Multiple system reaction to trimethoprim-sulfamethoxazole.

Trimethoprim-sulfamethoxazole may cause life-threatening reactions and even death, but such reactions are rare and do not detract from its usefulness. As with any therapy, however, caution should be observed in its use in children, and especially in the elderly.

Enrichment of measles virus-like RNA in the nucleocapsid fraction isolated from subacute sclerosing panencephalitis brains.

A procedure has been developed which facilitates the detection of measles virus RNA sequences in human brains. The procedure involves isolating subviral components (nucleocapsids) from brain tissues prior to RNA purification, followed by hybridization of these RNAs to cDNA synthesized from measles virus 50 S RNA template. Using these techniques we were able to obtain an RNA fraction which was manyfold enriched in measles virus-specific RNA, relative to unfractionated subacute sclerosing panencephalitis (SSPE) brain RNAs 70-100% of the measles virus-specific RNA present these SSPE brain samples were recovered in this enriched fraction.

Host cell factors involved in the production of slowly sedimenting nucleocapsids in measles virus-infected cells.

A decrease in the sedimentation rates of the measles virus nucleocapsid, and the RNA contained within, were observed during acute measles virus infection when the growth conditions of Vero cells were altered. The change in sedimentation rates of virus nucleocapsids in these experiments was apparently due to the physiological state of the cell and was independent of the history of the measles virus used for infection since: (i) the same virus stock was used to infect cells from which nucleocapsids were prepared, (ii) nucleocapsid sedimentation rates were rapid when Vero cells freshly revived from liquid nitrogen were infected, but nucleocapsid profiles showed no decrease in the amount of slowly sedimenting material using the same cells and changing the virus preparation used for infection. Frequent cell splittings and numerous medium changes were among the growth factors which appeared to correlate to slowly sedimenting particle production. Changes in the amount of self-complementarity of the measles virus RNA were also observed under these conditions.

Radioimmunoassay of measles virus nucleocapsid antigen.

A double antibody competitive binding radioimmunoassay (RIA) was developed as a tool for investigating the involvement of measles virus in persistent virus infections. The assay employs 125I-labelled measles virus nucleocapsids as the labelled antigen. Nucleocapsids were purified from cytoplasmic extracts of virus-infected Vero cells, treated with trypsin to prevent clumping and iodinated to a specific activity of about 15 microCi/microgram. Electrophoretic analysis of iodinated trypsin-treated nucleocapsids revealed only labelled polypeptide with a relative mol. wt. (Mr) 40 000, indicating that trypsin had cleaved the 60 000 mol. wt. native polypeptide to a 40 000 mol. wt. subunit. The assay could detect as little as 0.1 ng of nucleocapsid protein. Either native (Mr 60 000) or cleaved Mr 40 000) nucleocapsid polypeptide was detected in the assay. As much as 100 micrograms of protein from uninfected Vero cells did not react in the RIA. Another measure of specificity was the fact that 400 ng of purified nucleocapsid protein from simian virus 5, Newcastle disease virus or canine distemper virus did not react in the assay. In the RIA, nucleocapsid antigen of virus isolated from subacute sclerosing panencephalitis (SSPE) was indistinguishable from that of Edmonston strain measles virus, indicating antigenic homology between the 40 000 mol. wt. nucleocapsid polypeptide of the SSPE virus and that of measles virus.

A model for communication skills development for family practice residents.

The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described.

Complementation analysis of measles virus temperature-sensitive mutants.

Two sets of independently isolated measles virus temperature-sensitive mutants were quantitatively tested for complementation. Analysis of the nine possible combinations of representative mutants indicated that only one pair of mutants is noncomplementing. Thus, the measles virus mutants studied to date define five complementation groups.

Isolation and characterization of temperature-sensitive mutants of measles virus.

Nine temperature-sensitive (ts) mutants of nonattenuated Edmonston strain measles virus were isolated from wild-type virus which was grown in the presence of 5-fluorouracil. Adsorption, temperature shift, and complementation experiments indicated that all these mutants were restricted at an intracellular stage of infection. However, all the mutants were more rapidly inactivated at 41 C than was wild-type virus, suggesting that the ts product of each mutant either influences or is a structural component of the virus. Three complementation groups were found to be represented among the mutants. Group A contained one mutant and it did not induce synthesis of detectable amounts of viral antigen at the nonpermissive temperature (39 C). Group B consisted of six mutants which did not induce viral antigen synthesis at 39 C and one mutant which did. Group C was represented by one mutant and it induced viral antigen synthesis at 39 C. The two mutants which induced sythesis of viral antigen also induced synthesis of relatively small amounts of virus-specific RNA at 39 C. These mutants, while producing cytoplasmic and nuclear accumulations of viral antigen at 39 C, were restricted in production of syncytia and hemadsorption. All the mutants were less neurovirulent than wild-type virus, as indicated by their inability to produce acute disease in newborn hamsters.

Replication of measles virus: continued synthesis of nucleocapsid RNA and increased synthesis of mRNA in the presence of cycloheximide.

The effect of cycloheximide on virus specific RNA synthesis in Vero cells infected with either wild-strain (Edmonston) or subacute sclerosing panencephalitis strain measles virus was investigated. At 3 days postinfection, cells treated with cycloheximide (2.6 x 10(-4) M) and then exposed to [(3)H]uridine showed a marked increase in labeled virus-specific RNA. A major portion of this incremental labeled RNA was putative viral mRNA which sedimented at 16, 22, and 30S. Five distinct classes of polyribosomes, which were not evident in untreated cells, were found in cycloheximide-treated cells and each contained similar species of virus-specific RNA. Viral nucleocapsid RNA, 50 and 18S, was synthesized and encapsidated in the presence of cycloheximide. The latter observation is in apparent contrast to reports that cycloheximide inhibits replication of RNA of classical paramyxoviruses, and may indicate that mechanisms for replicating RNA of measles virus are different from those for replicating RNA of paramyxoviruses.

Replication of measles virus: distinct species of short nucleocapsids in cytoplasmic extracts of infected cells.

Cytoplasmic extracts of Vero cells infected with wild-strain Edmonston measles virus were found to contain two and probably three distinct species of nucleocapsids. Species sedimenting at 200 and 110S contained RNA which sedimented at 50 and 16 to 18S, respectively. The third nucleocapsid species which sedimented at 170S was not present in all experiments and was not characterized in detail. Essentially all 200 and 170S, as well as a portion of the 110S, nucleocapsids were membrane associated and probably present in part in cell-associated virions. Five of six plaque purified strains derived from wild-type Edmonston virus produced only 200S nucleocapsids. One of these five plaque-purified strains subsequently produced both 200 and 110S nucleocapsids after being passaged by using undiluted inocula. These results suggest that measles virus may produce distinct classes of defective virus containing short nucleocapsids and subgenomic viral RNA.