Imaging of slow viruses.

The symptoms associated with slow viral or prion diseases of the central nervous system tend to have multiple neurologic symptoms, and different patients may present with different symptoms. This review discusses the most common slow virus infections and their imaging findings.

Utility of positive bronchoalveolar lavage in predicting respiratory failure after hematopoietic stem cell transplantation: a retrospective analysis.

Pulmonary complications occur frequently after hematopoietic stem cell transplantation (HSCT) and account for considerable mortality when associated with respiratory failure. Bronchoalveolar lavage (BAL) is commonly used in the diagnostic evaluation of pulmonary infiltrates in HSCT patients. Although the yield of BAL is well established in this setting, the impact on outcome is controversial. In addition, respiratory failure in HSCT patients is associated with high mortality. To determine if positive BAL predicted less respiratory failure and better survival, a retrospective review (between 1992 and 1998) of all HSCT patients who had bronchoscopy with BAL as part of their diagnostic evaluation for new pulmonary infiltrates was performed. Twenty-one patients met the inclusion criteria. Eleven patients (52%) had a positive BAL, defined as the isolation of infectious microorganisms or pulmonary hemorrhage in the lavage specimen. Most of the positive findings were pathogenic organisms (bacterial, fungal, and viral). Respiratory failure (defined as need for both intubation and mechanical ventilation) occurred in 11 of 21 patients (52%)-8 of 11 (73%) who had positive BAL compared with 3 of 10 (30%) who had negative BAL (P = .09). The overall mortality rate was 11 of 21 patients (52%). All deaths except one occurred as a direct result of respiratory failure. Although this study confirmed the high mortality rate in HSCT patients with respiratory failure, the BAL results were not predictive of outcome.

Prognostic impact of EBV-related LMP-1, histologic type, and environmental factors in nasopharyngeal carcinoma in a German population.

INTRODUCTION: This retrospective study addressed the possible involvement of latent Epstein-Barr virus (EBV) infection, in particular LMP-1 expression, and further exogenous factors, i.e. tobacco, alcohol and occupational hazardous substances, in nasopharyngeal carcinoma (NPC) in a German population. PATIENTS AND METHODS: From 1980 to 2000, 44 patients suffering from histologically confirmed NPC were entered into the study. 33 specimens were available for immunostaining (IHC) to analyze LMP-1 expression. Information about environmental exposures were obtained employing a detailed standardized questionnaire. RESULTS: Outcome of patients with squamous cell NPC (SC-NPC) was significant worse than that of those with non-keratinizing NPC (NK-NPC). Age and tumor size correlated with response to therapy. The group with negative conventional LMP-1 staining showed better overall survival after 5 years compared to the group with positive or marginally positive LMP-1 detection (not significant). Nevertheless, after staining by tyramid-augmented IHC (TSA-IHC), nearly all specimens with negative LMP-1-staining in conventional IHC were found to be clearly positive. All patients with SC-NPC were smokers. The distribution of smokers and non-smokers in the group of NK-NPC was balanced. Comparable to the tobacco observation, there was also a correlation between high alcohol consumption and SC-NPC. CONCLUSION: Prognosis of NPC is mainly dependent on histologic type. Prognostic impact of LMP-1 is still unclear since LMP-1 was detected in all specimens using TSA-IHC. Therefore, TSA-IHC-LMP-1 detection might be interesting for diagnostic specification and development of new therapeutic strategies in NPC.

[Prions, infections and confusions in the "transmissible" spongiform encephalopathies. The other evidence-based science. III. Review]. / Priones, infecciones y confusiones en las encefalopatías espongiformes "trasmisibles". Ciencia basada en la otra evidencia III. Revisión.

There are some neurological disorders with a pathological hallmark called spongiosis which include Creutzfeld-Jakob disease and its new variant, the Gertsmann-Straussler-Scheinker Syndrome and the Fatal Familial Insomnia in humans; and Scrapie and Bovine Spongiform Encephalopathy, among others, in animals. The etiological agent has been considered either transmissible or hereditary or both. Curiously, this agent has no nucleic acids, is impossible to filter, is resistant to inactivation by chemical means, has not been cultured and is unobservable at electron microscopy. All of these facts have led to some researches to claim that these agents are similar to viruses appearing in computers. However, after almost fifty years of research, is still not possible to explain why and how such elements produce the diseases commented about. On the contrary, during these years have been possible to know that these entities called slow viral infections, transmissible amyloidosis, transmissible dementia, transmissible spongiform encephalopathies or prion diseases appear in individuals with genetical predispositions exposed to several worldwide immunological stressors. The possibility that prions are the consequence and not the cause of these diseases in animals and man is day by day more reliable, and supports the suggestion that a systematic intoxication due to pesticides as well as mycotoxin ingestion, produced mainly by different molds such as Aspergillus, Penicillium or Fusarium, seem to be the true etiology of these neurodegenerative disorders.

[The Epstein-Barr virus in patients with infectious endocarditis]. / Virus Epshteina--Barr u bol'nykh infektsionnym éndokarditom.

