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Etiology and clinical manifestations have been studied in 153 adult patients with lower respiratory tract infection, and the results are presented according to clinical and radiographic diagnosis. Laboratory investigations revealed that bacterial infection, mycoplasma and chlamydia included, occurred as often in 22 patients whose clinical diagnoses of pneumonia were not evident radiographically, as in 20 patients with radiographic pneumonia. In the latter group significantly higher values of erythrocyte sedimentation rate and C-reactive protein were demonstrated. The most common pathogen was influenzavirus A, followed by respiratory syncytial virus, Streptococcus pneumoniae, and Mycoplasma pneumoniae. Chlamydia pneumoniae infection was found in 3 patients with radiographic pneumonia. The study supports the traditional view that patients with a positive chest radiograph as a rule present more serious manifestations of lower respiratory tract pathology than patients with a normal radiograph. However, as only 1/9 patients with pneumococcal infection and 2/7 with mycoplasmal infection had radiographic evidence of pneumonia, radiography alone did not seem to offer sufficient information for selecting patients for antibacterial therapy.

Readers comment on how vitamin D deficiency may affect oral health in menopause (August 2009), and on whether drugs for prostate cancer prevention are equivalent (August 2009).

Administration of triiodothyronine (liothyronine, 15 micrograms, q 8 h, for 6 treatments) caused marked decrease in serum concentration of thyroxine (T4) and estimates of free T4 (fT4) concentration in clinically normal cats. A prospective clinical study was done to evaluate the use of this suppression test for diagnosis of hyperthyroidism in cats with clinical signs suggestive of the disease, but lacking high serum concentration of iodothyronines. Twenty-three cats were confirmed as hyperthyroid on the basis of histologic changes in the thyroid gland or clinical improvement in response to administration of methimazole. Mean +/- SD serum concentration of T4 (34.3 +/- 12.7 to 31.3 +/- 11.5 nmol/L) and estimate of fT4 concentration (26.6 +/- 6.4 to 25.6 +/- 6.9 pmol/L) did not change after administration of liothyronine to these cats. Twenty-three cats were classified as nonhyperthyroid by histologic confirmation of other disease, abnormal results of other diagnostic tests that strongly supported primary disease other than hyperthyroidism, or spontaneous remission of weight loss without treatment. Mean +/- SD serum concentration of T4 (27.9 +/- 10.3 to 11.7 +/- 6.4 nmol/L) and estimate of fT4 concentration (21.7 +/- 5.4 to 10.4 +/- 4.4 pmol/L) decreased significantly (P less than 0.001) in response to administration of liothyronine. Discriminant analysis was used to identify variables from iodothyronine assays (eg, absolute concentration of T4 or absolute estimate of fT4 concentration, or changes of T4 or fT4 concentration) that provided the best diagnostic sensitivity and specificity.(ABSTRACT TRUNCATED AT 250 WORDS)

The aging cardiovascular and renal systems put the elderly patient at increased risk of end-organ damage from marked hypertension. Thus, the office-based physician needs to be skilled in making the diagnosis of a hypertensive urgency or emergency based on accurate blood pressure readings and an assessment of the heart, brain, retina, and kidney. Hypertension urgency and emergency are distinguished from each other by the clinical decision of how quickly the blood pressure must be lowered. The clinician has a wide variety of agents from which to choose for pharmacologic treatment, with the goal being a smooth and safe reduction in blood pressure.

A Legionella-like organism (strain 1762-AUS-E) was isolated from a cooling tower of an air-conditioning system in Adelaide, South Australia, Australia. The isolate was presumptively identified as a Legionella strain by its growth requirement for L-cysteine and its cellular branched-chain fatty acids. Strain 1762-AUS-E was serologically distinct in the slide agglutination test with absorbed antisera. DNA hybridization confirmed that it is a new Legionella species for which the name Legionella adelaidensis is proposed.

