Human infections with Borna disease virus: seroprevalence in patients with chronic diseases and healthy individuals.

Borna disease virus (BDV) is as yet an unclassified infectious agent which causes a neurologic disease in horses and sheep and is transmissible to other animal species. Human sera were tested for BDV-specific antibodies by immunofluorescence and immunoprecipitation. The sera were collected from three thousand subjects in Europe, the USA, and Africa classified by clinical syndromes/infectious diseases, and from healthy controls. In all three continents, positive serum samples were detected which recognized the major BDV antigen of 38/40 KD present in the nuclei of infected cells. In contrast to 2% of seropositives among the normal population, significantly higher prevalences (13-14%) were present among patients with chronic progressive diseases of the brain and the immune system. In children, antibody frequencies were two to four times higher than in adults. The results suggest a latent infection with BDV in humans leading to low antigen expression in healthy subjects and frequent reactivation events in chronically ill patients.     

Successful cryopreservation of microvenous allografts.

Vein grafts are used in approximately 20% of microsurgical cases. Although autogenous veins currently form the major source, they are associated with increased operating time and donor site scars. Cryopreserved allograft veins may serve as an alternative source. To our knowledge, cryopreservation of veins (1 mm or less) has not been reported. In this article we have described the process of cryopreserving rat veins (less than 1 mm in diameter) and their preliminary use as interpositional vein grafts.     

Nursing Research in Chile

A 1989 Pan-American Health Organization (PAHO) study on nursing research trends in seven Latin American countries (Brazil, Colombia, Chile, Ecuador, Honduras, Mexico and Peru) showed that most nursing research is conducted in Brazil, followed by Colombia and Chile ⁸ .     

Aortic Valve Rheumatoid Nodules Producing Clinical Aortic Regurgitation and A Review of the Literature

The majority of cardiac involvement in rheumatoid arthritis (RA) is an incidental finding at postmortem, as less than 3% of patients with RA have clinical cardiac signs or symptoms. Most cardiac involvement in RA involves the pericardium and has been known since Charcot first described an RA patient with pericarditis in 1881. Cardiac involvement takes two different forms: non-specific inflammatory changes and specific granuloma formation. Specific rheumatoid nodules in the heart are an infrequent complication of RA. This is the first case report of a surgically excised heart valve with rheumatoid nodules. A 74-year-old RA patient with a high seropositive rheumatoid factor presented with severe aortic regurgitation and underwent a valve replacement. The native aortic valve showed significant stenosis with multiple, classic rheumatoid nodules. Cardiovas Pathol 1999;8: 333–338     

Binge Drinking and Bone Metabolism in a Young Actively Growing Rat Model

BACKGROUND: Chronic alcohol consumption has been demonstrated to be deleterious to bone health. However, binge drinking is the prevalent form of drinking in young people, which was the impetus for the present study to determine the effect of week-end and week-long binge drinking on bone health in a young actively growing animal model. METHODS: Four-week-old, female, Sprague-Dawley rats were given the amount of 5% alcohol by gavage to be equivalent to a 63 kg woman drinking six beers a day for either 2 or 5 consecutive days per week. RESULTS: There were no changes in the 5-day binge animals, but the 2-day binge animals were hypocalcemic. Similarly, 2-day binge animals had slightly increased bone chemistry and histomorphometric values for both tibia and femur, but only femur length, dry weight, and ash weight as well as femur density, presented either as g/ml or ash weight per unit volume, were increased by a statistically significant level. Cross-section periosteal Mineral Apposition Rate (MAR) was significantly decreased in the 2-day alcohol fed animals. CONCLUSIONS: Actively growing rats given 5% alcohol by gavage for 2 days per week have an increased bone length, bone weight, and bone density. The interpretation of these results must be viewed with great caution because studies of chronic alcohol consumption, and many studies of acute drinking, clearly indicate deleterious effects of alcohol on bone health. Those fed alcohol for 5 days per week showed no change.     

