Mucosal immunization of sheep with a Maedi-Visna virus (MVV) env DNA vaccine protects against early MVV productive infection

Gene gun mucosal DNA immunization of sheep with a plasmid expressing the env gene of Maedi-Visna virus (MVV) was used to examine the protection against MVV infection in sheep from a naturally infected flock. For immunization, sheep were primed with a pcDNA plasmid (pcDNA-env) encoding the Env glycoproteins of MVV and boosted with combined pcDNA-env and pCR3.1-IFN-gamma plasmid inoculations. The pcDNA plasmid used in the control group contained the lacZ coding sequences instead of the env gene. Within a month post-challenge, the viral load in the vaccinated group was lower (p < or = 0.05) and virus was only detected transiently compared with the control group. Furthermore, 2 months later, neutralizing antibodies (NtAb) were detected in all the control animals and none of the vaccinated animals (p < or = 0.01). These results demonstrated a significant early protective effect of this immunization strategy against MVV infection that restricts the virus replication following challenge in the absence of NtAb production. This vaccine protective effect against MVV infection disappeared after two years post-challenge, when active replication of MVV challenge strain was observed. Protection conferred by the vaccine could not be explained by OLA DRB1 allele or genotype differences. Most of the individuals were DRB1 heterozygous and none was totally resistant to infection.     

Surgical importance of highly located innominate artery in neck surgery

Massive hemorrhage is an unusual complication of tracheotomy, and the most common causes are injury to the anterior jugular veins and the thyroid isthmus, or unrecognized variations of the vascular structures, such as the arteria thyroidea ima. We present a case of high-running innominate artery that ascends until the third tracheal ring and courses horizontally anterior to the trachea in a patient with laryngeal carcinoma. If not noticed during tracheolaryngeal surgery, trauma to this vessel and subsequent hemorrhage may be fatal. In this report, the case is presented and the surgical significance of this anomaly is emphasized.     

Preliminary investigation of the feasibility of magnetic propulsion for future microdevices in blood vessels

The Magnetic Resonance Submarine (MR-Sub) project is a first attempt to validate a new propulsion method for future small magnetically controlled microdevices suited for minimally invasive applications in blood vessels. A Magnetic Resonance Imaging (MRI) system provides the driving force in three dimensions to a ferromagnetic core that could be embedded onto a specialised microdevice. The paper describes preliminary tests made to match the magnetic force induced by an MRI system on a ferromagnetic sphere with the drag force it encompasses in a cylindrical tube. These tests provide a proof of concept demonstrating that this new method of propulsion is very promising within the constraints of such types of operations. This conclusion is based on specific measurements showing that 1010/1020 carbon steel spheres (3.175 mm and 2.381 mm in diameter) can withstand a maximum flow of 0.370 +/- 0.0064 l/min (19.5 cm/s) and 0.311 +/- 0.01209 l/min (16.4 cm/s) respectively when placed inside a 6.35 mm diameter PMMA tube and subjected to a 18 mT/m magnetic field gradient.     

Is the failure to detect stimulus deviance during sleep due to a rapid fading of sensory memory or a degradation of stimulus encoding?

The mismatch negativity (MMN) is thought to reflect the outcome of a system responsible for the detection of change in an otherwise repetitive, homogenous acoustic environment. This process depends on the storage and maintenance of a sensory representation of the frequently presented stimulus to which the deviant stimulus is compared. Few studies have been able to record the MMN in non-rapid eye movement (NREM) sleep. This pattern of results might be explained by either a rapid fading of sensory memory or an inhibition of stimulus input prior to entry into the cortical MMN generator site. The present study used a very rapid rate of presentation in an attempt to capture mismatch-related negativity prior to the fading of sensory memory. Auditory event-related potentials were recorded from 12 subjects during a single sleep period. A 1000 Hz standard stimulus was presented every 150 ms. At random, on 6.6% of the trials, the standard was changed to either a large 2000 Hz or a small 1100 Hz deviant. In wakefulness, the large deviant elicited an extended negativity that was reduced in amplitude following the presentation of the small deviant. This negativity was also apparent during REM sleep following the presentation of the large deviant. These deviant-related negativities (DRNs) were probably a composite of N1 and MMN activity. During NREM sleep (stage 2 and slow-wave sleep), only the large deviant continued to elicit a DRN. However this DRN might be overlapped by the initial activity of a component that is unique to sleep, the N350. There was little evidence of the DRN or the MMN during sleep following the presentation of the small deviant. A rapid rate of presentation, therefore, does not preserve the MMN following small deviance within sleep. It is possible that inhibition of sensory input occurs before entry into the MMN generating system in the temporal cortex.     

