Severe leukopenia and dysregulated erythropoiesis in SCID mice persistently infected with the parvovirus minute virus of mice

Parvovirus minute virus of mice strain i (MVMi) infects committed granulocyte-macrophage CFU and erythroid burst-forming unit (CFU-GM and BFU-E, respectively) and pluripotent (CFU-S) mouse hematopoietic progenitors in vitro. To study the effects of MVMi infection on mouse hemopoiesis in the absence of a specific immune response, adult SCID mice were inoculated by the natural intranasal route of infection and monitored for hematopoietic and viral multiplication parameters. Infected animals developed a very severe viral-dose-dependent leukopenia by 30 days postinfection (d.p.i.) that led to death within 100 days, even though the number of circulating platelets and erythrocytes remained unaltered throughout the disease. In the bone marrow of every lethally inoculated mouse, a deep suppression of CFU-GM and BFU-E clonogenic progenitors occurring during the 20- to 35-d.p.i. interval corresponded with the maximal MVMi production, as determined by the accumulation of virus DNA replicative intermediates and the yield of infectious virus. Viral productive infection was limited to a small subset of primitive cells expressing the major replicative viral antigen (NS-1 protein), the numbers of which declined with the disease. However, the infection induced a sharp and lasting unbalance of the marrow hemopoiesis, denoted by a marked depletion of granulomacrophagic cells (GR-1(+) and MAC-1(+)) concomitant with a twofold absolute increase in erythroid cells (TER-119(+)). A stimulated definitive erythropoiesis in the infected mice was further evidenced by a 12-fold increase per femur of recognizable proerythroblasts, a quantitative apoptosis confined to uninfected TER-119(+) cells, as well as by a 4-fold elevation in the number of circulating reticulocytes. Therefore, MVMi targets and suppresses primitive hemopoietic progenitors leading to a very severe leukopenia, but compensatory mechanisms are mounted specifically by the erythroid lineage that maintain an effective erythropoiesis. The results show that infection of SCID mice with the parvovirus MVMi causes a novel dysregulation of murine hemopoiesis in vivo.     

Anesthesia and analgesia for minor injuries to children

Today's children are rambunctious, playful, and aggressive and are provided through the miracles of modern technology with ample opportunities to injure themselves. As such, they are a source of both joy and terror to their parents. It is a "given" that many of them will injure themselves in the course of growing up. When they come to us in the ED waiting room, they are typically very frightened and usually in pain. We are fortunate that we have techniques and drugs to alleviate this pain and to attenuate their fear. It is our responsibility as anesthesiologists to ensure that these drugs and techniques are used appropriately and cause no further harm. We hope the information contained in this chapter may be of benefit in achieving this goal.     

Imported measles. A potential control problem

From Dec 23, 1978, through Jan 31, 1979, an outbreak of five laboratory-confirmed cases and four clinical cases of measles occurred in a Vietnamese refugee population living in a single housing complex in Albuquerque, NM. The index cases were in two refugee siblings in whom measles was incubating on arrival in the United States. Despite spread through three subsequent generations of disease transmission within the Vietnamese population, there was no additional spread into the general Albuquerque population. Responsible factors included the age distribution of susceptible persons, the social isolation of the refugee population, and the physical structure of the housing complex. There is a need to identify the problem of imported measles in "ethnic islands" in need of vaccination.     

Ultrastructural evidence for an innervation of epithelial enterochromaffine cells in the guinea pig duodenum

The innervation of the duodenal enterochromaffine cells (E.C.) of the guinea pig was studied at the electronmicroscopic level. Pretreatment with 5-OH-dopamine was performed to visualize catecholaminergic (CA) nervous elements. Near the basement membrane of all examined E.C. in the crypts, bundles of unmyelinated nerve processes were observed, only partly ensheathed in a Schwann cell cover. At least 4 types of processes could be observed. 1) Boutons containing only small clear vesicles, probably cholinergic fibres; 2) boutons with small clear vesicles, and in addition large (greater than 200 nm) granules with a dense matrix (P-type-fibres); 3) boutons with small electron-dense vesicles, probably CA-fibres; and 4) processes with few vesicles but having the appearance of dendrites. No typical synaptic arrangements were observed, but the minimal distance between the E.C. and the nerve bundles was 150 to 250 nm, thus well within the functional limits of the "autonomic gap". Thus epithelial E.C. may be influenced by several types of nervous elements, including CA-fibres.     

