A minor prevalent strain in a severe outbreak of foal diarrhea associated with serotype 3 rotavirus

An epizootic of foal diarrhea due to serotype 3 rotavirus (RV) was observed in 89 of 168 cases (53%) during the period from March to July in 1987. A total of 51 strains of RV were isolated from the 62 diarrheal feces examined, and one isolate (CH-3) showed a unique electropherotype of viral RNA which differed from the others that widely prevailed on this farm. No positive reaction was observed between strain CH-3 and each of the antisera against serotypes 1 to 12 of human and animal RV in neutralization tests. However, dsRNAs of the CH-3 virus were hybridized with a probe prepared from a strain of equine serotype 3 RV.     

Bilateral retinal vasculitis associated with clotting disorders

We found distinct alterations of the clotting and fibrinolytic mechanisms in a 27-year-old man who suffered from typical bilateral vasculitis, clinically and fluoroangiographically manifest as obstruction of the central retinal veins. The partial thromboplastin time was slightly increased, a partial clot lysis occurred after one hour, the plasminogen level was markedly low, and alpha2-macroglobulin was decreased, as were factor XII and IgG. Kallikrein was absent. Similar changes, though not so pronounced, were also found in the patient's son and in his brother.     

ICU患者肠内营养相关性腹泻分析

目的:观察43例ICU病人肠内营养相关性腹泻的临床特点.方法:选择2009年1月-2010年1月行肠内营养并发腹泻43例患者使用的肠内营养液的量、速度,以及患者低蛋白血症、是否应用广谱抗生素的情况,将调查数据进行统计学分析,分析肠内营养并发腹泻的发生原因,提出有效的干预措施.结果:肠内营养相关性腹泻的发生与营养液供给的量和速度、病人并发低蛋白血症以及药物的使用等有关.结论:综合干预可以改善病人的低蛋白血症,降低肠内营养病人腹泻的发生率.     

Bilateral enophthalmos associated with hydrocephalus and ventriculoperitoneal shunting

BACKGROUND: Progressive bilateral enophthalmos in the absence of previous trauma is rare. METHODS: Three patients with progressive bilateral severe enophthalmos whose only significant medical history was that of congenital hydrocephalus were treated by ventriculoperitoneal shunt placement. RESULTS: The patients demonstrated severe bilateral enophthalmos with poor eyelid apposition to the globes resulting in superficial keratopathy. Orbital computed tomographic scans confirmed the severe enophthalmos, with apparent reduced orbital fat volume. Orbital bony anatomy appeared normal. CONCLUSIONS: Bilateral progressive enophthalmos may be associated with hydrocephalus and ventriculoperitoneal shunting. The causal mechanism remains speculative.     

Reovirus-like agent associated with fatal diarrhea in neonatal pigs

Large numbers of a reovirus-like agent were visualized with electron microscopy in bacteria-free gut homogenates obtained from piglets with a fatal diarrhea resembling transmissible gastroenteritis. The syndrome, of vomiting, diarrhea, dehydration, and death, was reproduced in piglets artificially infected with these bacteria-free gut homogenates. Reovirus-like particles persisted in serial piglet passage and none was seen in uninfected, asymptomatic controls. Hyperimmune sera (made in recovered piglets) aggregated the reovirus-like particles, as judged by immunoelectron microscopy, and neutralized the infectious agent. The cytoplasm in enterocytes on infected intestinal epithelium fluoresced when this hyperimmune sera was used in an indirect fluorescent antibody test. Feeding cow colostrum or diets containing porcine gamma globulin protected infected piglets. No cytopathogenic effect was noted in infected tissue cultures, nor did this agent affect neonatal guinea pigs, hamsters, mice, and rats. The agent did not agglutinate human O or A erythrocytes.     

Posthyperventilation apnea associated with severe hypoxemia

We studied a 14-year-old girl who suffered fractures of her mandible and tegmen following a fall from a balance beam. Thirteen days after hospitalization, she developed severe, protracted, recurrent episodes of hyperventilation; subsequently, she suffered posthyperventilation apnea, which at times was prolonged and association with severe hypoxemia with an arterial oxygen pressure as low as 25 mm Hg. The patient was treated with added dead space and chlorpromazine hydrochloride (Thorazine). Postulated mechanisms for her disorder are discussed. The importance of close clinical and laboratory observation in similar cases is stressed.     

