Parvovirus B19 infection of the fetus. Histology and in situ hybridization.

Fetal tissues from 16 spontaneous abortions, two terminations, and one perinatal death, 18 of which were associated with maternal human parvovirus B19 infection, were examined for B19 infection by histology and in situ hybridization using a digoxigenin-labeled B19-DNA probe. In 15 spontaneous abortions and one termination, erythroblasts with intranuclear inclusions (lantern cells) reacted with B19-DNA by in situ hybridization. No internal or external fetal malformations were observed. Because 13 (86.7%) spontaneous abortions with lantern cells occurred between the 20th and 28th weeks of gestation, it is postulated that B19 infection may be a particular threat to the fetus during this stage of gestation.     

Adult-onset rod disease with abundant intranuclear rods

Summary The third case of adult-onset rod disease (nemaline myopathy) with abundant myofibrillar as well as intranuclear rods is described. The 61-year-old woman suffered from progressive weakness of proximal extremities and of the neck, mimicking polymyositis. Muscle biopsy revealed a striking myopathic pattern, with intranuclear rods occurring in 31% of the fibres. On light and electron microscopy and by immunohistochemical study, the rods differed from myofibrillar rods. The absence of -actinin in intranuclear rods suggests an enhanced readiness of actin filaments to bind to diverse proteins, instead of overproduction of -actinin as the pathogenetic basis of the rod formation.     

Immunoglobulin M antibodies to hepatitis B core antigen: evaluation of enzyme immunoassay for diagnosis of hepatitis B virus infection

In acute and chronic hepatitis B, antibodies of the immunoglobulin M (IgM) class against the hepatitis B core antigen (anti-HBc IgM) have been demonstrated. For the determination of anti-HBc IgM, a sensitive enzyme immunoassay with anti-mu-coated flat-bottomed microtiter plates is described and evaluated. The specificity of the anti-HBc IgM test system was proven by pretreatment of presumed anti-HBc IgM-positive samples with anti-mu to block anti-HBc IgM. The test system was highly sensitive. In the acute stage of hepatitis B, anti-HBc IgM could be demonstrated in serum dilutions up to 10(-7) (mean titer, 10(-5)), and in sera from patients with chronic hepatitis B, the mean titer was 10(-3). In a study of unselected patients whose sera were sent at irregular intervals for testing, anti-HBc IgM persisted in a high percentage (52%) for at least 13 to 18 months after onset of illness despite the fact that these patients eliminated hepatitis B surface antigen (HBsAg) and produced antibodies to HBsAg (anti-HBs). By using the anti-HBc IgM test as an additional aid in the diagnosis of acute HBsAg-negative hepatitis, the hepatitis B etiology could be established in 13 of 42 patients (31.4%). Investigations of the prevalence of anti-HBc IgM in different groups of patients with chronic hepatitis B infection showed 89.4% anti-HBc IgM-positive results in patients with chronic active hepatitis B, 60% in patients with HBsAg-negative chronic active hepatitis, 58.2% in patients with primary liver carcinoma and markers of hepatitis B infections, and 34.9% in healthy carriers of HBsAg.     

Antigenic and molecular analyses of different Chlamydia pneumoniae strains.

Chlamydia pneumoniae is an important human respiratory pathogen. Classification of C. pneumoniae isolates into distinguishable serovars or genotypes has not yet been reported. To determine whether antigenic or molecular variants among C. pneumoniae isolates exist, six strains were studied via immunoblot analysis and DNA sequence determination of the entire major outer membrane protein (MOMP) gene omp1. The strains included four prototype strains and two clinical isolates from our laboratory. Immunoblot analysis of sera from patients infected with C. pneumoniae revealed antigenic differences between the C. pneumoniae strains. Strong reactivity of one serum sample with a 65-kDa protein in two C. pneumoniae strains which was not observed with the other strains was the most prominent finding. All sera reacted with the 40-kDa MOMP. Comparison of the omp1 DNA sequences revealed that the omp1 genes of all strains were identical and were 100% identical to the sequence of the omp1 gene of C. pneumoniae AR-39. The results of this study demonstrate that unlike C. trachomatis, the omp1 gene is conserved in C. pneumoniae. Furthermore, it was shown that C. pneumoniae strains are antigenically different. This finding indicates that more than one serovar of C. pneumoniae exist.     

