CD8+ immunodominance among Epstein-Barr virus lytic cycle antigens directly reflects the efficiency of antigen presentation in lytically infected cells

Antigen immunodominance is an unexplained feature of CD8+ T cell responses to herpesviruses, which are agents whose lytic replication involves the sequential expression of immediate early (IE), early (E), and late (L) proteins. Here, we analyze the primary CD8 response to Epstein-Barr virus (EBV) infection for reactivity to 2 IE proteins, 11 representative E proteins, and 10 representative L proteins, across a range of HLA backgrounds. Responses were consistently skewed toward epitopes in IE and a subset of E proteins, with only occasional responses to novel epitopes in L proteins. CD8+ T cell clones to representative IE, E, and L epitopes were assayed against EBV-transformed lymphoblastoid cell lines (LCLs) containing lytically infected cells. This showed direct recognition of lytically infected cells by all three sets of effectors but at markedly different levels, in the order IE > E > L, indicating that the efficiency of epitope presentation falls dramatically with progress of the lytic cycle. Thus, EBV lytic cycle antigens display a hierarchy of immunodominance that directly reflects the efficiency of their presentation in lytically infected cells; the CD8+ T cell response thereby focuses on targets whose recognition leads to maximal biologic effect.     

Understanding the lives of older women

AIM: To understand why some women adjust successfully in later life while others, in similar circumstances, become overwhelmed by life and dislike their old age. METHOD: Qualitative data were generated from field notes of participant observation carried out over ten months. In-depth interviews were also carried out with 11 young older and frail older women, aged 60 to 89 years, attending day centres. A grounded theory approach was adopted to collect and analyse participant observation and interview data. FINDINGS: Adjustment in later life occurs regardless of circumstance. Three areas were identified as being the main obstacles for many. These are depression, maintaining intimacy through friends and family, and managing the change process associated with older age. In addition, a core category of searching for meaning was discovered and used to understand how depression, intimacy and managing change affect adjustment in later life. CONCLUSION: Nurses could use their skills and experience of listening carefully to older patients to discover whether they are distressed, and assess whether there is a need for psychological and emotional support. There is a need for more research into carrying out adjustment work with older women who are struggling to enjoy their later years and with older men to discover themes that are relevant to them.     

Multifocal primary breast lymphoma

Primary breast lymphoma (PBL) is a rare condition, accounting for only 0.04 to 0.5% of breast malignancies and less than 2% of extranodal lymphomas. Clinical presentation and imaging may suggest a benign condition. Reports of treatment vary widely. Surgical therapy has been reported to include only biopsy or extend to partial mastectomy, total mastectomy, or even radical mastectomy. Chemotherapy with various agents is often used. Radiotherapy has been used in the adjuvant setting or as primary local therapy. Immunotherapy and radioimmunotherapy have shown some promise in other lymphomas and may be useful here as well. There is no standard or consensus of treatment for PBL. This report describes a case of multifocal PBL in a 45-year-old female and discusses the physical findings, diagnosis, and treatment options for this condition.     

Endocarditis parietalis fibroplastica (Loffler's disease)

A case of endocarditis parietalis fibroplastica (Löffler''s disease) is described and the aetiology and pathogenesis briefly discussed. Some of the relevant literature is reviewed.     

Protein patterns during regeneration and wound healing in the adult newt: a comparative study using gel electrophoresis

Gel electrophoresis was performed on tissue extracts made from regenerating tails, limbs and deep razor blade wounds to the back of adult newts. In general, 3 types of changes appeared in posttrauma gels: decrease in density of some bands, increase in others, and "new" bands. Patterns were very similar in limb and tail regeneration suggesting that the two processes do not differ significantly with regard to alterations in the major soluble proteins. The patterns further indicated that certain wound-healing events also occur in regeneration. Some of these events are prolonged in the latter, while others are long-lasting in both. The results also suggest the existence of a regeneration-specific protein.     

Training for primary and preventive eye care

This paper discusses what health workers at various levels can be expected to do in providing eye care with regard to recognizing, managing and preventing common eye conditions. Three particular levels, Kenya's ophthalmic clinical officer (secondary level), general clinical officers and nurses (first referral level) and primary health workers (primary level) will be discussed. Appropriate and effective training methods will be described especially with regard to curriculum content and resourses. Emphasis in eaching is placed on the public health techniques already well understood by health workers and on the connection those techniques have to the prevention of blindness.     

Infection of Israeli culicoides with African horse sickness, blue tongue and akabane viruses

Type 9 African horse sickness virus and type 4 bluetongue virus multiplied to a high titre in an Israeli strain of Culicoides puncticollis after intrathoracic inoculation. Akabane virus persisted for at least 10 days in this midge after intrathoracic inoculation but with little evidence of virus multiplication. All 3 viruses failed to multiply in C. puncticollis after ingestion by the oral route and all were inactivated by 4 days post infection. Five other species of Israeli Culicoides supported multiplication of bluetongue virus after intrathoracic inoculation.