Bilateral subclavian artery aneurysm associated with idiopathic cystic medial necrosis

Although cystic medial necrosis, either idiopathic or associated with Marfan's syndrome, usually becomes manifest as an ascending aortic aneurysm, aortic insufficiency, aortic dissection, or a combination of these disorders, a rare case of bilateral subclavian artery aneurysm secondary to idiopathic cystic medial necrosis has occurred. Subclavian artery aneurysms most commonly represent poststenotic dilatation from anterior scalene or cervical rib compression, occasionally are associated with generalized arteriosclerotic peripheral vascular disease, and rarely are secondary to syphilitic or mycotic infections. Subclavian artery aneurysms have a major risk of rupture, embolus, or thrombosis, and therefore should be repaired. A reverse saphenous vein or prosthetic bypass graft from the carotid to the axillary artery provides adequate flow to the upper extremity. The aneurysm should be completely excised if possible, since reexpansion through small collaterals or through insufficient closure by ligation can occur and compress the brachial plexus after successful bypass. The clinical presentation, angiographic findings, and operative repair of a subclavian artery aneurysm secondary to cystic medial necrosis are described.     

Group B rotavirus associated with an outbreak of neonatal lamb diarrhea

A 66-year-old woman was admitted because of postmenopausal vaginal bleeding. Diagnostic workup revealed a poorly differentiated endometrial adenocarcinoma. A total abdominal hysterectomy and bilateral salpingo-oophorectomy was carried out (FIGO stage Ia, G3). One and a half years later she developed a solitary humeral metastasis which was treated by local radiotherapy and progesterone acetate. Because osseous metastases in endometrial adenocarcinoma are rare, the literature is reviewed. In analogy to the treatment of pulmonary metastases the option of disarticulation of the patient's arm is discussed.     

Strength and pain measures associated with lateral epicondylitis bracing

BACKGROUND: In the experiment described here, we investigated the effects of the immunosuppressants FK506 and leflunomide (Lef) on the survival of hamster hearts and liver xenografts in Lewis rats. METHODS: Lewis rats were used as recipients of hamster heart or liver grafts using different regimens of FK506 and Lef. Donor-matched heart grafts were transplanted into long-term surviving Lewis rat recipients of hamster xenografts to test donor-specific prolongation of xenograft survival. Hyperimmune, late xenograft rejection, and naive sera were transferred into long-term surviving Lewis rat recipients of hamster heart xenografts to determine whether these sera could inhibit the efficacy of donor-specific long-term survival. Anti-donor-specific antibodies were analyzed by flow cytometry. RESULTS: After a short induction with FK506 plus Lef, maintenance treatment with FK506 alone was sufficient to prolong survival of hamster xenografts. All hamster heart and four of six hamster liver xenografts survived for more than 3 months. Second hamster hearts were permanently accepted by Lewis rats bearing long-term surviving hamster heart xenografts when rats were treated with FK506 monotherapy (mean survival time >60 days, n=4). Long-term surviving hamster heart grafts were rejected after transfer of hyperimmune serum but not late xenograft rejection serum or naive serum. Lef and FK506 significantly reduced the production of anti-donor-specific antibodies in Lewis rats transplanted with hamster liver and heart xenografts. CONCLUSION: Long-term survival of hamster liver and heart xenografts in Lewis rats could be induced by a regimen of short-term FK506 in combination with Lef followed by FK506 monotherapy. The acquired sensitivity of late xenoreactivity to FK506 reflects primarily a modification in the host immune response to the hamster graft.     

Identification of a novel enteric Helicobacter species in a kitten with severe diarrhea

A previously undescribed Helicobacter sp. was recovered from a cat with severe diarrhea. Based upon the absence of any other identifiable cause of diarrhea, this helicobacter may be involved in the development of the disease signs. The organism could not be cultured but was described on the basis of 16S rRNA gene sequence analysis and morphology and appeared to be a new species, with Helicobacter canis being the most genetically similar species. The presence of a diarrhea-inducing helicobacter in a companion animal may pose a risk of zoonosis.     

Personality factors associated with severe traumatic disability.