The origin and role of confronting cisternae (CC) have been clouded in mystery since their discovery in 1955. Early investigations suggested that CC arose from either nuclear envelope (NE) or by stacking of endoplasmic reticulum (ER) cisternae. Electron microscopic studies of mitotic HeLa cells suggest that CC are fragments of NE (Fig. 1) that arise as portions of the NE fold back on one another. Because lamin B is a NE specific protein, a monoclonal antibody to lamin B was used to probe the origin of CC. The monoclonal antibody to lamin B was then detected by utilizing a secondary antibody conjugated to the fluorochrome rhodamine which fluoresces red when exposed to UV light. Fluorescent microscopy of interphase HeLa cells demonstrates that only the NE fluoresces red when the cells are probed with a monoclonal antibody to lamin B (Fig. 2). There is no label localized in the cytoplasm which supports the evidence that lamin B is only localized to the NE in interphase cells.

Source Citation Barrett-Connor E, Mosca L, Collins P, et al. Effects of raloxifene on cardiovascular events and breast cancer in postmenopausal women. N Engl J Med. 2006;355:125-37. 16837676

Source Citation Cardozo L, Lose G, McClish D, Versi E. A systematic review of the effects of estrogens for symptoms suggestive of overactive bladder. Acta Obstet Gynecol Scand. 2004;83:892-7. 15453881

(2003) JAMA 289, 3243. Chlebowski RT, Hendrix SL, Langer RD, et al. . Influence of estrogen plus progestin on breast cancer and mammography in healthy postmenopausal women: the Women’s Health Initiative Randomized Trial. . ; . : . –53 . [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] QUESTION: In postmenopausal women, does oestrogen plus progestogen hormone therapy (HT) increase the risk of abnormal mammographic results and diagnoses of breast cancer? Randomised (allocation concealed*), blinded (clinicians, participants, data collectors, outcome assessors, and monitoring committee),* placebo controlled trial with a mean 5.6 year follow up (Women’s Health Initiative [WHI]). 40 US clinical centres. 16 608 postmenopausal women who were 50–79 years of age (mean age 63.3 y). Exclusion criteria were previous hysterectomy, breast cancer, or probable survival

Source Citation Soares CN, Almeida OP, Joffe H, Cohen LS. Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women. A double-blind, randomized, placebo-controlled tri...

An antibody-capture enzyme-linked immunosorbent assay (ELISA) for detection of antibody to turkey coronavirus (TCV) utilizing infectious bronchitis virus (IBV) antigen was developed. Anti-TCV hyperimmune turkey serum and normal turkey serum were used as positive or negative control serum for optimization of the ELISA system. Goat anti-turkey immunoglobulin G (light plus heavy chains) conjugated with horseradish peroxidase was used as detector antibody. The performance of the ELISA system was evaluated with 45 normal turkey sera and 325 turkey sera from the field and the cutoff point was determined. Serum samples of turkeys experimentally infected with TCV collected sequentially from 1 to 63 days postinfection were applied to the established antibody-capture ELISA using IBV antigens. The optimum conditions for differentiation between anti-TCV hyperimmune serum and normal turkey serum were serum dilution at 1:40 and conjugate dilution at 1:1600. Of the 325 sera from the field, 175 were positive for TCV by immunofluorescent antibody (IFA) assay. The sensitivity and specificity of the ELISA relative to IFA test were 93.1% and 96.7%, respectively, based on the results of serum samples from the field turkey flocks using the optimum cutoff point of 0.18 as determined by the logistic regression method. The ELISA values of all 45 normal turkey sera were completely separated from that of IFA-positive sera. The ELISA results of serum samples collected from turkeys experimentally infected with TCV were comparable to that of the IFA assay. Reactivity of anti-rotavirus, anti-reovirus, anti-adenovirus, or anti-enterovirus antibodies with the IBV antigens coated in the commercially available ELISA plates coated with IBV antigens could be utilized for detection of antibodies to TCV in antibody-capture ELISA.

SUMMARY. Epithelial damage in infectious bronchitis occurs early in the disease process. Heterophil infiltration into the tracheal mucosa is greatest at that time. To determine the contribution of heterophils to tracheal epithelial damage of infectious bronchitis, eight 3-wkold specific-pathogen-free chickens were made heteropenic by four daily intramuscular injections of cyclophosphamide at 75 mg/kg body weight. Infection with Massachusetts 41 infectious bronchitis virus was timed to coordinate heteropenia with peak tracheal epithelial damage. Heteropenia was monitored by total leukocyte and differential cell counts of peripheral blood. Tissue damage and heterophil infiltrate were monitored by histopathology of tissues taken at termination of the study. Heteropenic birds had lower peripheral blood and tracheal heterophil numbers than nonheteropenic birds. No difference was found in epithelial damage of heteropenic and nonheteropenic birds. Epithelial damage in infectious bronchitis is most likely due to damage by the virus and not due to the infiltrated heterophils.

