[Surgical treatment in severe acute pancreatitis. Last 15 years of experience in Emergency County Hospital of Baia Mare]. / Corelatii clinico-terapeutice in pancreatita acuta grava: experienta ultimilor 15 ani in Spitalul Judetean de Urgenta Baia Mare.

The aim of this study is to investigate the particular course of the patients operated for severe acute pancreatitis in a period of 15 years in surgical department of Emergency County Hospital of Baia Mare. Medical records of 202 patients admitted and operated for severe acute pancreatitis, were studied. Follow-up parameters were: age, gender, etiology, moment of operation, the type of operations and postoperative evolution of this patients. In the group of deceased patients alcoholic etiology of pancreatitis was prevailing. Almost a half of patients were operated in the first day of admission. A high number of patients were operated for diagnosis of acute abdomen with intention of exploratory laparotomy. In the last years, besides the usual closed drainage, open drainage and planning drainage were performed. Postoperative mortality is still high. The diagnose of severe acute pancreatitis is difficult in emergency. Global mortality in pancreatitis remains high, especially in the period of enzymatic shock, and is correlated with masculine gender, alcoholic etiology and somewhat with precocity of operation.

Prevalence of Salmonella spp. in oysters in the United States.

Food-borne diseases such as salmonellosis can be attributed, in part, to the consumption of raw oysters. To determine the prevalence of Salmonella spp. in oysters, oysters harvested from 36 U.S. bays (12 each from the West, East, and Gulf coasts in the summer of 2002, and 12 bays, four per coast, in the winter of 2002-2003) were tested. Salmonella was isolated from oysters from each coast of the United States, and 7.4% of all oysters tested contained Salmonella. Isolation tended to be bay specific, with some bays having a high prevalence of Salmonella, while other bays had none. Differences in the percentage of oysters from which Salmonella was isolated were observed between the summer and winter months, with winter numbers much lower probably due to a variety of weather-related events. The vast majority (78/101) of Salmonella isolates from oysters were Salmonella enterica serovar Newport, a major human pathogen, confirming the human health hazard of raw oyster consumption. Contrary to previous findings, no relationship was found between the isolation of fecal coliforms and Salmonella from oysters, indicating a necessity for specific monitoring for Salmonella and other pathogens rather than the current reliance on fecal coliform testing.

[Observing an SSU Em 118 dispatch center for continuous quality improvement. The case of SSUEm 118 Varese]. / Una centrale operativa SSU Em 118 a giudizio per verifica e revisione di qualità. Il caso SSU Em 118 Varese.

The present paper highlights quality aspects of the management of an Emergency Health Service Center (SSUEm 118, Varese) in order to identify the corrective measures required in a service that is increasingly close to the citizens real needs and expectations. Data were collected retrospectively on a total 54,301 calls for assistance in the period October 1997-March 1999 from an area covering some 1,300 sq.km with a population of 1,150,000 residents. That resident population was dramatically increased on a daily basis by heavy vehicle traffic particularly on the motorways to the area's many factories and to the Intercontinental Airport Malpensa 2000. The survey employed 7 anaesthetists and resuscitation staff, 14 nurses and 8 Italian Red Cross works from the Emergency Center. The researchers analysed the following phases: call reception and telephone conversation: ambulance dispatch, patient transportation and the alerting of the hospital of destination. The ServFMEA method was used for Quality Control with appropriate dispatch and the conduct and timing of the ambulance service in the Varese SSUEm 118 area. The data collected allowed for a detailed analysis of the accuracy of the information provided over the telephone (over-triage 58%, undertriage 2%), the usefulness of the telephone filter, the colour coding (correct in 40% of cases), pick-up times (5'40" on average) which were related to problems inherent in the ambulance call-out and the way ambulances reached the emergency (BLS 99%, ALS 1%, Air rescue < 1%). It was concluded that Varese SSUEm 118 was effectively and efficiently run in its first 18 months and results were improved as far as they could be given the inadequate funding of the Italian Heatlh Service.

