Neuronal apoptosis in herpes simplex virus - 1 encephalitis (HSE)

Herpes simplex virus infections are encountered often due to their ubiquitous nature. Common sites involved include skin, mucous membrane, genitalia, eye and the nervous system. HSV infection of the central nervous system can be life threatening. Little is known about the pathogenesis of this cataclysmic disease, at the cellular level. Virus induced apoptosis may play a role in the molecular pathogenesis of encephalitis. This study aims to detect the presence of apoptosis: a) In the brain tissue obtained at autopsy from a patient who succumbed to Herpes simplex virus - 1 encephalitis (HSE) and b) In a human glioblastoma cell line (SNB 19). Wedge tissue samples were obtained from the inferior surface of the frontal lobe and fixed in buffered formalin. Tissue sections were stained with haematoxylin and eosin for histopathological analysis. An indirect immunoperoxidase assay was performed for the detection of HSV -1 antigen in the tissue sections. Apoptosis in the brain tissue was detected employing the TUNEL assay (Terminal deoxynucleotidyl Transferase (TdT) mediated deoxy Uridine Triphosphate Nick End Labeling) using a commerically available kit (TdT Fragel DNA fragmentation detection kit, Oncogene Research Products, CA). HSV-1 induced apoptosis of SNB 19 cells were detected in-vitro by: a) Membrane blebbing assay and b) Hoechst 33258 staining. Classical features of viral encephalitis including the presence of intranuclear inclusions, neuronal loss and perivascular cuffing were seen in the tissue sections. The immunoperoxidase assay revealed the presence of abundant viral antigen in the neurons, microglial and satellite cells. TUNEL assay revealed many apoptotic neurons, microglial and satellite cells. In-vitro assays showed evidence of HSV-1 induced apoptosis in the SNB 19 cell line. These results suggest that virus induced apoptosis may play a role in the molecular pathogenesis of HSE. Further studies are warranted to elucidate the role of HSV-1 induced apoptosis, especially employing cell lines of neuronal origin.     

Trisomy 18q: 46, XX,13q+,t(13;18)(q32;q11) in a newborn associated with multiple congenital anomalies due to paternal reciprocal translocation, 46, XY,-13,+der(13)/t(13;18)(q32;q11)

A 20-day-old female neonate presented with multiple congenital anomalies, convulsions and failure to thrive. Karyotype analysis of the proposita revealed an unbalanced translocation, 46, XX,13q+,t(13;18)(q32;qll)pat resulting in partial trisomy 18q. Her father and a 5-year-old sister were phenotypically normal, balanced translocation carriers, 46, XY, -13, + der(13),t(13;18)(q32;qll) and 46, XX,-13,+der(13),t(13;18)(q32;qll), respectively. The case presented here is the second liveborn reported with trisomy 18q and is of interest from the point of view of the structural chromosomal aberration resulting in the manifestations of most features of trisomy 18 and some of 13q monosomy. The infant died due to convulsions at the age of 2 months.     

Inherited lysosomal storage disease associated with deficiencies of β-galactosidase and α-neuraminidase in sheep

Histopathologic, ultrastructural and Golgi impregnation studies disclosed lesions characteristic of a neuronal lysosomal storage disease in related sheep with onset of neurologic signs at 4–6 months. Biochemical and enzymatic evaluation disclosed storage of GM₁ ganglioside, asialo-GM₁, and neutral long chain oligosaccharides in brain, urinary excretion of neutral long chain oligosaccharides, and deficiencies of lysosomal β-galactosidase and α-neuraminidase. Retrospective and limited prospective genetic studies suggested autosomal recessive inheritance. A gene-dosage effect on β-galactosidase levels was documented in fibroblasts from putative heterozygous sheep. Fibroblasts from affected sheep did not have increased β-galactosidase activity after incubation with the protease inhibitor, leupeptin. In some aspects this disease is similar GM₁ gangliosidosis, but is unique in that a genetic defect in lysosomal β-galactosidase may cause the deficiency of lysosomal α-neuraminidase.     

Beneficial effect of MDL 73404 in dextran sulfate-mediated murine colitis

We show here that MDL 73404, a water soluble analog of alpha-tocopherol, provides protective and healing effects in dextran sulfate sodium-mediated colitis in mice. MDL 73404, showed significant dose response at all levels of the disease. The maximum effective dose was 10 mg/kg/day, p.o. and the ED₅₀ dose was 1.75 mg/kg/day, p.o. (mean). Histology showed remarkable prevention or healing depending upon the protocol. In all protocols, MDL 73404 was significantly better than olsalazine (150 mg/kg/day, p.o.). MDL 73404 also inhibited PGE₂, 6-keto-PGF_1alpha, TXB₂ and LTB₄. These results suggest that MDL 73404 provides protective and healing effects in this model.

