Modified abaxial sesamoid nerve block provides enhanced proximal diffusion compared to basisesamoid block and lower proximal diffusion than traditional low plantar nerve block in equine hind limbs: ex vivo and in vivo study.

OBJECTIVE: To determine the proximal diffusion distance of radiopaque contrast medium and mepivacaine/methylene blue solution and incidence of inadvertent intrasynovial and intravascular injections of modified sesamoid nerve block (MASB) when compared with traditional plantar nerve analgesia techniques of the equine distal hind limb. SAMPLE: Ex vivo model: 18 hind limbs; and in vivo model: 5 horses in a crossover study. METHODS: In the ex vivo model, a mepivacaine/methylene blue solution was used to compare the diffusion distance between MASB, basisesamoid block (BSB), and traditional low plantar block (TLPB). Ten minutes after injection, skin was dissected and proximal diffusion distance of the dye patch was measured. In the in vivo model, both hind limbs were injected with radiopaque contrast medium with either MASB or TLPB. Ten minutes after injection, a radiograph was acquired and the proximal diffusion of the contrast medium patch was measured. RESULTS: In the ex vivo model, solution proximal diffusion distance for MASB was significantly longer than BSB (P < .050) and significantly shorter than TLPB (P < .050). Both techniques reached the proximal aspect of DFTS similarly (P = .289), and no difference in the incidence of intrasynovial or intravascular injections was observed (P = .292). In the in vivo model, contrast medium proximal diffusion of MASB was significantly shorter than TLPB (P < .050). The proportion of injections that diffused subcutaneously to the proximal aspect of the proximal pouch of the DFTS was not significantly different between techniques (P = .136). No difference in the incidence of DFTS intrasynovial or intravascular injections was observed (P = .305). CLINICAL RELEVANCE: MASB presented significantly more proximal diffusion than BSB and less proximal diffusion than TLPB, consistently reached the proximal aspect of DFTS, and presented a very low risk of intrasynovial and intravascular injections.

Pathological characteristics for the diagnosis of Pneumocystis carinii pneumonia. A retrospective autopsy study.

The clinical records of 63 patients who during the period 1980-1983 showed pneumocysts in lung specimen imprints obtained at autopsy have been reviewed in order to establish possible characteristics for the diagnosis of Pc pneumonia. Autopsies were performed at 2 Copenhagen hospitals, Rigshospitalet and the Finsen Institute. The 63 Pc-positive cases included 9 with blood diseases, 27 with solid tumors, 5 with immunological disorders and 22 with other diseases. The characteristic extensive changes in the lungs in Pc pneumonia included increased firmness, dark red/brown or black/grey colour of sectioned areas, stasis and edema sometimes excessive, and foci of white/grey or red/brown areas giving the lung a marbled or speckled appearance. The content of air was always decreased. The microscopic changes reported included intra-alveolar eosinophilic material, an intra-alveolar transudate containing macrophages and very few neutrophilic granulocytes, dilated capillary tubes, stasis and edema, thickened alveolar septae and peri-alveolar or diffuse fibrosis. The chest X-rays showed no specific features, and the infection had been subclinical in all cases; the only evidence of Pc infection was the demonstration of pneumocysts in imprints of lung specimens stained with toluidine blue in combination with observations during pathology. The diagnosis depends to a great extent upon a keen alertness in addition to the information given in the clinical record.

Survival periods in male and female Wistar rats with steroid-induced Pneumocystis carinii pneumonia.

Rats treated with corticosteroids developed Pneumocystis carinii pneumonia. Male rats showed the same mortality (100%) as female rats, but the female rats survived on average 11.7 days longer than the male Wistar rats.

Antibody to human papilloma virus in Danish dentists.

The aim of this study was to investigate the seroprevalence of antibody to human papilloma virus (HPV) among Danish dentists in order to determine whether this virus constitutes an occupational hazard for dentists. Serum samples from 452 Danish dentists were tested for antibody against a common capsid antigen to HPV by a complement fixation reaction. Nine (2.0%) were seropositive. Dentists' odds ratio for seropositivity was after adjustment for age 0.6 (90% confidence interval: 0.3-1.4) compared to that of voluntary blood donors. In conclusion, Danish dentists do not seem to be at an increased risk of becoming infected with HPV.

Pneumocystis carinii in human lungs at autopsy.

