Calicivirus emergence from ocean reservoirs: zoonotic and interspecies movements.

Caliciviral infections in humans, among the most common causes of viral-induced vomiting and diarrhea, are caused by the Norwalk group of small round structured viruses, the Sapporo caliciviruses, and the hepatitis E agent. Human caliciviruses have been resistant to in vitro cultivation, and direct study of their origins and reservoirs outside infected humans or water and foods (such as shellfish contaminated with human sewage) has been difficult. Modes of transmission, other than direct fecal-oral routes, are not well understood. In contrast, animal viruses found in ocean reservoirs, which make up a second calicivirus group, can be cultivated in vitro. These viruses can emerge and infect terrestrial hosts, including humans. This article reviews the history of animal caliciviruses, their eventual recognition as zoonotic agents, and their potential usefulness as a predictive model for noncultivatable human and other animal caliciviruses (e.g., those seen in association with rabbit hemorrhagic disease).

Basic fibroblast growth factor and epidermal growth factor downmodulate the growth of hematopoietic cells in long-term stromal cultures.

The bone marrow microenvironment consists of stromal cells and extracellular matrix components which act in concert to regulate the growth and differentiation of hematopoietic stem cells. There is little understanding of the mechanisms which modulate the regulatory role of stromal cells. This study examined the hypothesis that mesenchymal growth factors such as basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF) modulate stromal cell activities and thereby influence the course of hematopoiesis. Both bFGF and EGF were potent mitogens for marrow stroma. However, both factors proved to be inhibitory to hematopoiesis in primary long-term marrow cultures. Inhibition was also observed when hematopoietic cells and bFGF or EGF were added to subconfluent irradiated stromal layers, demonstrating that the decline of hematopoiesis was not due to overgrowth of the stromal layer. Loss of hematopoietic support in bFGF and EGF was dose-dependent. Removal of bFGF and EGF permitted stromal layers to regain their normal capacity to support hematopoiesis. In stroma-free long-term cultures, neither factor affected CFU-GM expansion. Basic FGF slightly enhanced granulocyte-macrophage colony forming unit (CFU-GM) cloning efficiency in short-term agarose culture. Basic FGF did not reduce the levels of interleukin-6 (IL-6), GM-CSF, or G-CSF released by steady state or IL-1-stimulated stroma. Similarly, the constitutive levels of steel factor (SF) mRNA and protein were not affected by bFGF. Basic FGF did not alter the level of TGF-beta 1 in stromal cultures. We conclude that bFGF and EGF can act as indirect negative modulators of hematopoietic growth in stromal cultures. The actual mediators of regulation, whether bound or soluble, remain to be identified.

Autologous transplant programs in community hospitals: role of centralized stem cell processing laboratories.

Transplantation of bone marrow and peripheral blood stem cells was initially limited to large, research-oriented institutions. General acceptance of autologous transplantation has grown rapidly in recent years and there is now interest in the establishment of autologous transplant programs in community hospitals. However, the lack of facilities to process and cryopreserve stem cells can be a major obstacle to small transplant programs. In response to this problem, we suggest that a centralized stem cell processing facility can offer the required services to several hospitals within a metropolitan area. The establishment of processing facilities within currently existing blood banks and blood centers is a logical extension of their current roles in hematotherapy. In this paper, we describe the operation of one such centralized processing facility.

Water environment microwave thawing.

A rapid, controlled microwave oven thawing technic for fresh frozen plasma (FFP) that minimizes flocculent formation while maintaining excellent coagulation factor, total protein, and albumin levels is presented. This method, using an unmodified microwave oven and a tap-water environment, decreases thawing time from 37.5 minutes for the standard 37 degrees C water bath to approximately 11 minutes for either one or two units of FFP.

Case report of a primary cystic sarcoma of the kidney, demonstrating fibrohistiocytic, osteoid, and cartilaginous components (malignant mesenchymoma).

The first case of a primary, cystic sarcoma of the kidney, containing fibrohistiocytic, osteoid, and cartilaginous elements (malignant mesenchymoma) is reported. The neoplasm occurred in a 29-year-old white woman, who had a right upper quadrant mass at least four years prior to presentation. Light and electron microscopy findings are presented. A 14-month follow-up revealed an extensive tumor recurrence in the right perirenal area with no apparent metastastic disease.

Hemotherapy in elective surgery: an incidence report, review of the literature, and alternatives for guideline appraisal.

The growing demand upon existing reserves of blood requires a more efficient use of this limited resource. Numerous regional medical centers have shown the current practice of type and crossmatch to be highly inefficient, whereas the proven, safe type and screen method for reserving blood units effectively increases the available blood pool and decreases costs of maintaining a blood bank. Approaches other than the crossmatch to transfusion ratio are proposed to provide objectivity for establishing procedures to be converted to type and screen and the appropriate number of units for patients requiring a type and crossmatch. Cumulative blood ordering recommendations are provided.

Cutaneous Rhizopus infection. Occurrence as a postoperative complication associated with an elasticized adhesive dressing.

A 29-year-0ld woman in good health except for scoliosis suffered severe sequelae during the postoperative course for placement of a Harrington rod. A cutaneous Rhizopus infection in and about the incision site was attributed to the use of a contaminated elasticized adhesive (Elastoplast) dressing. The comtamination was established as a nosocomial problem, which is extremely difficult to control. The extent of the infection, subsequent long recovery course, and remarkable sequelae make this case unusual.

Extra-abdominal desmoid arising from a capsule around a silicone breast implant.

Musculo-aponeurotic fibromatosis is an extremely rare lesion in the breast, only 16 previous cases having been reported. The unilateral tumor in our patient occurred after subcutaneous mastectomy and bilateral placement of implants. The histological evidence suggests that this tumor arose from the capsule surrounding one of the implants.

Cerebral granulomatous angiitis: case report and literature review.

Granulomatous angiitis is a pathologically distinct central nervous system segmental vasculitis of unknown etiology and pathogenesis which may be indirectly related to herpes zoster infections. The condition primarily affects adults and presents with nonspecific, unexplained progressive neurological dysfunction. The cerebrospinal fluid is often under increased pressure and contains excess protein and white cells, mostly lymphocytes. The necrotizing vasculitis primarily affects the small intracranial arteries and veins and alters vascular permeability, ind,cing cerebral edema. Angiography demonstrates segmental, diffuse, distal vascular irregularity and narrowing, while computed tomography shows poorly defined, diffuse, non-contrast-enhancing low density areas with or without mass effect. In the approprite clinical setting, the angiographic and CT findings should be highly suggestive. The possibility of efficious therapeutic intervention makes early diagnosis important. CT can also be used to monitor therapeutic response.