合支,形成粗大的副眼动脉,入眶处外径达2.5mm,经眶上裂的最外侧处的上角部入眶,向     

膝后外侧部结构的断层解剖及临床意义

目的：为MRI诊断膝后外侧部结构损伤提供断层解剖学依据。方法：用火棉胶包埋技术对8侧成人尸体膝部进行矢状和冠状位l～2mm厚的连续切片，观察膝后外侧部结构在断面上的形态、位置和毗邻关系。结果：腓侧副韧带和弓状韧带在冠状切片显示较好；小豆腓骨韧带在矢状切片显示较好；胭腓韧带在矢状和冠状切片均可显示；胭肌的肌腹部、肌腹一肌腱连接部和胭肌腱股骨部在冠状层面可显示，胭肌腱斜行部在矢状面显示较好。结论：膝部矢状和冠状断层切片能清晰显示膝后外侧部结构，有利于正确辨认这些结构的影像学表现。     

视神经和视交叉冠状断层解剖与MRI

目的：研究视神经和视交叉在冠状断面上的解剖特征与MRI表现,为相关疾病的影像诊断和外科手术提供解剖学资料。方法：选取15例成人尸头标本,以冷冻切片法切制成连续冠状断层标本;应用3．0TMRI扫描仪,获取10例志愿者头部的sE序列T1WI和T2WI图像;在上述断层标本和MRI图像上,观察分析冠状断面上视神经的形态、位置和毗邻关系。结果：视神经眶内段居于眶中心偏内上方,断面呈圆形,其周围有视神经鞘包绕,蛛网膜下隙清晰可见,眼动脉位于其上方;视神经管内段居于眶内上方,断面呈水平卵圆形,周围可见视神经鞘,蛛网膜下隙不明显,眼动脉位于其下方;视交叉冠状断面呈“一”字型,分隔上方的视隐窝和后下方的漏斗隐窝,其上方有大脑前动脉A1段,下方为灰结节和垂体柄。结论：冠状断面町以清楚显示视神经、视交叉的形态特点与毗邻关系。     

颈椎线圈联合体部阵列线圈使用 SPACE-STIR 序列对臂丛神经在 3.0 TMRI 上显示的应用价值简

目的探讨颈椎线圈联合体部阵列线圈使用SPACE-STIR序列对臂丛神经显示的应用价值。方法选择30例颈椎MRI检查的患者,其中男性18例．女性12例;年龄25-54岁,平均年龄33岁;无臂丛神经病史和相关临床症状。5例外伤后临床怀疑臂丛神经受累的患者．其中男性3例．女性2例：年龄17-54岁,中位年龄41岁。使用3．0TMRI对患者行MRI检查。采用横断位快速自旋回波T1WI、T2WI及冠状位SPACE-STIR序列,观察各序列中臂丛神经图像显示的情况及其病变的MRI影像学特征。检查中对同一被检者仅使用颈椎线圈和使用颈椎线圈联合体部相控阵线圈各检查1次,检验两种方法臂丛神经远端清晰显示率。结果30例颈椎检查者共60侧臂丛神经．使用颈椎线圈T1WI上臂丛神经显示优良率为50％,T2WI为52％,SPACE-STIR为70％;颈椎联合体部阵列线圈T1WI上臂丛神经显示优良率为67％,T2WI为77％,SPACE-STIR为97％。SPACE～STIR序列优于快速自旋回波T1WI、T2WI。使用颈椎线圈联合体部阵列线圈臂丛神经远端清晰显示率为93％,而单独使用颈椎线圈清晰显示率为52％;两者比较,差异具有统计学意义（χ^2=26．12,P〈0．05）。5例臂丛神经损伤诊断结果MRI示神经连续性中断。结论联合线圈成像结果对臂丛神经显示较单个线圈全面、清晰,且对准确判断病变累及范围特别是远端更有优势。联合常规T1WI、T2WI序列更能有效、全面地显示臂丛神经。     

The utility of IS6110 sequence based polymerase chain reaction in comparison to conventional methods in the diagnosis of extra-pulmonary tuberculosis