Serological markers of Epstein-Barr virus (EBV) infection has been investigated in 28 patients with infectious endocarditis. In 75% of patients IgM antibodies to "early" antigen of the virus which are the marker of active viral infection occurred vs 6.2% among healthy blood donors. Specific for infectious endocarditis reaction profile (anti-EBV combination in one person) indicates reactivation of latent viral infection. The conclusion is made on the necessity of further investigation of both the role of EBV in pathogenesis of pyoseptic diseases and immunologic mechanisms for reactivation of latent viral infections.

[Creutzfeldt-Jakob disease]. / A Creutzfeldt-Jakob-betegségröl.

A most common form of human prion disease, also known as non-conventional slow virus diseases; Creutzfeldt-Jakob's disease is described in detail. The available data on the pathogenesis of the illness have recently changed and constitute a most exciting article of contemporary medicine. 109 cases are introduced that have been verified neuropathologically in Hungary until now; their summed up clinical data, the pathological findings and their epidemiological characteristics are discussed. It must be emphasized that the diagnosis of the illness cannot be inevitably confirmed clinically. Transplantation of organs or tissues of all deceased, who suffered of an illness with dementia, should be strictly avoided accordingly.

[Latent cervical virus infection as a possible cause of early abortion]. / Latente zervikale Virusinfektion als mögliche Ursache des Frühaborts.

Cervical smears of 50 women who had an abortion were examined by dot-blot hybridization for human papillomavirus (HPV), herpes simplex virus (HSV) types 1 and 2, and cytomegalovirus (CMV) DNA. HPV DNA type 16 or 18 positivity was shown in 17.6% of the cases; in the aborted material, however, it amounted to 30.8%. IgM-positive titres were present in a few cases. In cervical smears of intact pregnancies, positivity for HPV DNA types 6 and 11 was detected in 9.5% and for the HSV DNA types 1 and 2 and CMV DNA in 48.0% of the cases. In this group of patients mostly positive IgM and IgG titers were present.

Naturally occurring scrapie-like spongiform encephalopathy in five domestic cats.

Naturally occurring transmissible spongiform encephalopathies have been recognised in sheep, man, mink, captive deer and cattle. Recently a similar disease was reported in a domestic cat. This paper describes the clinical and pathological findings in five cats with similar signs, including further observations on the original case. All the cats had a progressive, neurological disease involving locomotor disturbances, abnormal behaviour and, in most cases, altered sensory responses. Histopathological examination of the central nervous system revealed changes pathognomonic of the scrapie-like encephalopathies, including widespread vacuolation of the grey matter neuropil, vacuolation of neuronal perikarya and an astrocytic reaction.

[Fundamental and applied studies of AIDS of the nervous system. A new stage in the study of slow infections of the nervous system]. / Fundamental'nye i prikladnye issledovaniia v oblasti neiro-SPIDa. Novyi étap v izuchenii medlennykh infektsii nervnoi sistemy.

Problems of the etiology, pathogenesis, classification, clinical manifestations, diagnosis and treatment of neuro-AIDS are analyzed. The causes of the origin and mechanisms of the development of multiple sclerosis and lateral amyotrophic sclerosis, attributable presumably to slow infections are discussed from the standpoint of the retroviral etiology. In the author's opinion, it is more probable in the first case.

[Intravital laboratory diagnosis of human subacute spongioid encephalopathies (Creutzfeldt-Jakob syndrome and amyotrophic leukospongiosis)]. / Prizhiznennaia laboratornaia diagnostika podostrykh spongioznykh éntsefalopatiicheloveka (bolezni Kreittsfel'da-Jakoba i amiotroficheskogo leikospongioza).

Methods aimed at the detection of causative agents in the CSF and peripheral blood lymphocytes are recommended for the use in intravital laboratory diagnosis of slow infections of the central nervous system. The results obtained enable recommending the biotest on guinea-pigs or indication of the causative agent of amyotrophic leukospongiosis (AL) in cell culture coupled with the punctate immunoenzyme assay for the diagnosis of AL. As to the diagnosis of Creutzfeldt-Jacob disease, it is suggested that the biotest on guinea-pigs and the punctate immunoenzyme assay may be used.

[Atherosclerosis and chronic persistent virus infection]. / Ateroskleroz i khronicheskaia persistentnaia virusnaia infectsiia.

Clinical, epidemiological and serological data as well as literature reviews were used to formulate and substantiate a concept on the presence of cause-sequel (etiological) relation between chronic persistent (slow) infection caused by the Epstein-Barr herpes virus (chronic infectious mononucleosis) and atherosclerosis. Detailed findings of the etiologic agent of atherosclerosis makes it possible to plan principally new ways of its diagnosis, treatment and prophylaxis.

Conventional electroencephalography as a diagnostic tool: possibilities and limits.

After a short historical review, the Author describes some relevant new acquisitions supplied by the Electroencephalography in the latest years. In particular, some of the most typical EEG patterns observed in inflammatory and degenerative diseases, in seizure disorders and in sleep disturbances are reviewed. The Author underlines the importance of the EEG as a tool of diagnosis and functional investigation of CNS and the specific fields in which EEG may be supported by the more recent computer-assisted techniques.