Infrarot-Temperaturmessung im Gehörgang mit dem DIATEK 9000 Instatemp und dem DIATEK 9000 Thermoguide Einflußgrößen und Vergleich mit anderen Methoden der Temperaturmessung des Körperkerns

Temperature of the tympanic membrane is recommended as a “gold standard” of core-temperature recording. However, use of temperature probes in the auditory canal may lead to damage of tympanic membrane. Temperature measurement in the auditory canal with infrared thermometry does not pose this risk. Furthermore it is easy to perform and not very time-consuming. For this reason infrared thermometry of the auditory canal is becoming increasingly popular in clinical practice. We evaluated two infrared thermometers – the Diatek 9000 Thermoguide and the Diatek 9000 Instatemp – regarding factors influencing agreement with conventional tympanic temperature measurement and other core-temperature recording sites. In addition, we systematically evaluated user dependent factors that influence the agreement with the tympanic temperature. Materials and Methods. In 20 volunteers we evaluated the influence of three factors: duration of the devices in the auditory canal before taking temperature (0 or 5?s), interval between two following recordings (30, 60, 90, 120, 180?s) and positioning of the grip relative to the auditory-canal axis (0, 60, 180 and 270°). Agreement with tympanic contact probes (Mon-a-therm tympanic) in the contralateral ear was investigated in 100 postoperative patients. Comparative readings with rectal (YSI series 400) and esophageal (Mon-a-therm esophageal stethoscope with temperature sensor) probes were done in 100 patients in the ICU. The method of Bland and Altman was taken for comparison. Results. Shortening of the interval between two consecutive readings led to increasing differences between the two measurements with the second reading decreasing. A similar effect was seen when positioning the infrared thermometers in the auditory canal before taking temperatures: after 5?s the recorded temperatures were significantly lower than temperature recordings taken immediately. Rotation of the devices out of the telephone handle position led to increasing lack of agreement between infrared thermometry and contact probes. Mean differences between infrared thermometry (Instatemp and Thermoguide, CAL-Mode) and tympanic probes were ?0.41±0.67?°C (2 SD) and ?0.43 ±0.70?°C, respectively. Mean differences between the Thermoquide (Rectal-Mode) and rectal probe were ?0.19±0.72?°C, and between the Thermoguide (Core Mode) and esophageal probe ?0.13±0.74?°C. Discussion. Although easy to use, infrared thermometry requires careful handling. To obtain optimal recordings, the time between two consecutive readings should not be less than two min. Recordings should be taken immediately after positioning the devices in the auditory canal. Best results are obtained in the 60° position with the grip of the devices following the ramus mandibulae (telephone handle position). The lower readings of infrared thermometry compared with tympanic contact probes indicate that the readings obtained represent the temperature of the auditory canal rather than of the tympanic membrane itself. To compensate for underestimation of core temperature by infrared thermometry, the results obtained are corrected and transferred into core-equivalent temperatures. This data correction reduces mean differences between infrared recordings and traditional core-temperature monitoring, but leaves limits of agreement between the two methods uninfluenced.     

A brief review of ultrasensitive prostate-specific antigen assays for the evaluation of patients after radical prostatectomy

Summary The development of immunoassays for prostate-specific antigen (PSA) and their clinical utility are summarized. Because of the complexity of the PSA molecule and anti-PSA antibodies, there is currently no standard in PSA measurement [1, 2]. Evaluating various immunoassays requires the knowledge of the lower limit of detection as well as the biological and clinical thresholds of a given assay [1]. There have been recent reports demonstrating earlier detection of residual prostate cancer after radical prostatectomy by ultrasensitive assays for PSA [3, 4]. Because of the recent evidence for non-prostatic sources of PSA such as the male urethra [5–7], the possibility of their contaminating PSA levels must be evaluated when more sensitive assays for PSA are under consideration.This work was funded in part by a grant from the American Foundation of Urologic Disease, by the American Cancer Society, by the Richard M. Lucas Cancer Foundation, and by the Veterans Administration.     