IS6110 sequence based polymerase chain reaction (PCR) was compared with conventional bacteriological techniques in the laboratory diagnosis of extra-pulmonary tuberculosis (EPTB). One hundred and ninety one non-repeated clinical samples of EPTB and 17 samples from non-tuberculous cases as controls were included. All the samples were processed for Ziehl-Neelsen staining for acid fast bacilli (AFB) and 143 samples were processed by culture for M. tuberculosis . All the samples were processed for PCR amplification with primers targeting 123 bp fragment of insertion element IS6110 of M. tuberculosis complex. Of the total 191 samples processed, 34 (18%) were positive by smear for AFB. Culture for AFB was positive in 31(22%) samples among the 143 samples processed. Either smear or culture for AFB was found positive in 51(27%) samples. Of the total 191 samples processed 120 (63%) were positive by PCR. In 140 samples, wherein both the conventional techniques were found negative, 74 (53%) samples were positive by PCR alone. Among 51 samples positive by conventional techniques, 46 (90%) were found positive by PCR. PCR assay targeting IS6110 is useful in establishing the diagnosis of EPTB, where there is strong clinical suspicion, especially when the conventional techniques are negative.     

Dual infection with hepatitis A and E viruses in outbreaks and in sporadic clinical cases: Cuba 1998-2003

Viral hepatitis ranks as the fifth cause of morbidity for infectious diseases in Cuba. Epidemics are observed frequently in the population, the hepatitis A virus being the main agent responsible for such epidemics. Previous reports also confirmed the circulation of the hepatitis E virus. From 1998 to 2003, 258 serum samples were collected by the Reference Laboratory on Viral Hepatitis during 33 outbreaks of acute viral hepatitis as well as from 39 sporadic clinical cases. Sera were tested for anti-HAV and anti-HEV IgM by EIA. Overall of the 33 outbreaks studied sera from 12 (36.4%) were positive for anti-HAV IgM only, from 7 (21.2%) were positive for anti-HEV IgM only, and from 14 (42.4%) were positive for antibodies to both viruses. Individually of the 258 sera collected, 137 (53.1%) were positives for anti-HAV IgM, 20 (7.8%) were positives for anti-HEV IgM, 33 (12.8%) were positives for both markers and 68 (26.4%) were negative to both. Of the clinical cases, 4 (10.3%) were positives for anti-HAV IgM, 13 (33.3%) were positives for anti-HEV IgM and 5 (12.8%) were positives for both markers. Seventeen (43.6%) sera were negatives for all viral hepatitis markers available (A-E). A high positivity for HEV was found in outbreaks tested with the kit produced by CIGB. In particular HEV seems to infect individuals of all ages. The results demonstrate the co-circulation of and co-infection with two enterically transmitted viruses; however a higher positivity was observed for anti-HAV than to anti-HEV (53.1% vs. 7.8%) in outbreaks.     

Evaluation of two rapid methods for the detection of herpes simplex virus antigen in patient specimens

An indirect immunofluorescent antibody procedure (IFA) for the detection and typing of herpes simplex virus (HSV) and an enzyme-linked immunosorbent assay (ELISA) procedure were compared with conventional viral culture. Specimens for culture and ELISA were inoculated into serum free viral transport medium (VTM) and, for IFA, onto slides provided in the kit. Tissue cultures (MRC-5 and primary rabbit kidney) were inoculated and examined daily for cytopathogenic effect (CPE). The remaining VTM was frozen at -70 degrees C until tested by the ELISA system. Slides for IFA were stained with HSV common and HSV-2 specific monoclonal antibodies. Of 155 specimens, 47 (30 percent) were unsatisfactory for the IFA test owing to an inadequate number of epithelial cells on the slides. Of 108 adequate specimens, 45 were culture positive; 39 were positive by the IFA test with a sensitivity of 87 percent and a specificity of 90 percent. Of the 39 positives, 29 (75 percent) were correctly classified as type 1 or type 2, six (15 percent) were typed incorrectly, and four (10 percent) were inadequate for typing by the IFA test. All 155 specimens were suitable for testing by the ELISA procedure. Of 55 specimens positive by culture, only 25 (sensitivity 45 percent) were positive by ELISA. However, the specificity was 100 percent. After incubation of two, three, and six days, the tissue cultures detected 71 percent, 89 percent, and 100 percent of the positives, respectively.     