A sudden death syndrome was induced in chicks and poults fed diets containing Fusarium fujikuroi, formulated to contain 0-330 mg/kg moniliformin (M) with or without the maximum recommended therapeutic concentration of monensin. Lesions of monensin toxicosis were not observed. Clinical signs were referable to cardiac dysfunction (sudden death, dyspnea, cyanosis, depression). Poults and chicks dying early in the study had no gross lesions or had lesions of right ventricular dilation. Treated poults and chicks dying late in the study or euthanatized at termination of the study had lesions of bilateral myocardial hypertrophy, usually concentric. Absolute heart weights and relative heart weights, expressed as a percentage of body weight, were significantly greater in treated birds than controls (P 0.05) than those in controls (controls, 0.28 +/- 0.08 mmol/liter; exposed 0.38 +/- 0.11-0.55 +/- 0.13 mmol/liter). Poults ingesting 80-330 mg/kg M had significantly greater serum pyruvate concentrations than controls (controls 0.33 +/- 0.09 mmol/liter; exposed 0.43 +/- 0.13-1.00 +/- 0.006 mmol/liter). The Vetronics System was used to evaluate electrocardiographic alterations in a limited number of chicks and poults surviving to the end of the feeding trial. Electrocardiographic alterations in poults and chicks fed diets containing > or = 40 mg/kg and > or = 160 mg/kg M, respectively, were consistent with ventricular hypertrophy, myocardial injury, and hypoxia. Electrocardiographic alterations were more striking in poults than in chicks. Altered myocardial metabolism due to M toxicosis, in conjunction with the unusual susceptibility of domestic poultry to altered cardiac metabolism, is believed to be the cause of the organ-specific lesions in these birds. These findings suggest that cardiac injury with subsequent alterations in cardiac electrical conductance may be a cause of the sudden deaths observed in poultry chronically intoxicated with dietary M.

SUMMARY. Cyclophosphamide (Cytoxan?) was given at 75 mg/kg body weight via daily intramuscular injections for 4 days to 3-week-old specific-pathogen-free (SPF) chickens in an attempt to determine if heteropenia could be induced in chickens. Control birds were given a like quantity of phosphate-buffered saline, the diluent for Cytoxan?. Peripheral blood heterophil numbers were determined and monitored by total leukocyte and differential cell counts. Birds were grouped in pairs on day 0 based on total leukocyte count. The number of heterophils each bird had on day 0 served as a baseline heterophil count for that bird. Thereafter heterophil numbers were determined on the last day of drug treatment and every other day until blood heterophil numbers were 20% of that bird's baseline heterophil count (heteropenia). The effects of Cytoxan? on trachea, lung, liver, kidney, bursa of Fabricius, bone marrow, spleen, and thymus were determined by microscopic examination of those tissues collected the day following heteropenia. Cytoxan? had no effect on trachea, lung, liver, kidney, and thymus. Bursa of Fabricius and spleen had decreased amounts of lymphoid aggregates. Bone marrow of Cytoxan?-treated chickens was hypocellular. The study was then repeated to determine the reversibility of Cytoxan?-induced heteropenia. Cytoxan?-treated birds were allowed to recover until blood heterophil numbers equaled or exceeded those of control birds. Cytoxan?, through bone marrow suppression, induced a reversible heteropenia that developed between treatment days 10 and 12. In addition, Cytoxan? induced a reversible lymphocytopenia between days 4 and 10 and a regenerative anemia between days 8 and 10. The ability to produce heteropenia in SPF chickens will allow the use of a heteropenic model for further study of the heterophil's contribution to the inflammatory response.