The cold dependent accumulation of COR TMC-AP3 in cereals with contrasting, frost tolerance is regulated by different mRNA expression and protein turnover.

The accumulation of specific cold-regulated (COR) proteins is a component of the hardening process and different amount of COR proteins has been related to different degrees of cold tolerance. A number of different mechanisms controls the accumulation of the COR proteins in the plant cells. In this work we describe the mechanisms controlling the accumulation of the COR protein TMC-AP3, a putative chloroplastic amino acid selective channel protein [1] in barley, durum, wheat, emmer and bread wheat. Winter barley and, to less extent, winter bread wheat showed a higher cor tmc-ap3 expression at low temperature than the spring one while no significant differences were detected between the emmer and the durum. wheat genotypes. After 2 days of de-hardening the transcript level dropped down in the same way in all tested genotypes, nevertheless the decrease in protein content was genotype dependent. In all frost resistant genotypes the amount of COR TMC-AP3 after 9 days of de-hardening was higher compared with that of susceptible ones. These findings suggest that resistant and susceptible genotypes have different protein degradation rate and/or mRNA translational efficiency. Differences in the protein degradation rate were not dependent from the amino acidic sequence of the protein, being extremely similar in all tested genotypes. A genetic study based on Chinese spring/Cheyenne chromosome substitution lines showed that the turnover of TMC-AP3 is a polygenic trait controlled by a number of loci being the most important located on chromosomes 1B, 2B, 2D and 4D.

Normal discrimination performance accompanied by priming deficits in monkeys with V4 or TEO lesions.

Primate visual areas V4 and TEO are important for many aspects of visual perception and ablation of these areas leads to a wide range of deficits in visual discrimination, attention to less salient items, recognition of visually transformed objects, visual grouping and in visual memory. All these studies demonstrate that monkeys with V4 or TEO lesions have higher perceptual thresholds or are slower or less accurate than normal monkeys on a particular visual task. Here we show that when monkeys with V4 or TEO lesions perform a simple discrimination task on which they are unimpaired, they perform the task differently from normal monkeys. We examined visual priming in a feature detection task and discovered that it is diminished by lesions of TEO and abolished by lesions of V4. The results support the hypothesis, based on a recent demonstration of visuotopic priming in humans, that areas V4 and TEO are indispensable for normal visual form priming.

Transmission of vesicular stomatitis virus from infected to noninfected black flies co-feeding on nonviremic deer mice.

Vesicular stomatitis is an economically important arboviral disease of livestock. Viremia is absent in infected mammalian hosts, and the mechanism by which insects become infected with the causative agents, vesicular stomatitis viruses, remains unknown. Because infected and noninfected insects potentially feed on the same host in nature, infected and noninfected black flies were allowed to feed on the same host. Viremia was not detected in the host after infection by a black fly bite, but because noninfected black flies acquired the virus while co-feeding on the same host with infected black flies, it is concluded that a viremic host is not necessary for an insect to be infected with the virus. Thus co-feeding is a mechanism of infection for an insect-transmitted virus.

Laboratory vector competence of black flies (Diptera:Simuliidae) for the Indiana serotype of vesicular stomatitis virus.

In previous experiments we have demonstrated that colonized and wild black flies are competent laboratory vectors of different Mexican and Western USA isolates of vesicular stomatitis virus, serotype New Jersey (VSV-NJ). We have recently demonstrated biological VSV-NJ transmission by black flies using animal models. In the study described here, we tested the vector competence of colonized and wild black flies for the vesicular stomatitis virus, serotype Indiana (VSV-IN). A 1998 equine isolate was used. After a 10 day incubation period, saliva from experimentally infected Simulium vittatum and S. notatum was individually collected and tested for the presence of infectious virus. Virus was detected in the saliva of both species following oral infection, indicating that they are competent laboratory vectors of VSV-IN. In addition, the results suggest that the black fly gut may exert evolutionary pressures on the virus.