Investigation of strongyle EPG values in horse mares relative to known age, number positive, and level of egg shedding in field studies on 26 farms in Central Kentucky (2010–2011)

A parasite study was done in 1,300 horse mares on 26 farms in Central Kentucky over a 5-month period in 2010 and 2011. The mares included 1,114 Thoroughbreds (TB) on 24 farms, 64 Standardbreds (SB) on 1 farm, and 122 mixed light horse types (MLH) on 1 farm. The objective of this research was to determine strongyle eggs per gram of feces (EPG) counts for evaluation by known age, number positive, and level of egg shedding by the mares. This was done to establish strongyle EPG profiles for the mares to aid in determining whether antiparasitic treatment was necessary. Eggs found were considered those of small strongyles. (A) For the Thoroughbred mares, (1) 362 (32%) were EPG-positive, and (2) the average (percentage) of EPG-positive mares by year of age was 3-5 (54%), 6-10 (36%), 11-15 (24%), 16-20 (17%), and >20 (21%); (3) EPG average counts were similar for all age categories except for the 6- to 10-year-olds, which were higher; (4) and the average (percentage) of positive mares by 100 units of EPG counts was ≤100 (50%), ≤200 (62%), ≤300 (70%), ≤400 (76%), ≤500 (80%), and >500 (20%). (B) For the Standardbred mares, 31 (48%) were EPG-positive; (2) the average (percentage) of EPG-positive mares by year of age (no >20 sampled) was lowest for the 3-5 and 16-20 categories and highest for the 6-10 and 11-15 groups; (3) EPG average counts by years of age were lowest for 3-5, 11-15, and 16-20 groups and highest for the 6-10 group; and (4) the average (percentage) of positive mares by 100 units of EPGs was 62% for the ≤100 category, 71-84% for ≤200 to ≤400 units, and the highest (97%) for the ≤500 unit. (C) For the mixed light horse type mares: (1) 94 (77%) were EPG-positive, (2) the average (percentage) of EPG-positive mares by age was lowest for the two oldest age groups, higher for the 11 to 15-year-old age group, and highest for the two youngest age groups; (3) EPG average counts by year of age were lowest for the 16-20 group, higher for the 6-10 and >20 groups, and highest for 3-5 and 11-15 groups; (4) the average (percentage) of positive mares by 100 units of EPG counts was lowest for the ≤100 category (23%), increasing about 10% progressively in ≤200 to ≤500 categories, but lower (37%) for the >500 category. (D) For all the three mare types (TB, SB, and MLH), 37% of the mares were EPG-positive, and 63% of the mares were EPG-negative; for the age (years) of positive mares, about one half belonged to the 3-5 category and a progressive decrease was seen for the 6-10, 11-15, and 16-20 groups, and 36% for the >20-year-olds; the mean strongyle EPGs highest range was seen in the 11- to 15-year-olds; the highest mean was in the 6- to 10-year-olds, and the lowest mean in the 3- to 5- and 16- to 20-year-olds. For the grouping of the strongyle EPG values by units of 100, three-fourths were in the ≤500 category, and the lowest percentage was for the >500 category. This research showed the value of strongyle EPG profiling for the mares. It was most useful for TBs where data from a large number of horses showed that over two-thirds were EPG-negative, indicating that there would be no known problem in deciding not to deworm them. While data were not as clear-cut on the SB and MLH mares, several of those which were negative and with "low" EPG values could be excluded from antiparasitic treatment.     

Evaluation of the INNO-LIA HTLV I/II assay for confirmation of human T-cell leukemia virus-reactive sera in blood bank donations

We have evaluated a new serological confirmatory test (INNO-LIA HTLV I/II Ab [INNO-LIA]) for human T-cell leukemia virus (HTLV) using a large collection of samples from Brazilian blood donors (S?o Paulo region) and compared the results with those obtained by Western blotting (WB) tests (WB2.3 and WB2.4). Blood donations were initially screened by enzyme-linked immunosorbent assays (ELISAs) based on viral lysates, and repeatedly reactive samples were further tested by WB2.3. When available, samples were also tested by PCR, two additional ELISAs based on recombinant antigens (recombinant ELISAs), a new-generation WB assay (WB2.4), and the INNO-LIA. Of the 18,169 samples tested, 292 (1.61%) were repeatedly reactive in the ELISAs (viral lysate based) and were further tested by WB2.3; 97 were positive (19 that were typed as HTLV type I [HTLV-I], 12 that were typed as HTLV type II [HTLV-II], and 66 that were nontypeable), 17 were negative, and 178 had indeterminate results. Of the samples with indeterminate results, 172 were tested by INNO-LIA, which could resolve 153 samples as negative. Regarding the positive samples, WB2. 3 and INNO-LIA produced concordant results for all HTLV-I-positive samples, whereas for HTLV-II they agreed for 10 of 12 samples; the 2 samples with discordant results were considered to be positive for HTLV-II by WB with WB2.3 but negative for HTLV-II by INNO-LIA and the two recombinant ELISAs. Furthermore, of the 66 nontypeable samples, 60 underwent testing by INNO-LIA; 54 turned out to be negative by the latter test as well as by recombinant ELISAs. In conclusion, the new serological confirmatory assay for HTLV (INNO-LIA HTLV I/II Ab) resolved the results for the majority of the indeterminate and positive-untypeable samples frequently observed by WB assays.     

