Effect of Cryptosporidium baileyi in specific pathogen free chickens vaccinated (CVI988/Rispens) and challenged with HPRS-16 strain of Marek's

This study was performed to examine the effect of Marek's disease virus (MDV) serotype 1 vaccine (CVI988/Rispens) on the pathogenicity of Cryptosporidium baileyi , and to determine whether C. baileyi infection could prevent the development of vaccinal Marek's disease (MD) immunity in specific pathogen free (SPF) chickens. Sixty-eight SPF homozygous B13 White Leghorn chickens were divided into seven groups. C. baileyi was orally administered at 5 days of age (day 4) in chickens infected with Rispens vaccine at day 0 or at day 8 and challenged with HPRS—16 strain of oncogenic MDV at day 15. Relevant control groups were constituted. The chickens were kept in isolators until the end of the experiment at day 62. The parameters evaluated were clinical signs, kinetics of oocyst shedding, mortality, macroscopic and microscopic lesions, cryptosporidia location in various organs and serum anti- C. baileyi antibodies at days 42 and 62. Our results show that C. baileyi , which is considered to be non-pathogenic when inoculated orally, may become highly pathogenic. It induced severe mortality and developed in organs other than classical target sites when chickens were vaccinated with Rispens vaccine and challenged with the HPRS—16 strain of MDV.However,parasite infection does not prevent the induction of vaccinal immunity for MD. Our results also show that vaccination of B13 chickens at hatching induces higher protection against challenge with HPRS—16 MDV at day 15 than vaccination at day 8.     

Evaluation of sodium L-thyroxine (T4) requirement in replacement therapy of hypothyroidism

Sodium-L-thyroxine (T4) was utilized in the treatment of 15 pediatric patients with hypothyroidism. Adequacy of replacement therapy was confirmed by clinical evaluation in conjunction with determination of serum thyroxine, tri-odothyronine, and thyrotropin concentrations. Daily dose of thyroxine capable of including clinical and biochemical euthyroidism ranged from 2.5 to 5 mug/kg of body weight with a mean of 3.5 +/- 0.3 mug in the 4- to 17-year-old age group. Two infants with congenital hypothyroidism diagnosese observations imply that physiologic requirements of thyroxine are distinctly lower than previously recommended dosages. Further studies to establish more precise therapeutic guidelines are needed.     

Hydatid cyst of the mediastinum: 2 cases

Hydatid cysts of the mediastinum are very uncommon. We report two cases of mediastinal hydatic cyst. The first case was located in the cardiophrenic recess while the other was within both the heart and mediastinum. A review of the imaging findings and value of various techniques is presented.     

Humoral and cell-mediated immunity in growth hormone-deficient children: effect of therapy with human growth hormone

To delineate the role of growth hormone (GH) in the development and function of the immune system, immunological parameters including quantitative immunoglobulins, T and B lymphocytes, phytohemagglutinin lymphoproliferative response and delayed hypersensitivity skin tests were studied in nine GH-deficient children prior to GH therapy and at 2 months and 9 to 12 months following therapy. The phytohemagglutinin response (74.1 +/- 37.6, mean +/- SD), and the T rosette (58.3% +/- 9.4), B rosette (21.1% +/- 6.1), IgG (810 +/- 241 mg/dl), (IgA 140 +/- 85), and IgM (176 +/- 70) levels in GH-deficient children were comparable to age adjusted values in normal children. Following GH therapy the phytohemagglutinin response increased significantly at 9 to 12 months post-therapy, 123.2 +/- 51.9 versus 74.1 +/- 37.6, p less than 0.05. T and B rosettes, immunoglobulin concentrations, and hypersensitivity skin tests were not affected by GH therapy. Although an effect of GH was not demonstrable by these studies, a positive role of GH cannot be entirely excluded since total GH deficiency did not exist in all children.     

