Influenza A pneumonia presenting as progressive focal infiltrates in a stem cell transplant recipient.

BACKGROUND: Stem cell transplant recipients are susceptible to pulmonary infections, including influenza A. Typically, isolated influenza pneumonia has a diffuse, interstitial infiltrate pattern. OBJECTIVES: To describe the unusual clinical and radiographic course of influenza A pneumonia in a stem cell transplant recipient. STUDY DESIGN: Case report in which microbiologic assays, bronchoscopic and pathologic specimens are obtained. RESULTS: We describe a patient with influenza A pneumonia 8 months following a peripheral blood stem cell transplant who presented with minimal respiratory symptoms and rapidly progressing, focal pulmonary infiltrates. The large size and appearance of the masses have not been reported before in a patient with isolated influenza. CONCLUSION: This case highlights the differences of presentation and importance of early diagnosis and treatment of immunocompromised patients infected with influenza.     

Detection and localization of single-base sequence differences in foot-and-mouth disease virus genomes by the RNase mismatch cleavage method.

The RNase mismatch cleavage method was examined for its efficiency of indicating single-base sequence differences in the capsid protein-coding regions of different foot-and-mouth disease virus subtype O1 strains. The method was found suitable for indicating such differences. RNase A as well as RNase T1 contributed to substrate conversion. Examples for the cleavage of eleven different single-base mismatches in RNA double-strands are now known. All virus genomes found to differ from each other exhibited three or more non-neighboured single-base sequence differences. Other genomes found to be indistinguishable by this method were those of a recent field isolate adapted to cell culture, and those of a vaccine production strain; its progeny was transmitted to pig and cow and then analyzed. The results suggest that host change does not necessarily select for antigenic variant virus, and that virus submitted to some kind of selection pressure is changed at more than one position.     

The incidence of gout in patients with Dupuytren's disease.

In a retrospective study we found that the incidence of gout in patients with Dupuytren's disease is 3.5%. The mean serum uric acid was 330 mumol/l. (5.5 mg./100 ml.) in men and 240 mumol./l. (4.0 mg./100 ml.) in women. The rate of hyperuricaemia was 7%. These are not significantly higher than the expected figures in Britain.     

Phase mapping from left ventricular radionuclide ventriculograms: interobserver reliability and accuracy of the programme

Phase analysis of data from radionuclide ventriculograms is known to provide space-time information on the mechanical emptying of pixels located in the ventricular regions. It could therefore perhaps be useful for detecting abnormal sequences of contraction of the ventricles as well as to localize sites of premature electromechanical action. The phase programme used in this investigation is designed to trace the electromechanical action of the ventricles from colour-coded phase images (first harmonic Fourier transform), not only visually from a cinematic representation, but particularly from a data output of x, y coordinates and phase angles of sites chosen as they empty in the ventricular regions. Six healthy baboons were subjected to conventional radionuclide ventriculography, performed hourly for the duration of 11 h under anaesthesia. The programme was used by two independent observers to map the progression of emptying for each of the thus acquired 66 left ventricular phase images. The interobserver reliability and the accuracy achieved in mapping normal contraction patterns was found to be good. Abnormalities which appeared during the prolonged anaesthesia and which were confirmed with 12 lead electrocardiography were likewise detected consistently.     

CongenitaI Polycystic Disease of the Brain: Report of an Unusual Case

Multiple congenital supratentorial intracerebral cysts occurred in a newborn infant. The cysts, of varying size, content and lining, occupied the cerebral hemispheres. They formed a mosaic pattern on CT scan and left no trace of a recognisable ventricular system. Multiple surgical procedures were performed during the first year of life, and at one year the child was very well and asymptomatic, with two functioning shunts.     

Gd-DTPA-cascade-polymer: Potential blood pool contrast agent for MR imaging

Gadolinium-DTPA (diethylenetriaminepentaacetic acid)-cascade-polymer, a potential new blood pool contrast agent for magnetic resonance (MR) imaging, was compared with a known blood pool agent, Gd-DTPA-polylysine, in an animal model. The relative signal intensities of liver, renal cortex, pancreas, and trunk muscle were assessed in 12 pigs between 4 seconds and 120 minutes after injection of a 20 μmol/kg dose of each contrast agent, by using a FLASH (fast low-angle shot) sequence. Except for muscle, all tissues showed visible enhancement after injection of either contrast agent. After injection of Gd-DTPA-polymer, enhancement patterns in the liver, renal cortex, and pancreas were similar to those seen after injection of Gd-DTPA-polylysine. No statistically significant differences in enhancement between the two contrast agents were found at any time point. The authors conclude that the contrast kinetics of Gd-DTPA-cascade-polymer are similar to those of Gd-DTPA-polylysine and that this agent may also be used as a blood pool contrast agent for MR imaging.