Sequence variability in the env-coding region of hepatitis C virus isolated from patients infected during a single source outbreak

Summary The variability of the hepatitis C virus genome was investigated in a group of German patients who developed chronic hepatitis C after parenteral administration of contaminated immunoglobulin to prevent Rh sensitization after pregnancy. The nucleotide and deduced amino acid sequence alterations of the E1 and the first hypervariable region of the E2 gene of the hepatitis C virus (HCV) genome from sera of two randomly selected patients were studied by comparison of HCV sequences obtained from the original inoculum (anti Rh immunoglobulin) and from patient sera collected in 1979 and 1989. All isolates were classified as subtype 1b but showed nucleotide insertions of up to 12 nucleotides at the cleavage site of E1/E2. Microheterogeneity of HCV genomes was found in the immunoglobulin supporting the quasispecies model of HCV distribution. Remarkable nucleotide exchanges over the 10 year period in the E1 region (0.9–5.2×10^–3 base substitutions per genome site per year) and especially in the first hypervariable region of the E2 gene (about 1.5×10^–2) occurred. The HCV genome undergoes a selection of variants, though it is not known if this derives from mutation or selection of pre-existing rare variants.     

Untersuchungen über die Pupillenreflexe beim Menschen

Zusammenfassung Es wird eine Methode beschrieben, die eine fortlaufende Aufzeichnung der Pupillenbewegungen beim Menschen ermöglicht.Es wird die Reaktion der Pupille auf einen kurz dauernden Lichtblitz und auf eine längerdauernde Belichtung bei verschiedenen gesunden Versuchspersonen aufgezeichnet und eingehend beschrieben.Durch gleichzeitige Registrierung an beiden Augen wird der Verlauf von konsensueller und direkter Lichtreaktion miteinander verglichen.Die Latenzzeit der Pupillenreaktion auf Licht und Verdunkelung wird bestimmt.Die Reaktion der Pupille auf Lidschlu\ wird registriert und mit dem Lichtreflex verglichen.Es wird die Konvergenzreaktion der Pupille gleichzeitig mit der Konvergenzbewegung des Auges registriert und beschrieben.     

Immunization of woodchucks (Marmota monax) with hepatitis delta virus DNA vaccine

We investigated the DNA immunization approach in order to induce a protective immune response against hepatitis delta virus (HDV) superinfection of chronically woodchuck hepatitis virus (WHV) infected woodchucks. The animals were immunized with an expression vector encoding HDAg by gene gun. T cell and humoral immune responses induced by this protocol were determined and compared with those induced by HDAg immunization using a CpG oligonucleotide as an adjuvant. After immunization the woodchucks were challenged with 10⁶ genome equivalents of HDV. The protein immunization with HDAg induced good humoral and T helper cell responses in the woodchucks, but did not protect them from HDV superinfection. The DNA immunized woodchucks were also not protected from HDV superinfection, however, the course of infection was modified: HDV viremia occurred later, the typical fluctuation of the HDV RNA titer with several peaks was absent, and antibodies to HDV were not detectable.     

Psychometric properties of the apathy evaluation scale in patients with Parkinson's disease

Parkinson's disease (PD) frequently entails non‐motor symptoms, worsening the course of the disease. Apathy is one of the core neuropsychiatric symptoms that has been investigated in recent years; research is however hampered by the limited availability of well‐evaluated apathy scales for these patients. We evaluated the psychometric properties of the Apathy Evaluation Scale (AES) in a sample of PD patients. Psychometric properties, convergent and discriminant validity and sensitivity/specificity were evaluated in patients with (n = 582) or without dementia/depression (n = 339). Internal consistency was high in the entire sample as well as in patients without dementia/depression. Correlations were moderate for convergent validity (UPDRS I item 4: motivation). While apathy could be differentiated from cognitive decline, it was related to depression (Geriatric Depression Scale, GDS‐15). The overall classification accuracy based on the UPDRS I item 4 was comparable for AES and GDS scores. The AES exhibits good psychometric properties in PD patients with and without dementia and/or depression. Commonly used screenings on the presence of apathy had low detection rates compared to the AES and reflected both apathetic and depressive symptoms. Psychometric evaluation of available instruments will support further research on the clinical relevance of apathy for disease progression and treatment approaches in PD patients.