Bite transmission of vesicular stomatitis virus (New Jersey serotype) to laboratory mice by Simulium vittatum (Diptera: Simuliidae).

Laboratory-reared female black flies (Simulium vittatum Zetterstedt) were infected experimentally with a 1997 vesicular stomatitis virus New Jersey serotype isolate and allowed to feed on susceptible laboratory mice. All mice exposed to black fly bite seroconverted by day 21 after infection, an indication of virus transmission. In addition, viral RNA was detected in the spleen of several mice. These findings are consistent with the hypothesis that black flies are involved in VSV-NJ transmission during epizootics in the western USA and represent the 1st confirmed example of biological transmission of an arbovirus by a member of the Simuliidae using an animal model.

Learning from the pupil: a spatial visual channel in the absence of V1 in monkey and human.

The pupil of the normal human subject constricts in response not only to average increases in light energy, but also selectively to the spatial structure of a visual stimulus even when there are no energy changes. This enables one to measure visual acuity and sensitivity as a function of spatial frequency. It is known that pupillometric measures of acuity correlate well with those determined psychophysically for normal human observers. The purpose of the present study was to measure pupillary changes with stimuli delivered to the 'blind' hemifields of monkeys with unilateral V1 removal, and also with stimulation of a human subject (G.Y.) with putative V1 destruction. The results show that there are small but reliable pupillary changes to flux-equated gratings in the blind fields both in monkeys and human. The response profile in both species is very similar: it is narrowly tuned, with a peak at approximately 1 cycle/degree and a cut-off acuity of approximately 7 or 8 cycles/degree, a significant reduction compared with the intact hemifield. The result also maps well onto the psychophysically determined spatiotemporal response profile to gratings in the blind field, as determined independently for G.Y. Thus, there is a narrowly tuned spatial visual channel that does not require the integrity of V1 in monkey or human. There was no evidence under these particular conditions in either monkeys or subject G.Y. of a pupillary response to an equiluminant change from white to green or red in the hemianopic field. The pupil holds promise as a non-verbal, indirect method for determining the spatial profile, sensitivity and other properties of residual visual capacity, both in animals and humans.

Vector competence of select black fly species for vesicular stomatitis virus (New Jersey serotype).

Black flies collected from southern Arizona were evaluated for their vector competence to the Oaxaca and Camp Verde isolates of vesicular stomatitis virus (New Jersey serotype) (VSV-NJ). The Camp Verde isolate is the index isolate of the 1982-1983 VSV-NJ epizootic that infected humans and livestock in 14 western states. Previous experiments have shown that colonized Simulium vittatum females are competent laboratory vectors of both virus isolates. However, under controlled laboratory conditions, Simulium bivittatum and S. longithallum were found to be incompetent vectors of both virus isolates. After oral infections, the Oaxaca isolate replicated in 35% and 38% of S. bivittatum and S. longithallum, respectively, but did not disseminate to the salivary glands. Thus, virus was not detected in the saliva of either black fly species with either VSV-NJ isolate, indicating the presence of a midgut barrier. Simulium notatum was found to be a competent laboratory vector of both virus isolates. Infectious virions were detected in the saliva of 23% and 26% of S. notatum infected orally with the Oaxaca and Camp Verde VSV-NJ isolates, respectively. This study suggests that the black fly identified as S. bivittatum was probably not involved in virus dissemination during the 1982-1983 epizootic in the western United States. Because the geographic distribution of S. notatum is not known, its involvement in that epizootic remains obscure.

The hidden observer, hypnotic dreams, and age regression: clinical implications.