Die akute Pankreatitis Klassifikation – Diagnostik – Therapie

Acute pancreatitis is a multietiologic entity with rather diverse clinical courses. Whereas edematous pancreatitis has a mortality of less than 1%, nowadays; still approximately 20% of all patients with the necrotizing form succumb to the disease. To further improve therapeutic results a standardized approach should be used. For effective treatment the differentiation between edematous and necrotizing pancreatitis is crucial. All patients with signs of pancreatic necroses during abdominal ultrasound and patients with organ insufficiencies should undergo a CT-scan to define exactly the nature and the extent of the disease. Primarily all patients are treated conservatively. Main indications for operative intervention are signs for infection of pancreatic necroses and an acute abdomen due to local complications of acute pancreatitis. In cases of biliary origin an elective cholecystectomy has to be performed during a free interval to prevent a recurrence.     

,Retrogades autologes Priming’ verhindert den Anstieg des extravasalen Lungenwassers während der extrakorporalen Zirkulation und verbessert den postoperativen Verlauf bei Patienten nach koronarer Bypassoperation

Zusammenfassung In einer prospektiven, randomisierten Studie sollte der Effekt eines reduzierten Füllvolumens (Priming) für die extrakorporale Zirkulation (EKZ) durch retrogrades autologes Priming (RAP) auf das Ausma? der postoperativen interstitiellen ?dembildung untersucht werden. 20 Patienten, die sich einer elektiven koronaren Bypassoperation unterzogen, wurden entweder einer Gruppe mit Standardpriming (SP, 1602±202ml kristalloide Vorfüllung, n=10) oder einer RAP-Gruppe (395±150ml) zugeordnet. RAP wurde vor Beginn der EKZ durch langsames Ersetzen der kristalloiden Vorfüllung der arteriellen und ven?sen Linien mit Patientenblut durchgeführt. Perioperativ wurden die kardiale und pulmonale Funktion, das extravasale Lungenwasser (EVLW), der plasma kolloidosmotische Druck (KOD), die kristalloide Flüssigkeitsbilanz sowie das K?rpergewicht der Patienten aufgezeichnet. Ergebnisse Hinsichtlich demographischer und operativer Parameter waren die Patienten gleicherma?en auf die Gruppen verteilt. Durch RAP konnte der Abfall des KOD w?hrend der EKZ von 54% in der SP-Gruppe auf 41% signifikant reduziert werden. 2 Std. nach Ende der EKZ war das EVLW im Vergleich zu pr?operativ in der Standard-Gruppe um 21% signifikant erh?ht, w?hrend es in der RAP-Gruppe im gleichen Zeitraum unver?ndert blieb. Die Bilanz der kristalloiden Flüssigkeiten von OP-Beginn bis EKZ-Ende waren in der RAP-Gruppe signifikant niedriger als in der SP-Gruppe (1857±521 gegenüber 28310±637ml). Zwei Tage postoperativ ergab sich für die Standard-Gruppe eine Zunahme des K?rpergewichts um 1,5±1,2kg (p<0,05), w?hrend das Gewicht in der RAP-Gruppe unver?ndert blieb (0,1±0,9kg). Auch die Dauer des station?ren Aufenthaltes war in der RAP-Gruppe signifikant kürzer als in der Standard-Gruppe. Schlussfolgerungen Durch RAP kann die ausgepr?gte H?modilution und der Abfall des KOD mit Beginn der EKZ vermindert werden. Dadurch kann das Ausma? interstitieller ?deme am Beispiel des EVLWs sowie die perioperative Gewichtszunahme signifikant gesenkt werden, was schlie?lich zu einem verkürzten Klinikaufenthalt der Patienten führte. Besonders günstig k?nnte sich RAP auf den postoperativen Verlauf bei Patienten mit eingeschr?nkten Organfunktionen auswirken. Eingegangen: 1. Oktober 2001 Akzeptiert: 3. Januar 2002