To get some information about the prevalence of Pneumocystis carinii in the Danish population we have examined autopsy lung biopsies from patients at 2 large hospitals in Copenhagen, Righospitalet (RH) and Finseninstituttet (F), in a 5-year period from 1979 to 1984. Imprints made from the biopsies were stained with the toluidine blue O method and examined microscopically for pneumocysts. A total of 1762 patients were examined and pneumocysts found in 83 (4.7%); at RH 54 (4.9%) of 1106 patients and at F29 (4.4%) of 656 patients. A possible influence of certain climatic factors on the prevalence of pneumocysts in humans was shown: low temperature, low vapour pressure and low relative humidity seem to be correlated with low prevalence of pneumocysts. The general use of trimethoprim-sulfamethoxazole in the hospitals may possibly influence the prevalence of pneumocysts: the amount requested in the period of the investigation is negatively correlated with the prevalence of pneumocysts.

Locally injected bleomycin in the treatment of warts.

To evaluate the clinical effectiveness of intradermally injected bleomycin in saline and oil versus placebo, a double-blind study of 62 patients with 108 warts was made. Although bleomycin has been recommended in previous reports, we found no difference between the group treated with bleomycin and the placebo group.

Production of antiserum to respiratory syncytial virus polypeptides: application in enzyme-linked immunosorbent assay.

By use of crossed immunoelectrophoresis techniques, respiratory syncytial (RS) virus-specific precipitates were produced between RS virus cellular antigen [solubilized in tris(hydroxymethyl)aminomethane-glycine buffer, pH 9] and antiserum raised in rabbits against semipurified RS virus. When these precipitates were employed as antigens for further immunizations in rabbits, antibodies (anti-RSV-precip.I) were produced which reacted with only one RS virus antigen when tested by the crossed immunoelectrophoresis technique. Precipitates obtained between RS virus cellular antigen (labeled with L-[35S]methionine) and anti-RSV-precip.I were examined by polyacrylamide gel electrophoresis, which showed that anti-RSV-precip.I precipitated RS virus polypeptides of molecular weights 28,000 to 84,000. Anti-RSV-precip.I was employed as capture antibodies in the enzyme-linked immunosorbent assay, in which RS virus cellular antigen was used as the second layer. Determination of human RS virus immunoglobulin G antibodies by this enzyme-linked immunosorbent assay technique showed a high degree of sensitivity, specificity, and reproducibility.

In vitro susceptibilities of normal human skin fibroblasts to oncoviruses, and the decreased susceptibility to HSV of fibroblasts from untreated Hodgkin's patients.

Fibroblast cultures established from the skin of 56 healthy controls and 15 untreated Stages I and II Hodgkin's patients (HD) were studied in their 3rd, 4th and 5th in vitro passage with respect to transformation with Simian sarcoma virus (SSV) and SV40 and with respect to replication of herpes simplex virus (HSV) Types 1 and 2, pox virus and interferon release. Susceptibility to the 5 viruses varied independently, except for an inverse correlation between susceptibility to SSV and HSV. HD cultures showed a depressed replication of both types of HSV. There was a borderline (P = 0.02) correlation between magnitude of HSV replication and presence of HL-A type B-w44, but this does not explain the HD control difference. Furthermore, the level of serum antibodies to HSV common antigen was not related to magnitude of in vitro replication. The results thus speak against generally enhanced cellular susceptibility to HSV as a reason for the high titres of serum antibodies to HSV in HD patients.

Optimized enzyme-linked immunosorbent assay for detection of human and bovine rotavirus in stools: Comparison with electron-microscopy, immunoelectro-osmophoresis, and fluorescent antibody techniques.

Detection of human and bovine rotavirus in stools is described using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) with poly-styrene microtest plates as solid phase, immunoglobulin fraction of rabbit antiserum to rotavirus (human) as catching antibody, and the same reagent labelled with horseradish peroxidase as conjugate. The ELISA has been optimized with regard to simplicity, rapidity, sensitivity, and specificity. In a comparative study, stool specimens from 81 infants and children and 92 neonatal calves with diarrhoea were tested for rotavirus by ELISA, electron microscopy (EM), immunoelectro-osmophoresis (IEOP), and fluorescent antibody technique (FA). The relative sensitivity of the different assays for human and bovine rotavirus was: EM 68%, 76%; IEOP 80%, 76%; FA not determined, 85%; and ELISA 86%, 98%, respectively. Less than 1 ng of purified human rotavirus could be detected in ELISA, whereas 100 ng was the minimal amount detected by IEOP. It is concluded that the developed ELISA is a simple, rapid, reliable, and sensitive method for the diagnosis of human and bovine rotavirus infections.

Humoral and cellular immunity in sarcoidosis.

