Canine adenovirus type 2 infection in four puppies with neurological signs.

Four nine- to 11-week-old puppies developed respiratory and neurological signs due to an infection with canine adenovirus type 2 (cav-2); three of these were euthanased. They had moderate, diffuse pneumonia but there were no histological abnormalities in the central nervous system. Adenovirus-specific nucleic acid was detected by pcr in samples of lung and brain and the amplified product was 99.8 per cent homologous with the cav-2 reference strain Toronto a26/61. The positive pcr result was confirmed by in situ hybridisation in samples of lung, liver and spleen, but not in brain, and cav was isolated in cell culture from lung material; pcrs for canine distemper virus and canine herpesvirus-specific nucleic acids were negative, but large amounts of Bordetella bronchiseptica were isolated from lung material.

'Don't be fooled by the patient's make-up'!

One hundred and eighty-seven patients undergoing gynaecological surgery in two different international centres were reviewed daily by 'blinded' interviewers. They were analysed for the presence of nausea, vomiting, eating, mobilisation, general well-being and use of make-up. On starting to wear make-up their statement of well-being improved significantly but 1 in 3 patients in London complained of nausea, one in four still had a urinary catheter in place, required intramuscular analgesia or intravenous access, one in eight were unable to tolerate food, and one in 10 patients were pyrexial. Although wearing make-up was associated with improved well-being their was no correlation with their clinical condition.

[Fetal ultrasound--retrospect and prospects]. / Fetale Sonographie--Rückblick und Ausblick.

In a historical review the situation in obstetrics was shown in the last 3 decades. Compound-scans and "real-time-scan" were the fundamental instruments for the first sonographical diagnosis and changes in clinical practice. The demonstration of the foetal body and organs allows numerous measurements of length, areas, and volumes. Signs of foetal vital functions were studied in different aspects. Doppler-flow-measurements in different parts of the foetal circulatory system had brought to light new information. In future especially colour-coded flow measurement will show signs of foetal life such as drinking, vomiting, and urinating and will enable us to study these functions of foetal life.

[Vaginal sonography of the cervix in twin pregnancies]. / Die Vaginosonographie der Zervix bei Zwillingsschwangerschaften.

In a prospective study of 97 uncomplicated twin pregnancies, vaginosonographic cervix measurements of length, thickness and width of the internal os were performed. Furthermore, a group of 113 uncomplicated primipara was measured by vaginosonography. The twin pregnancies were examined sonographically at 4-5 week intervals between the 14th and 34th week of gestation. The results of the measurements were correlated between these two groups in accordance with duration of pregnancy and the number of deliveries. The results showed in general, that the cervical length of multipara-multiple pregnancy is longer than in the primipara-multiple pregnancy. Between the 13th and 17th week of gestation the cervix of primipara showed a length of 48.1 +/- 2.1 mm, the multipara twins showed a length of 52.3 +/- 3.4 mm. Between the 18th and 22nd gestational week, the primipara showed a cervical length of 49.4 +/- 3.6 mm and the multipara a length of 49.6 +/- 2.6 mm. In the 23rd to 27th week, the primipara had a cervical length of 39.4 +/- 2.4 mm, the multipara of 49.3 +/- 3.7 mm. From the 28th to 33rd week, cervical length was reduced in primipara to 31.2 +/- 2.9 mm, and in multipara to 42.7 +/- 5.1 mm. In the normal group of multipara, the cervical length was slightly longer. The assessment of cervical thickness showed the widest cervices in multipara gemini followed by the primipara gemini, the smallest cervices were found in primipara-single pregnancies.(ABSTRACT TRUNCATED AT 250 WORDS)

[Umbilical blood flow relations in pregnancy complications. Part 2. Pathologic index constellations]. / Umbilikale Strömungsverhältnisse bei Schwangerschaftskomplikationen. 2. Teil: Pathologische Indexkonstellationen.

In a study comprising a total of 700 pregnant women, umbilical resistance was examined. Measurements were taken at both sides of the cord. A decline in resistance was registered from the fetal abdominal wall to the placental insertion of the vessels. According to a collective of 500 patients with a normal development and outcome of their pregnancies a physiological constellation of the resistance indices could be confirmed. It was taken as a basis for the definition of pathological cases. Different pathologies were related quite clearly to a special (unphysiological) constellation of the indices.