This article summarizes data from three studies (Maré, Lynn, Kvaal, Segal, & Sivec, in press; Lynn, Maré, Kvaal, Segal, & Sivec, 1993) designed to extend research on the "hidden observer" to two phenomena of clinical relevance: hypnotic dreams and suggested age regression. Subjects received suggestions for a hypnotic dream or age regression and then received suggestions for a "hidden observer" (i.e., the subject possesses a part of the self that is aware of images and ideas that the conscious mind is unaware of) with respect to the dream or age-regression experience. Hidden reports contained more personally relevant information than the target suggestions (i.e., dream, age regression). Subjectives were also less likely to recall hidden reports. The high rate of hidden-observer responding (> 80%) was also evident in nonhypnotized simulating and relaxed subjects, although they did not exhibit as much primary process thinking in their dream reports as hypnotized subjects. Case studies of a trauma client and a forensic client are used to illustrate the clinical potential of hidden-observer suggestions.

Hypnosis and the dream hidden observer: primary process and demand characteristics.

In Study 1, virtuoso (n = 13; passed more than 10 suggestions on the Harvard Group Scale of Hypnotic Susceptibility, Form A [HGSHS:A] and Stanford Hypnotic Susceptibility Scale, Form C), high hypnotizable (n = 14; passed more than 8 suggestions on the HGSHS:A), and medium hypnotizable (n = 17; passed 4-8 suggestions on the HGSHS:A) Ss were administered a hypnotic dream suggestion followed by a "dream hidden observer" suggestion (i.e., access hidden part; have new thoughts and images pertinent to dream). The majority of Ss reported dreams (81.8%) and hidden observers (80%), with hidden reports being characterized by more personal content, less primary processes, and poorer recall than dream reports. Study 2 replicated major findings. Although hypnotized (n = 18) and low hypnotizable simulating Ss (n = 17) responded comparably on most measures, hypnotizable Ss' dreams contained more primary process than did simulating Ss, providing support for M. R. Nash's (1991) psychoanalytic model.

Direct versus indirect suggestions: a conceptual and methodological review.

The article reviews the literature on the effects of direct versus indirect hypnotic suggestions. A conceptual and methodological analysis of direct versus indirect suggestions is also provided. Three conclusions follow from the review: (a) Contrary to views of Ericksonian hypnotists, suggestion style has little effect on objective responding to hypnotic test items; (b) studies of clinical- and laboratory-induced pain and other measures of subjective experience have yielded contradictory results--however, the best controlled studies have not indicated that indirect suggestions are superior to direct suggestions; and (c) there is insufficient evidence to conclude that hypnotizability level and suggestion wording interact, such that low hypnotizable subjects are particularly responsive to indirect suggestions. Methodological and conceptual problems in defining and studying hypnotic communications, the lack of rigorous experimental controls, and research issues and directions are highlighted.

Biological transmission of vesicular stomatitis virus (New Jersey) by Simulium vittatum (Diptera: Simuliidae).

Simulium vittatum females were shown to be competent vectors for the New Jersey serotype (VSNJ) of vesicular stomatitis virus (Camp Verde strain). Seventy percent of females infected intrathoracically transmitted infectious virions in their saliva after a 10-d incubation period. When infected with virus per os, 63% of the flies tested were positive at day 10, and 45% of flies infected in this manner also secreted virus in their saliva by day 9 or 10 after infection. When ingested by S. vittatum females, VSNJ virus readily replicated and increased from a mean baseline titer of 1.2 x 10(4) pfu per fly to 3 x 10(4) pfu per fly on day 10. An eclipse phase was demonstrated between approximately 18 and 48 h postinfection. This experimental evidence supports the hypothesis that black flies play a major role in the epizootic transmission of VSNJ. This is also the first confirmed example of biological transmission of an arbovirus by a member of the Simuliidae.

Canine distemper virus infection and encephalitis in javelinas (collared peccaries).

Canine distemper virus has been isolated in dog lymphocyte cultures from the brains of three javelinas that became moribund with signs of encephalitis. Canine distemper viral antigen was demonstrated predominantly in neurons and morbillivirus-like structures were seen by electron microscopy in brains of diseased animals. Serological studies suggest that CDV infection may be common in javelinas.

Antigenic relatedness of pigeon herpes encephalomyelitis virus to other avian herpesviruses.