Comparison of two new tests for rapid diagnosis of respiratory syncytial virus infections by enzyme-linked immunosorbent assay and immunofluorescence techniques.

The sensitivity and the specificity of two new commercial reagent tests, an indirect fluorescent antibody test (FAT) with a mouse monoclonal antibody (MAb) against respiratory syncytial virus (RSV) and an enzyme-linked immunosorbent assay (ELISA) RSV antigen detection kit, were determined by a comparison of results from these tests with those of tissue culture isolation and an indirect FAT with bovine polyclonal antibody (BPA). Of 251 nasal aspirates from infants with suspected RSV infection, positive results were found for 99 (39%) by the FAT-MAb, 93 (37%) by the FAT-BPA, and 87 (35%) by the ELISA; 69 of 240 (29%) were positive by cultures. The FAT-MAb was a more sensitive technique than cultures, with 87% sensitivity for the FAT-MAb and 84% for the ELISA. It was also more sensitive than the FAT-BPA, with 97% sensitivity for the FAT-MAb and 85% for the ELISA. This could be caused only by the distinctive volume of suspended specimens used in these tests. Of 171 negative culture specimens, positive (but not false-positive) results were found for 18% by the FAT-MAb and for 12% by the ELISA. Inversely, 13% of 69 culture positive specimens were FAT-MAb negative and 16% were ELISA negative, emphasizing the importance of tissue cultures for the maximum recovery of RSV, as well as for detection of other respiratory viruses. The FAT-MAb and ELISA were easy to perform and interpret, thus facilitating wider use.     

肝硬变内HBV DNA及其五种抗原的表达及意义

取２２５例人肝硬变活检组织石蜡切片，检测了ＨＢＶＤＮＡ及其５种抗原。分别用免疫组化ＡＢＣ法检测ＨＢｘＡｇ、ｐｒｅ－Ｓ＿１和ｐｒｅ－Ｓ＿２抗原；用ＰＡＰ法检测ＨＢｓＡｇ和ＨＢｃＡｇ；用原位杂交方法检测ＨＢＶＤＮＡ；用免疫组化、原位杂交双标记方法检测ＨＢＶＤＮＡ和ＨＢｓＡｇ、ＨＢｘＡｇ或ＨＢｃＡｇ。结果显示，阳性检出率ＨＢｓＡｇ为７０．０％（１２８／１８３例），ｐｒｅ－Ｓ＿１抗原为６４．４％（８５／１３２例）、ｐｒｅ－Ｓ＿２抗原为６１．４％（８１／１３２例），ＨＢｘＡｇ为７５．３％（１１３／１５０例），ＨＢｃＡｇ为２２．４％（３９／１７４例），ＨＢＶＤＮＡ为６２．４％（５８／９３例）。双标阳性检出率ＨＢＶＤＮＡ和ＨＢｓＡｇ为３７．３％（１９／５１例），ＨＢＶＤＮＡ和ＨＢｘ－Ａｇ为８６．３％（４４／５１例），ＨＢＶＤＮＡ和ＨＢｃＡｇ为３９．２％（２０／５１例）。ＨＢＶＤＮＡ和ＨＢＶ５种抗原阳性病例中８０％以上均伴有肝细胞不典型增生。这一结果表明，在我国肝硬变的发生发展与ＨＢＶ慢性感染有密切的关系。     

Identification of the causative organism of tuberculous lymphadenitis in ethiopia by PCR