Prenatal thyroid function abnormalities in infants with idiopathic respiratory distress syndrome

Thyroxine (T4), triiodothyronine (T3), and thyrotropin (TSH) concentrations were measured on cord sera of 21 preterm infants with idiopathic respiratory distress syndrome (IRDS) and were compared to the values obtained from 15 healthy preterm infants. When log T3, log T4, and log TSH were considered as the dependent variables in the multivariate test Hotelling-Lawley-Trace, there was an overall difference between the two groups: F = 3.94, p = 0.03. When log T3 and log T4 were considered separately in an analysis of covariance, there was a significant difference between the two groups for log T3 after adjusting for birth weight and gestational age (F = 7.98, p = 0.008). However, for log T4 and TSH, there was no difference between the IRDS and control infants. These findings exclude the possibility of antenatal thyroid dysfunction in babies with IRDS. An explanation for reduced cord blood T3 concentration in infants with IRDS is lacking at present. Extrathyroidal factors that predispose to IRDS may also affect peripheral T3 generation. Alternatively, one might postulate that there is relative immaturity of both peripheral T3 generating pathway and lung development in infants who develop IRDS.     

Cystic meningioma. Apropos of 6 cases

We report six cases of meningioma, uncommon tumors which accounted for 2.7 of all meningiomas observed in our series. Computed tomography was performed in all patients and produced the diagnosis in only 40% of the cases. Surgical treatment was given. Histological examinations of the surgical specimens confirmed the diagnosis. CT and magnetic resonance imaging were sometimes misleading, suggestive of metastasis or glioblastoma. Selective carotid arteriography with opacification of the external carotid artery established the diagnosis. Prognosis was good after surgery.     

The square pronator: an "aspirin" strip in antalgic surgery for painful neuromas of the wrist

From June 96 to January 2001, 25 patients have been operated on for painful neuromas localised at the wrist. They were between 10 and 52 years of age. These neuromas were located in at the median nerve 17 cases, at the ulnar nerve in seven cases and at the radial nerve in one case. In all cases the pain was not spontaneous but triggered off by external stimulus. All these neuromas were in continuity except 1 case at the median nerve where a total severing was present. After external neurolysis, the quadratus pronatus muscle is wrapped around the neuromas in 24 cases and around epineurial suture in one case. No internal neurolysis was done. This flap was vascularized by the anterior interosseous artery in 23 cases and by the posterior interosseous artery in two cases of distal ulnar nerve neuroma. All patients have been improved by using this method. In 21 cases (84%) (17 median, 4 ulnar nerves) the pain has completely disappeared and in four cases (3 ulnar, 1 radial), the pain has considerably decreased but without total disappearance. In the cases of median nerve neuromas the dysaesthesia has greatly decreased. No complications and no sequelae on the donor site are reported.     

Prediction of difficult tracheal intubation in thyroid surgery

The incidence of difficult endotracheal intubation (DEI) for patients undergoing thyroidectomy has rarely been studied, and evaluation of factors linked to DEI is limited to a few studies. We undertook this prospective study to investigate the incidence of DEI in the presence of goiter (an enlargement of the thyroid gland) and to evaluate factors linked to DEI. We studied 320 consecutive patients scheduled for thyroidectomy. DEI was evaluated by an intubation difficulty scale. The trachea was intubated by an unassisted anesthesiologist, and the intubation difficulty scale was calculated. A univariate analysis was performed to identify potential factors predicting DEI, followed by a multivariate analysis. DEI was reported in 17 patients. The rate of easy tracheal intubation was 36.9%; the rate for patients who had minor difficulty of intubation was 57.8%. Sex (male), body mass index, Mallampati class, thyromental distance, neck mobility, Cormack grade, cancerous goiter, and tracheal deviation or compression were identified in the univariate analysis as potential DEI risk factors. With multivariate analysis, two criteria were recognized as independent for DEI (Cormack Grade III or IV and cancerous goiter). We conclude that the large goiter is not associated with a more frequent DEI. However, the presence of a cancerous goiter is a major factor for predicting DEI.