The Kveim reaction was studied in vivo in 50 patients with sarcoidosis. Commonwealth Serum Laboratories Kveim material and a new Danish Kveim material gave 14 and 8 positive reactions respectively, as well as 6 and 8 equivocal reactions. Forty-six of the patients were also tested in vitro for cell mediated immunity to the Danish Kveim material, using both the leucocyte migration agarose technique and the capillary technique. No significant migration inhibition or stimulation were found. A tuberculin skin test was performed in 49 of the patients, and in 45 a dinitrochlorobenzene sensitivity titer was determined. Both tests revealed a depression of the cell mediated immunity. The serum levels of immunoglobulins IgG, IgA, IgM, IgD, and IgE were determined. The serum of each patient was also examined to determine if organ-non-specific and granulocyte-specific antinuclear factors of IgG class, antibodies against native DNA, rheumatoid factor, mitochondrial antibodies, antibodies against thyroid cytoplasm, and parietal cell antibodies were present. IgG levels were above normal in 28 patients; IgE was above normal in 10 patients, 4 of whom were atopics or had an atopic disposition. Organ-non-specific antinuclear factors were present in 17 patients.

Rapid diagnosis of rotavirus infections: comparison of electron microscopy and immunoelectroosmophoresis for the detection of rotavirus in human infantile gastroenteritis.

Eighty-seven faecal samples from infants and children suffering from acute gastroenteritis were investigated for the presence of rotavirus by immunoelectroosmophoresis (IEOP) and electron microscopy (EM). Sixty-one % of the samples contained rotavirus antigens when examined by IEOP whereas only 50% were diagnosed as positive EM. However, where it was possible to perform EM within the same day that the sample was received it took 24 h to establish the diagnosis by IEOP. The high sensitivity of the IEOP method was achieved by application of antiserum produced in rabbits to rotavirus immunoprecipitates. The specificity and sensitivity of the diagnostic antiserum produced were tested by application of different immunoelectrophoretic methods.

Photodynamic inactivation of verrucae vulgares. I.

Verrucae vulgares (v.v.) stained in vivo and in vitro with 0.1% and 1% proflavine in 100% dimethylsulphoxide (DMSO) and 0.1% and 1% neutral red in 100% DMSO were examined grossly and by fluorescence microscopy. Light transmission studies were made using both whole v.v. embedded in methacrylate and 5 micrometer frozen sections. The dyes were seen to penetrate to the epidermal and dermal structures in the in vivo stained v.v. and accumulate in the cell nuclei. The average concentration of neutral red in the v.v. was estimated to be 2 X 10(-5) M. The concentration of proflavine was lower than that, but exceeded 10(-6)M. There was diffuse staining throughout the in vitro stained warts. From 400-600 nm the warts were penetrated by at least 1% of the light directed toward their surfaces.

Photodynamic inactivation of verrucae vulgares. II.

Photodynamic inactivation therapy, consisting of a double-blind, paired comparison treatment schedule, was used in treating 56 patients for recalcitrant, symmetrical verrucae vulgares. 0.1% proflavine in 100% dimethylsulphoxide (DMSO) and 0.1% neutral red in 100% DMSO were used as active dyes, and 1% picric acid in 100% DMSO and 1% color ruber in 100% DMSO and 1% color ruber in 100% DMSO served as corresponding placebos. A Westinghouse sunlamp and black light were used to irradiate the warts dyed with proflavine and its placebo, and the warts dyed with neutral red and its placebo were irradiated with an ordinary light bulb (Osram 588597). 50 patients completed the treatment. 10 of the 27 patients treated with proflavine and 10 of the 23 patients treated with neutral red were cured by the end of an 8 week period, with the warts disappearing simultaneously from the actively as well as the placebo-treated side. Complement fixing antibodies against wart virus were detected in one of the cured patients and 2 who were treatment failures.

Immunological studies in sarcoidosis: a comparison of disease activity and various immunological parameters.

We found it valuable to separate the heterogeneous types of sarcoidosis into more homogeneous groups on the basis of activity and duration of the disease. This view is supported in the present study by the finding of a marked depression of T-cell function in patients with chronic-active sarcoidosis. Patients with acute or chronic-inactive disease had only moderately depressed T-cell function as measured by tuberculin skin test and DNCB index. These results are in agreement with those of some previous investigations. The remainder of the abnormal findings, particularly low total number of circulation T lymphocytes, elevated serum IgG levels, and presence of autoantibodies, could not be correlated to disease activity, extent of the disease, or T-cell function. We have found no explanation for the presence of autoantibodies but suspect that they may be nonspecifically related to the disease process.

Immunological studies in sarcoidosis: a comparison of in vivo and in vitro Kveim tests.

No migration inhibition was observed in the 46 patients or the 12 controls when the Danish Kveim antigen was used in the LMAT. No migration inhibition was found in 23 of the same patients when the LMT was employed using the same antigens (Table 3).