Investigated whether persons with traumatic injuries are more extraverted than nontraumatically disabled persons. 111 rehabilitation patients with either traumatic or nontraumatic disabilities associated with either chronic pain or motor loss completed the Eysenck Personality Inventory and the SCL-90. Results show that the traumatically disabled Ss with motor loss (paraplegia or quadriplegia) were more extraverted and less distressed than Ss with nontraumatic disabilities or with traumatically induced pain. It is contended that the external orientation characteristic of extraversion and the style of learning through actively and repeatedly challenging the environment may account for the prominence of extraversion within the traumatically disabled group with motor loss and for the relative absence of distress for this group in the highly structured medical/rehabilitation environment. It is suggested that the psychological adjustment of more extraverted personalities to disability involving motor loss may be better facilitated by interventions that encourage experiential learning and challenging environmental limits than by introspective psychotherapy or counseling. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benign seizures associated with mild diarrhea: clinical analysis of 20 cases

Even without electrolyte imbalance, dehydration and fever, seizures are found occasionally in the cases of mild diarrhea. Such patients have shown favorable outcome during long-term follow-up. Twenty cases (10 boys and 10 girls) of benign seizure with mild diarrhea have been diagnosed at the Pediatric Department of Cathay General Hospital from January 1987 to March 1991. Ages-of-onset ranged from 3 months to 43 months (mean 19 months). Most cases were found between December and March (16 cases, 80%). Most seizure episodes were from 2 to 5 times (10 cases, 50%); the durations of seizures were mostly within a 5-minute period (16 cases, 80%). All seizures were generalized and symmetric, including tonic-clonic (13 cases, 65%), tonic (5 cases, 25%), and clonic (2 cases, 10%). Six out of 11 cases (54.5%) showed Rotazyme (Latex agglutination) positive. After six month to four year follow up, no patient had suffered any type of epilepsy, and psychomotor development was normal in all. Further discussion of clinical features is provided.     

Triple arthrodesis with lateral column lengthening for treatment of severe planovalgus deformity

The occurrence of abnormal nuclear DNA content in major salivary gland adenomas is not well known and its correlation with tumor recurrence has not been documented previously. From 1987 to 1991, 119 consecutive major salivary gland adenomas were operated on at Turku University Central Hospital. These tumors were analyzed by flow cytometry and 100 (84%) were found to be diploid, 12 (10%) near-diploid and 7 (6%) aneuploid with DNA indexes > 1.15. The mean proliferation rate measured as a percentage of cells in the S-phase fraction was 2.5 +/- 1.6%. The histological slides were then blindly reclassified according to current World Health Organization classification. As a result histological classification was changed in 3 tumors: malignant cells were found in 2 aneuploid tumors and 1 diploid neoplasm. Preoperative cytological fine-needle aspiration biopsy had been considered as possibly malignant in 2 of these cases. Among all case material 10 specimens were recurrent tumors; although the tendency to recur depended on the extent and adequacy of the surgery performed, multiple recurrences were associated with non-diploid tumors.     

Cutaneous necrosis associated with acquired severe protein S deficiency

The incidence of benign lymphoepithelial lesions of the parotid gland in patients afflicted with HIV has increased. Enucleation is a safe and effective procedure that provides the patient with complete removal of the cyst and a low recurrence rate. Enucleation of these parotid cysts should be considered in treating these patients.     

Giant T wave inversion associated with severe aortic regurgitation

In 1978, the Food and Drug Administration (FDA), developed a generic anesthesia equipment preuse checklist. The checklist was first released by the FDA in August 1986 and endorsed by the American Association of Nurse Anesthetists on October 18, 1986. The FDA checklist was revised in 1992 to improve the abilities of anesthesia providers to detect machine faults. In the present study, the investigators attempted to determine the effectiveness of the revised FDA checklist in detection of anesthesia machine faults as compared to providers' usual methods. Whereas no published study of preanesthesia safety inspection had been performed since the revision of the FDA checklist, the authors compared the detection abilities of anesthesia providers before and after inclusion of the revised FDA checklist. Twenty-two anesthesia providers were tested to compare the number of prearranged anesthesia machine faults that could be detected with (1) their usual checkout methods, and (2) with the revised FDA checklist. Data describing the subjects' fault detection abilities were analyzed using the t test for paired observation (P value < 0.05 considered significant). Statistical analysis revealed no significant difference (P = 0.479) when subjects used the FDA checklist and when they used their usual method. Use of the FDA machine checklist was no more effective than the provider's usual method in discovering machine faults. When using their normal method, 54.5% of providers did not discover more than 50% of programmed faults. Approximately 40.9% of providers who used the revised FDA checklist did not discover over 50% of programmed faults.