Tuberculous lymphadenitis (TBLN) is a common form of extrapulmonary tuberculosis with multiple differential diagnoses. Demonstration of the etiologic agent by smear microscopy or culture of fine needle aspirate (FNA) specimens is often unsuccessful. FNA specimens from 40 patients presenting at a rural health center in South Ethiopia and diagnosed as positive for TBLN on the basis of clinical and cytological criteria were analyzed for mycobacterial DNA by PCR. Thirty (75%) had cervical lymphadenitis and 11 (27.5%) were seropositive for human immunodeficiency virus (HIV). Three primer sets were initially used to identify the causative agent at the genus (antigen 85 complex), complex (IS6110 insertion sequence), and species (pncA gene and allelic variation) levels. Among the forty TBLN cases, 35 (87.5%) were positive by PCR at the genus and complex levels. Based on PCR for detection of allelic variation at position 169, 24 (68.6%) of the 35 were positive for Mycobacterium tuberculosis and 6 (17.1%) were positive for M. bovis. These six were positive in additional PCR assays using the JB21-JB22 primer set, which is highly specific for M. bovis. Five (14.1%) showed amplification for both M. tuberculosis and M. bovis with the allele-specific primer set. Cooccurrence of pyrazinamide (PZA)-sensitive and -resistant M. tuberculosis in those five cases was indicated, since all were negative in assays with the JB21-JB22 primer set. This feature was seen in 3 of 11 HIV-positive and 2 of 29 HIV-negative individuals (P < 0.001). Conclusion: among 35 PCR-positive cases of TBLN from southern Ethiopia, 29 (82.9%) were caused by M. tuberculosis and six (17.1%) were caused by M. bovis.     

Detection of respiratory syncytial virus in clinical specimens by viral culture, direct and indirect immunofluorescence, and enzyme immunoassay.

We evaluated prospectively the detection of respiratory syncytial virus (RSV) by culture and by direct antigen detection using an indirect immunofluorescence assay (IFA), a direct monoclonal immunofluorescence assay (DFA), and a monoclonal enzyme immunoassay (EIA). Of 221 specimens, 95 (43%) were culture positive for RSV, 4 (1.8%) contained more than one virus, and 17 (7.6%) contained a virus other than RSV. Overall, HEp-2 and Flow 6000 cells grew significantly more RSV isolates (82 and 72%, respectively) than A549 cells, which grew only 29% of the isolates. The mean time for RSV detection with HEp-2 cells was 2.9 days. This was significantly less than the mean time for RSV detection with either Flow 6000 cells (6.1 days) or A549 cells (6.4 days). Of 221 specimens, 129 were tested simultaneously by culture, IFA, and DFA. Of these 129 specimens, 62 (48%) were positive by culture, 69 (53%) were positive by IFA, and 70 (54%) were positive by DFA. For 92 specimens screened simultaneously by culture, IFA, and EIA, positive results were obtained for 33 (36%) of the specimens by both culture and IFA and for 29 (32%) of the specimens by EIA. Of 126 culture-negative specimens, 21 (17%) were positive for RSV when determined by IFA. Conversely, 14 (15%) of 95 RSV culture-positive specimens were negative by IFA, whereas DFA missed 19% of the culture-positive specimens. Compared with culture, the Kallestad EIA kit had a sensitivity and specificity of 73 and 92% respectively, but missed 9 (27%) of 33 culture-positive specimens. These data demonstrate that isolation by culture continues to be important for viral diagnosis of REV infections and that for valid comparative studies between viral isolations and rapid detection methods, both sensitive host cells and appropriate test conditions are required.     

Rapid 24-well plate centrifugation assay for detection of influenza A virus in clinical specimens

Two methods for detection of influenza virus in 234 clinical respiratory specimens were compared: (i) a 24-well plate-centrifugation assay using Madin Darby canine kidney (MDCK) cells and staining with monoclonal antibody pools to influenza A and B (Centers for Disease Control, Atlanta, GA) after incubation for 16 h and 40 h, and (ii) conventional tube cell culture using MDCK cells and primary rhesus monkey kidney cells. Influenza A was identified in 23 specimens (10%). No influenza B was recovered. The rapid centrifugation and tissue culture methods were positive for influenza A in 21 (91%) and 16 (70%) of the 23 specimens, respectively. Fourteen specimens were positive by both methods, 2 were positive by tissue culture alone, and 7 were positive by rapid centrifugation only. Of the 21 specimens positive by rapid centrifugation, 16 (76%) were detected after overnight incubation, and 5 (24%) were positive only after incubation for 40 h. Cytopathic effect was observed in 13 (81%) of the 16 isolates identified by tissue culture after an average of 6 days, and 3 (19%) were identified only by hemadsorption and staining with monoclonal antibodies at day 10. Compared with conventional tissue culture, the 24-well plate centrifugation assay is a more rapid and more sensitive method for detecting influenza virus in clinical specimens.