[Umbilical blood flow relations in patients with gestosis-- gestosis-specific Doppler phenomenon]. / Umbilikale Strömungsverhältnisse bei Gestosepatientinnen--gestosecharakteristisches Dopplerphänomen.

A collective of 48 pregnant women, whose pregnancies showed signs of a pregnancy-induced hypertension or gestotic tendencies was examined by Doppler ultrasound. The subject of interest was the resistance along the umbilical cord. Measurements were taken both ends of the umbilical cords. Usually, a decline of the indices is seen, which makes the difference between the two ends (Delta F) turn out positive. Pregnancies with any sign of a gestotic development, showed elevated resistances at the placental end of the cord. The indices of the foetal abdominal insertion were just about the same. Delta F changed significantly in our group of patients. Here, the values of both sides either did not differ from one another or the placental indices even exceeded the foetal ones. We called this special constellation of umbilical indices a Doppler phenomenon characterising gestotic pregnancies.

[The value of adjuvant irradiation in lymphatic vessel invasion in patients with a cervical carcinoma in histopathological stage Ib and with negative lymph nodes]. / Zum Wert der adjuvanten Bestrahlung bei Lymphgefässeinbrüchen bei Patientinnen mit einem Zervixkarzinom im histopathologischen Stadium Ib und negativen Lymphknoten.

The present retrospective study attempts to evaluate the significance of adjuvant radiotherapy as a prognostic factor for stage Ib cervical carcinoma without lymph node metastases but with lymph-vascular space invasion. 54 patients fulfilled the inclusion criteria: histopathological stage Ib, radical hysterectomy with pelvic lymphadenectomy, negative pelvic lymph nodes and lymph-vascular space involvement. Though larger tumors were found (tumor infiltration of the cervix greater than 2/3) in the irradiated group (chi 2-test p = 0.003), there was no significant difference in the five-year overall survival (92% five-year survival without vs. 90% with adjuvant irradiation). In contrast statistical significant difference was found in recurrence-free interval between these groups (Wilcoxon test p = 0.02).

[Vaginal ultrasound in puerperium. Cervix and lower uterine segment on the 1st p. p. day and uterus 6 weeks post partum]. / Vaginosonographie im Wochenbett. Zervix und unteres Uterinsegment am 1. p. p. Tag und Uterus 6 Wochen post partum.

In this study it was tried to demonstrate the involution of the puerperal uterus vaginosonographically. A collective of 54 patients with uncomplicated delivery and afebrile, inconspicuous puerperium was vaginosonographically examined on the 1st day postpartum and also 6 weeks post partum. To describe the uterus in its whole entity on the 1st day post partum an abdominal sonography was carried out too. The vaginosonographic examinations showed on the 1st day post partum an average cervical length of 40.7 +/- 8.4 mm, a width of 31.2 +/- 4.0 mm and an internal os of 5.6 +/- 3.0 mm. The width of the lower uterine segment was 15.7 +/- 7.7 mm. The control examination after 6 weeks result in a cervical length of 31.2 +/- 4.0 mm, a width of 28.2 +/- 3.9 mm and an internal os of 3.1 +/- 1.1 mm. The reformation of cervix occurs rapidly and can be seen even on the first day post partum.

[Umbilical blood flow indices in smoking women]. / Umbilikale Strömungsverhältnisse bei Raucherinnen.

A collective of 154 pregnant women, who smoked at least 5 cigarettes a day was examined by doppler ultrasound. Measurements were taken at the two ends of the umbilical cord. The results had been compared to the physiological constellation of the resistance indices. Elevation of the PI was mainly to be registrated at the fetal abdominal insertion of the umbilical vessels. It seems to be dependent on the duration and amount of smoking. There was no correlation to be found to the fetal outcome.

[Umbilical blood flow relations in different segments of the umbilical cord. Part 1. Physiologic index constellation]. / Umbilikale Strömungsverhältnisse an verschiedenen Abschnitten der Nabelschnur. 1. Teil: Physiologische Indexkonstellation.