     

A high resolution computer model for sound propagation in the human thorax based on the Visible Human data set

A parallel supercomputer model based on realistic tissue data is developed for sound propagation in the human thorax and the sound propagation behavior is analyzed under various conditions using artificial sound sources. The model uses the Visible Human male data set for a realistic representation of the human thorax. The results were analyzed in time and frequency domains. The analysis suggests that lower frequencies of around 100 Hz are more effectively transmitted through the thorax and that the spatial confinement of sound waves within the thorax results in a resonance effect at around 1500 Hz. The results confirm previous studies that show the size of the thorax plays a significant role in the type of sound generated at the chest wall.     

Troponin-T as a serum marker for myocardial infarction

We report here our experience with serum troponin T(TnT), measured with the sandwich immunoassay introduced by Boehringer Mannheim as a marker for myocardial infarction. We assayed TnT in serial serum samples from 30 patients with time courses of serum CK, CK-MB, AST, and LD that we consider typical of acute myocardial infarction (MI). In every patient but one, TnT rose in parallel with both CK-MB and AST, but remained elevated significantly longer. The ratios of the elevations of the different markers varied from patient to patient with marked variation in the ratio of TnT to CK-MB. There appeared to be a significant association between the magnitude of that ratio with the level of ALT. J. Clin. Lab. Anal. 11:125–128, 1997. © 1997 Wiley-Liss, Inc.     

Metronidazole ototoxicity--report of two cases.

Two cases of bilateral moderate to severe sensorineural hearing loss due to oral administration of metronidazole are reported. There has been only one case report of deafness following metronidazole therapy in the world literature. The hearing loss recovered gradually in a period of four to six weeks following withdrawal of drug and oral steroid therapy. The possible mechanism of ototoxicity is discussed. Awareness by the treating physician of ototoxicity due to any drug is stressed.     

Antiinflammatory profile of Tridax procumbens in animal and fibroblast cell models

The aqueous extract of Tridax procumbens leaves was lyophilized and studied on the excision wound model, rat skin fibroblast and rat paw oedema. Tridax procumbens did not significantly increase the fibroblast count compared with ibuprofen. Wound contraction was comparable in the Tridax and ibuprofen treated groups. Epithelialization was significant in the Tridax group. The aspirin treated group showed significant retardation in both parameters (p < 0.001). The fibroblast cell count, hydroxyproline/DNA ratio and collagen synthesis were insignificant in the control and Tridax treatment, while ibuprofen and aspirin treatment had a significant effect (p < 0.01) on the above mentioned parameters. In the carageenin induced oedema model, inhibition of oedema was comparable in 200 mg/kg Tridax and 50 mg/kg ibuprofen treatment, and the specific activity of the enzyme gamma glutamyl transpeptidase was comparable in the Tridax, ibuprofen and aspirin at 200 mg/kg, groups. © 1998 John Wiley & Sons, Ltd.     

Total gastrectomy with isoperistaltic jejunal interposition flap for symptomatic management of gastric polyposis from familial adenomatous polyposis

Patients with familial adenomatous polyposis (FAP) oftentimes have extracolonic polyps. The patient discussed in this case report had innumerable gastric polyps which were significantly affecting his ability to tolerate oral intake and his overall nutrition. Medical management was not sufficiently controlling his symptoms; therefore we proceeded with surgical intervention. We discuss the use of a total gastrectomy with an Isoperistaltic jejunal interposition flap for the symptomatic management of gastric polyposis. We describe the technique used and benefits to this specific procedure when it comes to long term outcome, complications, and monitoring.     

The Kirschner operation in unresectable esophageal cancer: current application

HYPOTHESIS: With the introduction of safe, effective nonoperative alternatives, bypass surgery for unresectable esophageal cancer is infrequently performed, but it has a limited role in palliation of esophageal cancer that needs to be defined. DESIGN: Retrospective cohort study. SETTING: Department of Surgery at Queen Mary Hospital in Hong Kong. PATIENTS: Patients who had unresectable esophageal cancer and underwent bypass surgery between January 1, 1991, and December 31, 1998. INTERVENTION: Bypass procedures were performed using a gastric or colonic conduit to the neck. MAIN OUTCOME MEASURES: Morbidity and mortality and quality of palliation. RESULTS: Thirty-eight patients underwent retrosternal bypass to the neck using a gastric (n = 27) or colonic (n = 11) conduit. Ten patients (26%) underwent unplanned bypass at the time of exploration for resection because of unexpected findings of T4 disease (n = 2) or technical difficulties in addition to advanced disease (n = 8). Between 1991 and 1994, 1 of 26 bypasses was unplanned and the hospital mortality was 42% (11/26), while between 1995 and 1998, 9 of 12 bypasses were unplanned and the hospital mortality was 8% (1/12). There were 12 hospital deaths in the planned bypass group (n = 28) and none in the unplanned bypass (n = 10) group (43% vs 0%, P =.01). The median survival in patients who underwent unplanned bypass was 6.9 months, compared with 1.9 months in patients who underwent planned bypass (P =.004). All patients were discharged from the hospital on at least a semisolid diet. CONCLUSIONS: The Kirschner operation is largely obsolete as a planned procedure because of high morbidity and mortality. Bypass surgery, however, is a reasonable option as an unplanned procedure when resection is precluded at the time of exploration because of unexpected adverse operative findings.