Effects of combined treatment on Turkish children diagnosed with attention-deficit/hyperactivity disorder: a preliminary report

OBJECTIVE: The main aim of this study was to investigate the effects of combined treatment on children diagnosed with attention-deficit/hyperactivity disorder (ADHD). METHOD: After careful screening, 47 children (57%) diagnosed with ADHD + oppositional defiant disorder (ODD) and 36 children (43%) diagnosed with ADHD + conduct disorder (CD) were included in the study. Treatment consisted of ongoing medication (methylphenidate) management and a parent-training program that continued for 5 months. Children were assessed in multiple domains by multiple sources of information at baseline and at the end of the 1st, 3rd, and 6th months by parent- and teacher-completed the Turgay Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S), Conners Parent Rating Scale (CPRS), and Conners Teacher Rating Scale (CTRS). Mother-child relationship was assessed by the Parental Acceptance and Rejection Questionnaire (PARQ). RESULTS: Combined treatment was effective in reducing the ADHD, ODD, and CD symptoms. Analyses of the data revealed that medication, rather than parent training, was responsible for the improvements both in the symptoms and in the mother-child relationship. CONCLUSIONS: The results of the study, in line with the Multimodal Treatment Study of Children with ADHD (MTA) findings, highlighted the role of stimulant medication in the treatment of ADHD.     

The safety and feasibility of continuous intravenous magnesium sulfate for prevention of cerebral vasospasm in aneurysmal subarachnoid hemorrhage

Introduction: Cerebral vasospasm in aneurysmal subarachnoid hemorrhage (SAH) is associated with poor outcome. The safety and feasibility of continuous high-dose intravenous magnesium sulfate (MgSO₄) for the prevention of cerebral vasospasm and ischemic cerebral injury has not been well studied. Methods: Patients presenting to our center within 72 hours of aneurysmal SAH (confirmed by computed tomography [CT] scanning and cerebral angiography) between June 2001 and October 2002 were enrolled in a prospective pilot study in which they received MgSO₄ as an adjunct to standard SAH management. Study patients received an intravenous infusion of 12 g of MgSO₄ in a 500-mL solution of 0.9% NaCl administered at a rate of 4.06 mM (or 0.5 g) every hour over a 24-hour period for 10 days to achieve a target predetermined serum Mg range of more than 1.5 to less than 4.0 mM/L. The effect of MgSO₄ on clinical examination, heart rate, and blood pressure was measured every 2 hours; serum glucose and phenytoin levels were monitored daily. Outcome measures included evidence of vasospasm on clinical examination, transcranial Doppler study ((TCD); velocity ≥100 cm/s), or repeat cerebral angiogram obtained within 10 days of SAH; and Glasgow Outcome Scale (GOS) score assessment and CT scan evidence of ischemic infarction at 30 days. Results: Nineteen patients (mean age: 55 years; range: 39–84 years; 11 males, 8 females) were enrolled in the study. Presenting Hunt & Hess grade was II or higher; mean Fisher grade was 3. Vasospasm was observed in nine patients (by clinical examination in two, TCD in five, and angiogram in nine). The mean serum Mg level was 2.7 mM/L (standard deviation: ±0.37) and was maintained during the infusion period. No clinical adverse effects, hemodynamic changes, or fluctuations in serum glucose or phenytoin levels were observed. None of the patients died; no CT evidence of ischemic infarction was present; and most had good outcomes (GOS 5 in 10 patients; GOS 4 in 8 patients). Conclusion: Our study confirmed the safety and feasibility of a continuous infusion of high-dose intravenous MgSO₄ in patients with aneurysmal SAH. Randomized controlled trials are required to confirm the promising results.     

The concept of the GPOH-HD 2003 therapy study for pediatric Hodgkin's disease: evolution in the tradition of the DAL/GPOH studies

Today it is possible to cure more than 90 % of children and adolescents with Hodgkin's disease with a combination of radiotherapy and chemotherapy. Since the DAL-HD 82 study, the main scientific focus has been on avoiding late effects such as the OPSI syndrome, late complications involving the heart, lungs, thyroid and/or gonads particularly sterility in men and premature onset of menopause in women, and the prevention of secondary malignancies. The GPOH-HD 2003 study will introduce FDG-PET to the initial diagnostic program and the assessment of response to therapy in order to evaluate further possibilities for reducing therapy. In this context, the central review of all clinical and radiological findings, systematically done since the DAL-HD 90 study, will be increasingly relevant in maintaining standardised stage classification and therapy group assignment which was established by the preceding studies. Continuing in the direction of the earlier studies, the indications for radiotherapy will be restricted even further. In the early stages (treatment group 1) patients with CR or a negative FDG-PET at the end of chemotherapy will receive no radiotherapy in order to reduce the risk of a secondary malignancy. In a randomized comparison, procarbazine will be replaced by dacarbazine in the COPP cycles to determine whether sterility in men and premature onset of menopause in women can be avoided by elimination of procarbazine while retaining the same clinical efficacy. Finally, relapse therapy is to be tailored according to the time of relapse, the initial therapy group, and the patient's response to the relapse therapy with more patients receiving autologous transplantation in order to further improve the results of relapse treatment.     

Cryptococcal laryngitis: case report and review of the literature

Infections caused by Cryptococcus neoformans may range from an asymptomatic illness to lethal systemic disease, especially in immunocompromised hosts. Although cryptococcal infection most commonly involves the lungs or the central nervous system, it can disseminate to virtually any organ. Laryngeal cryptococcal infections are extremely rare--only 5 cases have been reported in the literature. Herein, we describe cryptococcal laryngitis occurring in a 55-year-old man with asthma and allergic fungal sinusitis. He presented with hoarseness and cough. He was treated with itraconazole followed by fluconazole therapy with complete recovery from his laryngeal infection. The patient was disease-free when last seen 10 months after the diagnosis. We present a summary of all reported cases of cryptococcal laryngitis.