Based on a collective of 500 women with normal singleton pregnancies we examined the indices of flow resistance along the umbilical cord. Measurements were taken at the foetal abdominal side of the Aa. umbilicales on the one hand and at the placental insertion of the vessels on the other. According to our results we were able to establish a physiological constellation of the indices for each week of gestation, and - subsequently - for the whole duration of pregnancy. These constellations could be considered physiological. They may serve as a basis for the definition of pathological conditions.

[Imaging of premature uterine contraction in vaginal sonography]. / Die Darstellung von vorzeitigen Wehen in der Vaginosonographie.

A collective of 60 patients with clinical diagnosed contractions was vaginosonographically examined. During the ultrasound examination preterm labour was seen in 42 patients. In a control group (n = 50) preterm contractions were not detectable. The average time of the contractions was 88 seconds in the primipara group and 90 seconds in the multipara group and showed no statistical significance. In the group of the primipara a shortening of the cervical length of 17 (+/- 6) mm, in the multipara group 15 (+/- 5) mm was seen under contractions, furthermore a thickening of 8 +/- 4 mm respectively 10 +/- 5 mm. The internal os of the primipara opened 11 +/- 6 mm, of the multipara group 13 +/- 6 mm. The highest incidence of uterine contractions was found in the 32nd week. The paired students t-test showed a significance of p less than 0.001 for the cervical length, thickness and internal os and for the thinning of the dorsal uterine wall, subdividing the parity did not show statistical significance. The vaginosonography is able to help detecting preterm labour.

Definition of immunogenic determinants of the human papillomavirus type 16 nucleoprotein E7.

Specific T lymphocyte lines and T cell clones were established from peripheral blood mononuclear cells of asymptomatic seropositive individuals employing synthetic peptides which correspond to the sequence of the human papillomavirus (HPV) type 16 transforming protein E7. Specificity analysis of T cells as determined by means of [3H] thymidine incorporation after stimulation with individual peptides revealed three immunogenic determinants of E7 that are recognised in association with at least two different HLA haplotypes. One N-terminal region (aminoacids 5-18) was recognised by one T cell line. T cell clones and the corresponding T cell line established from another donor responded to a different N-terminal (17-38) and to a C-terminal region (69-86). The N-terminal sequence 5-18 and the C-terminal determinant contain a periodicity of hydrophilic and hydrophobic residues that have been found in many T cell epitopes. Phenotypic characterisation of T cell clones by indirect immunofluorescence revealed that the T cell clones expressed the CD4 surface glycoprotein suggesting that the specific E7 determinants were recognised in association with major histocompatibility complex (MHC) class II molecules. With regard to functional properties, at least three T cell clones exhibited specific cytotoxic activity towards autologous B lymphocytes transformed by Epstein-Barr virus in the presence of the relevant HPV16 E7 peptides. The implications of these results regarding the development of vaccination strategies and host-virus interaction are discussed.

Antibodies against the human papillomavirus type 16 early proteins in human sera: correlation of anti-E7 reactivity with cervical cancer.

By Western blot technique, 519 samples of human sera were tested for the presence of antibodies to the human papillomavirus (HPV) type 16 proteins E4 and E7 that had been expressed in Escherichia coli as fusion proteins. Sera were obtained from patients attending the University hospitals for reasons unrelated to HPV infections (controls), from patients with HPV-associated lesions, as well as from patients suffering from cervical cancer. Within the control population, 18.1% of them had antibodies that reacted with the E4 protein, and 3.9% of them had antibodies that reacted with the E7 protein. No sex-specific difference in the antibody prevalence was observed. The highest proportion of anti-E4 antibody-positive individuals (40.7%) was observed in the age group between 11 and 20 years. The frequency of anti-E4-positive sera was threefold higher in patients with HPV-associated genital lesions than that in age-matched controls. Antibodies against the HPV16 E7 protein were found 14 times more frequently in patients with cervical cancer, compared with age- and sex-matched controls (P less than .00001). From these data, we concluded that anti-E4 antibodies may be correlated with virus replication and that anti-E7 antibodies may represent a marker for cervical cancer development.