Is dolphin morbillivirus virulent for white-beaked dolphins (Lagenorhynchus albirostris)?

The virulence of morbilliviruses for toothed whales (odontocetes) appears to differ according to host species. In 4 species of odontocetes, morbilliviruses are highly virulent, causing large-scale epizootics with high mortality. In 8 other species of odontocetes, including white-beaked dolphins (Lagenorhynchus albirostris), morbilliviruses have been found as an incidental infection. In these species, the virulence of morbilliviruses is not clear. Therefore, the admission of 2 white-beaked dolphins with morbillivirus infection into a rehabilitation center provided a unique opportunity to investigate the virulence of morbillivirus in this species. By phylogenetic analysis, the morbilliviruses in both animals were identified as a dolphin morbillivirus (DMV) most closely related to that detected in a white-beaked dolphin in Germany in 2007. Both animals were examined clinically and pathologically. Case No. 1 had a chronic neural DMV infection, characterized by polioencephalitis in the cerebrum and morbillivirus antigen expression limited to neurons and glial cells. Surprisingly, no nervous signs were observed in this animal during the 6 months before death. Case No. 2 had a subacute systemic DMV infection, characterized by interstitial pneumonia, leucopenia, lymphoid depletion, and DMV antigen expression in mononuclear cells and syncytia in the lung and in mononuclear cells in multiple lymphoid organs. Cause of death was not attributed to DMV infection in either animal. DMV was not detected in 2 contemporaneously stranded white-beaked dolphins. Stranding rate did not increase in the region. These results suggest that DMV is not highly virulent for white-beaked dolphins.

Whipple's disease. A classic case report and review of the literature.

We report the case of a 43-year-old carpenter with abdominal complaints and progressive weight loss. The HLA-B27 positive male had been suffering migratory arthropathy for five years, only partially under control with corticosteroids and methotrexate therapy. Endoscopic investigation showed dark staining of the duodenal mucosa and the ileal mucosa had an erythematous aspect with multiple white spots. Abundant periodic acid Schiff positive macrophages were seen on histologic examination of biopsy samples. This is a classic presentation of Whipple's disease, a rare multisystemic disease caused by the Tropheryma whipplei. Typical symptoms are arthropathy, weight loss, abdominal pain and diarrhea, but also systemic and neurological manifestations may occur. The otherwise lethal disease can be treated with long term antibiotics.

Anesthesia for endobronchial laser surgery: a modified technique.

UNLABELLED: We describe a technique for endobronchial surgery with the neodynium:yttium-aluminum-garnet laser, in which an insufflation catheter with side holes placed into the contralateral mainstem bronchus is used for high-frequency positive pressure ventilation. Thirty-five patients (45 procedures) were treated during general anesthesia using a rigid bronchoscope in combination with a fiberoptic bronchoscope. Perioperatively, oxygen saturation (SaO2), mean arterial pressure, and heart rate were recorded. SaO2 during the recovery period was comparable to that during the intraoperative period but was significantly (P < 0.05) higher than that before the induction of anesthesia. There was a considerable (> or = 5%) increase in SaO2 at the end of the treatment in six patients, which indicates that the recanalization of the treated airway was successful. Our data support the assumption that, during endobronchial resection, selective ventilation of the nonaffected lung was adequate; in addition, subcarinal placement of the insufflation catheter with side holes was advantageous. We conclude that this technique contributes to the prevention of lung complications during endobronchial laser surgery. IMPLICATIONS: We describe a technique in which an insufflation catheter with side holes placed into the contralateral mainstem bronchus largely prevented inhalation of laser smoke and aspiration of blood and debris.

Docetaxel (Taxotere) is active in non-small-cell lung cancer: a phase II trial of the EORTC Early Clinical Trials Group (ECTG)

In a multicentre trial of the EORTC ECTG we have treated 43 non-pretreated patients with advanced non-small-cell lung cancer (NSCLC) with the new semisynthetic taxoid docetaxel (Taxotere). Six patients were ineligible; of the 37 eligible patients, ten had prior radiotherapy and 18 prior surgery. They received 100 mg m-2 in 1 h i.v. every 3 weeks, usually in an outpatient setting. Prophylactic steroids, antihistaminics or antiemetics were not routinely given. Two patients were not evaluable because they withdrew from the study because of a hypersensitivity reaction after the second cycle. The main toxicity was neutropenia (80% of cycles), although infections were rare (4%). One patient died from sepsis during neutropenia. Hypersensitivity reactions necessitating interruption of docetaxel (Taxotere) infusions were found in only 10% of cycles. The overall response rate was 23% with one complete response, and seven partial responses. Stable disease was found in 16 patients. The median duration of response was 36 weeks, and the median survival of all patients was 11 months. Docetaxel (Taxotere) is among the most active drugs for treatment of NSCLC.

Pulmonary migration following periurethral polytetrafluoroethylene injection for urinary incontinence.

We report a case of clinically significant migration of polytetrafluoroethylene (Teflon) paste particles to the lungs after periurethral injection. These particles were identified by standard and polarized light microscopy. Since the long-term effects in humans are not sufficiently known, we strongly warn against the use of polytetrafluoroethylene paste in children or young adults with a normal life expectancy.

[Microfluorimetric study of the effect of almitrine bismesylate (Vectarion) on intrapulmonary neuroepithelial bodies]. / Etude microfluorimétrique de l'action du bismésilate d'almitrine (Vectarion) sur les corps neuro-épithéliaux intrapulmonaires.

As Almitrine bismesylate is a potent peripheral chemo-receptor stimulant we have studied its action, after intra-peritoneal injection, on the intra-neuro-epithelial bodies (NEB) of 24 young rabbits (4 to 17 days old) measuring the intensity of the cytoplasmic fluorescence. The administration of Almitrine bismesylate in pharmacological doses provoked a marked rise (around 25%) in the intensity of fluorescence of NEB compared to a placebo group, indicating a raised cytoplasmic concentration of serotonin. These observations show that Almitrine bismesylate, in stimulating all the peripheral chemo-receptors equally, influences the NEB at the same time corroborating the intra-pulmonary chemoreceptor mature of the latter. The mechanism of action of Almitrine bismesylate on the NEB remains unexplained at a cellular level. Some supplementary studies are planned to elucidate these aspects.

Sclerosing peritonitis with mural bowel fibrosis in a patient on long-term CAPD.

A 66 year old white woman developed an incomplete small-bowel obstruction after 3 years of CAPD with lactate containing solutions. There were six episodes of peritonitis. The bowel obstruction was not due to a "sclerosing obstructive" (encapsulating) peritonitis but to a diffuse sclerosis of the serosal membranes extending into the muscle layers of the small and large bowels ("mural fibrosis"). This picture may be just one other expression of a spectrum of structural changes resulting from long-term chronic irritation of the abdominal cavity.