We present measurements of the middle atmospheric water vapor mixing ratio profile obtained using the ground-based Naval Research Laboratory (NRL) water vapor millimeter-wave spectrometer (WVMS) instrument at the Jet Propulsion Laboratory (JPL) Table Mountain Observatory. The measurements cover a period of 262 days from January 23, 1992, to October 13, 1992. During this campaign it was possible to retrieve useful daily mixing ratio profiles for 186 days. We thus have a nearly continuous record of water vapor mixing ratios for altitudes from approximately equals 35 to 75 km. The retrievals are obtained using the optimal estimation method. Details of the error analysis are presented, and a technique is introduced that reduces baseline effects and helps to estimate the baseline error. The high-altitude (greater than or approx. equal to 65 km) data show a sharp rise prior to the expected maximum near the summer solstice and a gradual decline in the following months. The mixing ratios generally peak between 55 and 65 km, at which point the mixing ratios are 6 - 7 parts per million by volume. The highest peaks occur in January, May, and October.

To the Editor. —Dr Smith and colleagues 1 conclude that there is an association between a first pregnancy and adverse adiposity changes independent of demographic and behavioral factors. This conclusion is flawed. One of the most important behavioral factors related to postpartum weight changes that was not discussed in this study or the accompanying Editorial 2 is lactation. The weight gain in pregnancy not only is related to fetal development, but also is in preparation for prolonged lactation. The benefits of breast-feeding to infants are well recognized and physicians have been urged to be a source of breast-feeding support. 3 The benefits of breast-feeding to the woman herself, including reduction in the risk of premenopausal breast cancer, are increasingly being recognized. 4 It is likely that the adverse weight consequences of a first pregnancy relate to inadequate lactation in the majority of women. The authors of this article noted that

Cellular response of chickens to infection with infectious bronchitis virus (IBV) was investigated by lavage of the respiratory tract of five 2-week-old specific-pathogen-free (SPF) chickens at 2, 8, 24, 48, 72, and 96 hours postinfection (PI) with either Massachusetts 41 (IBV-M41) or Australian T (IBV-T) IBV. Tissue response was monitored by microscopic examination of trachea and lung from five non-lavaged infected chickens collected at the same intervals. The total number of cells recovered by lavage from IBV-M41-infected chickens was dramatically higher than the total number recovered from IBV-T-infected chickens and uninfected controls. By contrast, the total number of cells recovered from IBV-T-infected chickens was no higher than that of the uninfected chickens. Heterophils constituted the majority of inflammatory cells recovered from both IBV-M41-infected and IBV-T-infected chickens. Heterophil numbers in IBV-M41-infected chickens paralleled total cell-number recovery, whereas heterophil numbers in IBV-T-infected birds were no higher than those in uninfected chickens. The number of lymphocytes recovered from IBV-M41-infected chickens increased 72 hours PI and continued to increase for the duration of the study. Lymphocyte numbers in IBV-T-infected chickens exceeded those in uninfected chickens only at 96 hours PI. The number of lavage macrophages in IBV-M41-infected chickens increased earlier than the number of lymphocytes but later reached a plateau. IBV-T macrophage numbers did not exceed those of uninfected chickens. Tissue damage occurred most consistently in the trachea and occurred when lavage heterophil numbers were rising or at their peak. Lavage cell recovery and composition reflected tracheal mucosa inflammatory cell infiltrate.

Avian pox virus was isolated from cutaneous pox lesions removed from turkey breeders that had been vaccinated three times with a commercial fowl pox vaccine. In three cross-immunization experiments with turkeys and two with chickens, the turkey pox isolate, designated NC5271, proved immunologically different from fowl, pigeon, and quail pox viruses. Significant protection against NC5271 virus infection and inducement of pox lesions was only attained when the homologous isolate was used as a vaccine. The potential need in the field for such a vaccine was discussed.

Monoclonal antibodies were produced against two strains of Legionella pneumophila serogroup 1. A panel of nine monoclonal antibodies were selected for their unique specificities observed in indirect fluorescent antibody tests with 130 strains of L. pneumophila serogroup 1. One monoclonal antibody was reactive with an antigen possessed by 128 of 130 strains. Two major subgroups were identified and 13 different antigen patterns were observed among the 130 serogroup 1 strains.

Levels of lymphocytic choriomeningitis virus antibody were assayed in 62 infected persons. The three tests used were indirect fluorescent antibody (IFA), complement fixation, and neutralization in mice. The sera first became positive by the IFA test, and IFA titers rapidly rose to a relatively high level, with the sera remaining positive long after the antibody detectable by complement fixation had disappeared. The IFA test appeared to be specific. The sera became positive last by the mouse neutralization test; with this test, antibody first appeared several weeks after infection. Virus-infected cells were stable when stored at -60 C, allowing diagnostic sera to be tested promptly by the IFA test. The IFA test for lymphocytic choriomeningitis antibody should increase the number of serological diagnoses, since it is not only rapid and specific, but detects cases not diagnosed by the other methods.