Pigeon herpes encephalomyelitis virus (PHEV) was compared with seven avian herpesviruses for antigenic relatedness using monospecific antisera and the indirect fluorescent-antibody (IFA), agar-gel-immunodiffusion, and serum-neutralization tests. No antigenic relationship was detected between PHEV and Marek's disease virus, turkey herpesvirus, infectious laryngotracheitis virus, and duck enteritis virus. A common precipitating antigen was detected between the PHEV and pigeon herpesvirus (PHV), owl herpesvirus (OHV), and falcon herpesvirus (FHV). These four viruses also cross-reacted in the IFA test. Weak neutralizing activity was detected only between PHV antiserum and PHEV. These results suggest that the PHEV should be classified as a herpesvirus related to, but distinct from, the PHV-OHV-FHV group of viruses with which it shares common antigens.

Differentiation of vaccine strains and field isolates of pseudorabies (Aujeszky's disease) virus: trypsin sensitivity and mouse virulence markers.

Five cloned virulent North American field isolates and 2 European vaccine strains of pseudorabies (PR) viruses were compared by their sensitivity to trypsin and their virulence for mice. Marked differences in trypsin sensitivity were detected between and among virulent and vaccine PR viruses. These differences were distinct enough to characterize a virus as either sensitive or resistant to trypsin. This test also differentiated 2 virulent viruses which were previously shown to be indistinguishable on the basis of their sensitivity to thermal inactivation. Mouse virulence was evaluated by comparing the mean times-to-death of mice infected with individual viruses. Three distinct levels of virulence were observed. The two vaccine viruses were differentiated from each other and from virulent virus. Mice infected with the vaccine viruses required 23 to 118 hours longer to die than mice which were infected with virulent virus. A significant difference of 5.6 hours (P less than .005) was also detected between mice infected with 2 different field viruses. When viruses were described according to their marker profiles, 5 of 6 possible combinations were revealed. The 2 vaccine viruses could be described by separate profiles and virulent viruses could be described by 1 of 3 profiles.

Differentiation of vaccine strains and field isolates of pseudorabies (Aujeszky's disease) virus: thermal sensitivity and rabbit virulence markers.

Eleven cloned North American pseudorabies virus (PRV) strains and the European vaccine strains K and BUK were characterized by their thermal sensitivity and rabbit virulence markers. Heat sensitivity of the strains and isolates ranged from the highly heat resistant strain K, to the extremely heat labile strain BUK and isolate Be. The inactivation curves of each virus were transformed to the logarithmic scale and their standardized slopes and predicted virus survival values at 30 minutes were plotted against each other. The result was a distribution of points that represented a thermal sensitivity spectrum (TSS). Virus strains were subsequently categorized into 1 of 3 groups according to their position in the TSS. Viruses were also categorized into three groups according to their ability to clinically infect rabbits, their ability to produce pruritus and the time required to kill. When individual strains were described according to their marker profiles, 5 of 9 possible marker combinations were revealed. The 2 vaccine strains were each described by separate profiles. Virulent field isolates were characterized by 1 of 3 different profiles.

Epizootiologic aspects of viscerotropic velogenic Newcastle disease in six pet bird species.

Pet birds of 6 species were exposed to a psittacine isolate to viscerotropic velogenic Newcastle disease (VVND) virus to evaluate the impact of VVND in those species. Species examined were the budgerigar, yellow-headed Amazon parrot, canary, halfmoon conure, lesser hill mynah, and blackheaded nun. Five of the 6 species were highly susceptible to infection with VVND virus. Canaries were relatively refractory to infection with the virus. Contact birds of the same species developed infections almost as rapidly as did the birds directly exposed to nebulized VVND virus. Mortality was most marked for the conures. Less than half of the parrots exposed to nebulized virus died of VVND. Of the directly exposed budgerigars, mynahs, and nuns, 16% to 22% died during an observation period of postexposure days 0 through 28.