[Intubation using a submental approach]. / Intubation par voie sous-mentale.

Authors report a case of sub-mental approach for endotracheal intubation in maxillo-facial surgery. This unusual technique was simple to perform and remained uncomplicated.

Non-essential loci in the BamHI-I and -F fragments of the HVT FC126 genome.

The sequence of BamHI-I fragment of the herpesvirus of turkeys (HVT) FC126 strain DNA was analyzed for the presence of potential open reading frames (ORFs). Four complete (ORFs 2 to 5) and 2 partial ORFs (ORFs 1 and 6) were detected. ORFs 2 and 3 were homologous to the HSV-1 UL55 and the EHV-1 gene 3, respectively. The ORF 6 was already partially sequenced by Smith et al. (Virology 207, 205-216, 1995), and was homologous to a Marek's disease virus (MDV) ORF located in a similar position (ORF 21; Ross et al., Virus Genes 7, 33-51, 1993a). No significant homology was found for the other ORFs. ORF 4 was antisense to ORF 3. Two HVT recombinants having an expression cassette inserted into two intergenic sites were generated and tested for viremia in chickens. Results demonstrated that these 2 intergenic loci are non-essential for in vitro and in vivo HVT replication. A 650 bp deletion in the repeat region flanking UL (TRL and IRL (BamHI-F)) has been identified in some DNA molecules of HVT FC126 strain. This deletion covers the entire truncated pp38 homologous ORF and the N-terminus of a small ORF which has no detectable homology with any known gene. Our results indicate that (1) this genomic region including the HVT pp38 homologue was not essential for in vitro and in vivo growth of HVT, and (2) this deletion had no apparent effect on Marek's disease (MD) protection induced by HVT.

In vivo results with a new device for ultrasonic monitoring of pig skin cryosurgery: the echographic cryoprobe.

One of the main difficulties encountered in cryosurgery is the uncertainty in the extent and depth of the tissue effectively treated during the freezing process. The objective of this study was to evaluate in vivo ultrasonic control of skin cryosurgery using a new echographic cryoprobe. An echographic cryoprobe, developed specifically for dermatology applications, combines a high-frequency (20 MHz) miniature ultrasonic transducer and a N2O-driven closed cryoprobe. Knowledge of the ultrasound velocity of frozen skin is a prerequisite for monitoring the iceball formation kinetics. Therefore, in a first study, we estimated the ultrasound velocity of frozen skin specimens. In a second step, the operation of the echographic cryoprobe was assessed, under in vivo conditions similar to those used in human therapeutics, on normal skin of three female "Large-White" pigs under anesthesia. The mean value of ultrasound velocity of frozen skin obtained by pooling the data from all the skin specimens included in this study was 2865 +/- 170 m per s. The average rates of growth (10(-2) mm per s) of the iceballs were found to be 12.2 +/- 1.0 (pig 1), 9.0 +/- 1.0 (pig 2), and 8.4 +/- 0.9 (pig 3). The echographic cryoprobe had a built-in high-frequency ultrasonic transducer that served two functions. It enabled in vivo real-time monitoring of depth penetration of the iceball and it gave important feedback to the operator or to the console relating to the rate of growth of the iceball. Automatic (i.e., operator-independent) detection of the echo signal from the freezing front and calculation of the depth penetration of the iceball was possible.

Herpesvirus of turkey recombinant viruses expressing infectious bursal disease virus (IBDV) VP2 immunogen induce protection against an IBDV virulent challenge in chickens.

Two recombinant herpesviruses of turkey (HVT) expressing the VP2 protein of infectious bursal disease virus (IBDV or Gumboro disease virus) have been constructed: vHVT001 and vHVT002. The VP2 open reading frame was inserted at the locus of the small subunit of ribonucleotide reductase gene (HSV-1 UL40 homolog) without any exogenous promoter in vHVT001 and at the locus of gl gene (HSV-1 US7 homolog) under the control of the human cytomegalovirus immediate-early promoter in vHVT002. The isolation of these recombinant viruses indicated that the deleted genes were not required for replication of HVT in chicken embryo fibroblasts. Efficacy of these recombinant viruses against IBDV strain 52/70 and Marek's disease virus (MDV strain RB1B) virulent challenges was evaluated in chickens vaccinated at 1 day of age. In the IBDV challenge, a good protection against mortality and bursal gross lesion was observed in vHVT002-vaccinated chickens: 100% with 10(5) PFU dose and 60% with 10(4) PFU dose; in contrast, only a weak level of protection was achieved after vaccination with vHVT001. Protection levels against MDV challenge obtained with vHVT001 and vHVT002 were low (around 10%) compared to that induced by the parental HVT (84%). In spite of the low protection level against MDV, this is the first report which describes induction of full protection against IBDV with a single inoculation of a recombinant virus.

[Difficult intubation: a prospective evaluation of the Mallampati and Wilson tests]. / Intubation difficile: évaluation prospective des tests de Mallampati et de Wilson.

This prospective study aimed to evaluate in 849 patients the Mallampati and Wilson scores for predicting a difficult intubation. All scheduled patients were included. Induction and tracheal intubation were carried out as usual. Intubation was deemed to have been difficult if any special procedure had been required (external compression excepted); difficult laryngoscopy was defined as grade 3 or 4 on the Cormack-Lehane scale. In accordance with these criteria, less than 36% of patients with difficult intubation or laryngoscopy were detected, with a high false positive rate (more than 75%) but a good negative predictive value (more than 90%). This study was not concordant with the results of the original studies. However, data from literature show a great variability of results between studies. Many factors may contribute to this variability: differences between samples of patients, evaluation of Mallampati or Wilson scale, protocols of induction and intubation or characterization of difficult intubation. This study suggests a poor reliability of the two tests.