We used the slide agglutination test to determine the serologic relationships of 22 Legionella spp. representing 33 serogroups. Antisera prepared against 14 of the Legionella spp. contained cross-reactive antibodies (1+ or greater) at their working dilutions. Numerous cross-reactions were observed for the blue-white fluorescing Legionella spp. With only three exceptions in the latter group, cross-reactive antibodies were removed by absorption, thereby producing serogroup-specific antisera. For screening tests or for identification only to the genus level, nine polyvalent antiserum pools were prepared. Routine use of slide agglutination test reagents should expand the number of Legionella spp. that can be identified in the clinical laboratory and, at the same time, provide a simpler, less costly test procedure.

The Viburnum mineralized area lies near the southern edge of the central stable region of the North American craton. Erosion of the Precambrian preceded establishment of basins and uplifts in early Paleozoic time. Shelf deposition prevailed in the Late Cambrian and Early Ordovician, followed by emergence and erosion resulting in the post-Knox unconformity. Silurian and Devonian deposition were followed by severe erosion, and Lower Mississippian strata were laid down on a rough karst surface. Emergence since Pennsylvanian time has exposed the Ozarks and surrounding areas to continous erosion, and the region has been stable. Block faulting surrounds the core of the uplifted St. Francois Mountains; farther west, long faults and joints trend northwest and northeast.The Upper Cambrian series in southeast Missouri comprises six formations, which are, in ascending order: Lamotte Sandstone, Bonneterre Formation, Davis Formation and Derby-Doerun Dolomite (Elvins Group), Potosi Dolomite, and Eminence Dolomite. These rocks are dominantly carbonates with varying amounts of detrital material, except for the basal Paleozoic sandstone, the Lamotte. In Late Cambrian time, clastic sedimentation was dominant in the Upper Mississippi Valley, with a progressive increase in carbonates southward to the Ozarks. Although hindered by considerable distance and a paucity of subsurface data, correlations between the two regions are presented with reasonable confidence.

A Legionella-like organism (strain 1087-AZ-H) was isolated from a pleural-fluid specimen from a renal transplant patient undergoing immunosuppressive therapy. Growth characteristics and gas-liquid chromatography profiles of the isolate were consistent with those for Legionella spp. The isolate fluoresced blue-white under long-wave UV light. Strain 1087-AZ-H was serologically distinct in the slide agglutination test with absorbed antisera. DNA hybridization studies placed it in a new Legionella species, Legionella tucsonensis (ATCC 49180).

Diethylaminoethyl (DEAE)-cellulose was used as a support material for preparing bacterial cell columns. Pretreatment of the bacterial cells with formalin was essential in obtaining satisfactory adherence of the cells to DEAE-cellulose. Cross-reacting antibodies were removed from antibody preparations against strains of Streptococcus mutans serotypes a and d by adsorption on appropriate bacterial cell columns. S. mutans serotype d was further divided into two subtypes on the basis of immunofluorescent staining with conjugates of immunospecifically adsorbed immunoglobulin G. The DEAE-cellulose-bacterial cell columns were regenerated after use by desorbing the cross-reacting antibodies with low-pH buffer and were used repeatedly over and 18-month period with no detectable loss in effectiveness.

Bacterial cell columns for immunoadsorption were prepared with Streptococcus cells and triethylaminoethyl cellulose (Cellex-T) matrix material as a model system. Good column flow properties and satisfactory retention of the cells were obtained with ratios as high as 2 ml of packed cells/3 g dry weight of cellulose. Anion-exchange fractionation of whole serum by the Cellex-T was prevented by using 0.25 M NaCl in the developing buffer. Antibodies were adsorbed directly from whole serum and recovered in high yield by desorption at pH 2.3. Pre-exposing bacterial cells to formalin and washing them with acetone was necessary to ensure that they remained on the column. One strain of Streptococcus s salivarius (SS 908) was satisfactorily retained on a column only after cells were labeled with fluorescein isothiocyanate and washed with acetone. The means by which Cellex-T retains bacterial cells appears to be a combination of electronic attraction and physical entrapment.