Subtotal colectomy with ceco-rectal anastomosis (Deloyers) for severe idiopathic constipation: an alternative to total colectomy reducing risks of digestive sequelae

The objective of this study was to determine the degree of knowledge on food and nutrition of school-age children's mothers from Chile's Metropolitan Region and to measure the impact of socioeconomic, sociocultural and demographic variables on knowledge. A representative and proportional sample of 4,509 school-age children was chosen from Chile's Metropolitan Region and the degree of knowledge on food and nutrition on mothers of 1,985 of them was determined. The sample was stratified according to grade (I, II, IV, VI, VIII elementary school grades and I and IV high school grades), sex, type of school and geographic area. Socioeconomic status (SES) was determined through Graffar's modified method. The degree of knowledge on food and nutrition was assessed by a test based on the specific objectives pursued by the elementary school curriculum programs of the Ministry of Education and submitted to adequate statistical proofs for its content validity and reliability. Mother's schooling level mean was 9.7 +/- 4.0 y. The field study was carried out on 1986-1987. Statistical procedures included analysis of variance, Student "t" test for comparison of the means, correlation and regression. Results revealed that mothers did not know food and nutrition matters in fundamental aspects related to the observance of a healthy lifestyle, both, for themselves and their family. The degree of knowledge of food and nutrition significantly and positively correlated with SES, mother's schooling and occupation level, housing conditions (quality and sanitation) and age, and significantly and inversely correlated with the number of sons and crowding, besides of being significantly higher in urban than rural mothers. Mother's schooling level and geographic area were the independent variables with the greatest explanatory power in the food and nutrition knowledge variance (r2 = 0.1723), but mother's schooling level explains 93.2% of the explained variance. Results suggest the need to introduce, during school age, nutrition education programs focused on mother and children to improve the population life quality.     

Activation of a retroviral membrane fusion protein: soluble receptor-induced liposome binding of the ALSV envelope glycoprotein

Cellular aspects of remodeling in intact arteries have not been fully investigated, mainly due to the lack of an appropriate methodology that allows for simple measurements. The aim of this study was to develop a method based on laser scanning confocal microscopy (LSCM), compare it with previous methodology, and apply it to the study of remodeling in hypertension. The morphology of mesenteric resistance arteries from stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar-Kyoto rats (WKY) was determined with wire myography on one segment with a standardized diameter setting (0.9[d100]) and with perfusion myography on a second segment from the same artery at the calculated equivalent pressure. The second segments were stained with the nuclear dye Hoechst 33342 (live tissue) or propidium iodide (fixed tissue) and measured with LSCM and MetaMorph software. Compared with wire myography, perfusion myography showed similar differences from those previously reported. Compared with LSCM, perfusion myography showed a similar lumen but significantly smaller wall thickness in both live and fixed tissue, probably due to measurement underestimation. In the study with LSCM, arteries from SHRSP compared with those from WKY showed (1) reduced lumen, (2) altered cell density that was significantly increased in the adventitia, decreased in the media, and unchanged in the intima, (3) significantly increased medial volume, (4) significantly smaller endothelial cell nuclei, and (5) adventitial-like cells in the media. We conclude that (1) LSCM is a reliable and straightforward method to study morphology in intact vessels, (2) it provides new information on the cellular changes in remodeling, (3) adventitia might play an active role in the process of remodeling in hypertension, and (4) endothelium "remodels" in hypertension.     

Comparative study of astrocytes in human and rabbit retinae

Immunohistochemical location of Glial Fibrillary Acidic Protein (GFAP) was used to compare the morphology of astrocytes in vascularized and partially vascularized retinae (human and rabbit, respectively). Astrocytes in human and rabbit retinae were found in the same regions as the blood vessels. These cells in partially vascularized retinae differed from those in vascularized retina in several respects. Firstly, there were six morphological types in rabbit retina and only two in human retina. Secondly, in rabbit retinae there were astrocytes only related to blood vessels called "perivascular astrocytes" which were absent in human retinae. Thirdly, the astrocytes were located in the nerve fiber layer and ganglion cell layer in both types of retinae, but in human retinae these cells could also be seen in the internal nuclear layer. These observations demonstrate that there are many differences between astrocytes in human and rabbit retina, suggesting that rabbit retina could be used with caution as an experimental model in comparative studies with human retina.     

Safe closure of therapeutic relationships with abuse survivors

1 Safe closure of a therapeutic relationship is needed because neither healer nor client can be a "stranger" again. 2 A "failed termination" may overshadow the therapeutic gains that were made during the working phase, constituting a "retraumatization." 3 Closure, as opposed to termination, involves a unique, individualized mutual transformation of the therapeutic relationship into a "real relationship."     

Hand-assisted laparoscopic splenectomy for hydatid cyst

Splenic hydatidosis is a rare condition. We performed a hand-assisted laparoscopic splenectomy for a large hydatid cyst localized in the center of the spleen. We discuss the advantages of the "helping hand."