[Interindividual differences in personality and behavior and subjective health problems in shift workers].

A total of 604 experienced shift workers were administered a battery of questionnaires in order to examine the relationships between the shift workers' features and subjective health complaints taken as signs of intolerance to shift work. The individual difference measures included: hard-driving and competitiveness, speed and impatience, relaxed, efficiency, flexibility of behaviour, evening, rigidity of sleeping habits, vigorous, languidness, inveterate, flexibility of habits, neuroticism, extraversion, lie-scale, age and work experience. The subjective health complaints included: generally poor health, musculo-skeletal, respiratory and psychosomatic-digestive complaints, and digestive problems. Correlation and multiple regression analyses showed that in workers some personality features and patterns of behaviour were related to the subjective health complaints. More health complaints were placed by workers who were emotionally unstable, less relaxed, inefficient, rigid (e.g. unable to control the behavioral arousal level), hard-driving and competitive, speedy and impatient (A-types), rigid in sleeping and other life habits, languid, older and with longer shift work experience.


[Levels and profiles of polycyclic aromatic hydrocarbons in Zenica in relation to the seasons].

Twelve polycyclic aromatic hydrocarbons were measured in samples of airborne particles collected in the town of Zenica in the Republic of Bosnia and Herzegovina every third or fourth day throughout the year. The concentrations were especially high in winter when in addition to permanent industrial emissions those from individual heating systems were also present and when owing to climatic and orographical circumstances temperature inversions occurred more frequently. The profiles of polycyclic aromatic hydrocarbons i.e. their ratios to benzo-a-pyrene did not demonstrate great seasonal variations with the exception of fluoranthene and pyrene. The mean annual concentrations (winter to summer concentration ratios) were higher than in the areas where there was no permanent source of emissions.


[Respiratory symptoms and pulmonary ventilating capacity in professional drivers and mechanics].

The prevalence of respiratory symptoms and ventilatory capacity were studied in 116 drives and 119 mechanics. The drivers and mechanics demonstrated a significantly higher prevalence of most chronic respiratory symptoms than control workers. Among drivers smokers there was a significantly higher prevalence of most chronic respiratory symptoms than among non-smoking drivers. Drivers and mechanics with more than 10 years of service also showed a higher prevalence of respiratory symptoms than those employed for less than 10 years. A certain number of subjects complained of acute symptoms during work shift. All ventilatory capacity tests, particularly FEF25, demonstrated lower values in comparison to predicted normal values. Our data for drivers and mechanics indicate that long-term employment, particularly in combination with smoking, may cause the development of respiratory symptoms and changes in lung function.


[The position and role of occupational medicine and specific health care of workers].

Specific care for workers' health has been largely deficient during the past decade, despite the existing legislation. Consequently, the protection of workers' health has been seriously endangered, with the resultant long-term damage. The main reasons for this were the absence of clearly defined responsibilities regarding the financing and execution of the specific health care measures as well as lack of penalty for their non-implementation. As a result, there was indifference on the part of enterprises, indifference and inadequate organization of occupational health services as executors of the specific health care measures, and indulgence on the part of the court, inspecting services and other competent bodies. The situation could be helped only if a completely different approach, suited to the market economy, were adopted. The State should prescribe only the general rules, while the carrying out of specific health care should, with rare exceptions, be left to the interested parties, enterprises in the first place, and to the law of supply and demand. Naturally, such approach can be successful only in the legal State where the ownership of enterprises and professional services is strictly defined and the court and inspection services are free to act independently. Only then will the responsibility of the owners in respect to the breaking of rules, impairing workers' health and unprofessional work of health and other personnel be raised to an appropriately high level. In such an environment the place and role of occupational health activity as well as its name are bound to see a radical change.


[Evaluation of the quality of life of disabled workers based on the most frequently used type of health care].

An investigation was conducted among the dock workers from the port of Rijeka, where disabled workers made 13.1% of the total number of the employed. The most common causes of disablement were musculo-skeletal and connective tissue diseases (27%), injuries (20%) and diseases of the nervous and circulatory systems (13%). Chronic diseases in these workers whose mean age was 43.8 years were twice as frequent as in other workers (mean age 39.7 years). The average working span of disabled workers was 12.2 years, compared to 8.9 years of the rest of the working population. Analysis showed that in the year after disability assessment, workers with reduced working capacity visited their physicians 2.1 and specialists 1.7 times less often than the other workers. In general, the rate of absenteeism in the year following the assessment of disability was reduced 3.5 times. All the differences were very significant, (P < 0.01). Results lead to the conclusion that medical and social rehabilitation of disabled workers as well as their integration into the working environment were very successful, which undoubtedly had a positive impact on the quality of their life.


[Recommendations in relation to shift work].

The purpose of the recommendations is to decrease as much as possible physiological, psychological and social problems connected with shift work. To achieve this goal working hours should be organized to take account of shift workers' tolerance to shift work. When recruiting new shift workers certain personal characteristics that make work in any shift work system inadvisable should be checked. As shift work can be considered to be an additional load, shift workers' health requires regular checking-up. If there are signs of health impairment, the workers should be removed from night shift work permanently or at least temporarily. The shift workers' free time should be arranged so as to facilitate recovery from shift work, especially after night shift. To decrease the workload during the night shift, if possible, workers should be given opportunity to take naps during work.


[The effect of aluminum on human health].

The paper aims at reviewing recent knowledge of the pathophysiological mechanisms involved in aluminium poisoning which is often manifested as anaemia, osteopathy and encephalopathy. In order to clarify the mechanisms of aluminium toxicity its metabolism and ways of human exposure are also described. The immunosuppressive effect as well as certain anticarcinogenic effects of aluminium are still insufficiently well known. It is pointed out that different chemical elements can exert a protective action during aluminium poisoning.


Regional cerebral oxygen consumption, blood flow, and blood volume in healthy human aging.

Using high-resolution positron emission tomography and the oxygen 15 continuous inhalation method, we examined the changes in cerebral metabolic rate of oxygen, blood flow, blood volume, and oxygen extraction fraction as a function of age in 25 optimally healthy, unmedicated volunteers who ranged in age from 20 to 68 years. Subjects were strictly selected for absence of cerebrovascular risk factors, dementia, or mental disorders; they had neither biological nor clinical abnormalities, and no focal anomaly on computed tomographic scan. Regions of interest were determined according to the anatomical structures defined on corresponding computed tomographic scan cuts obtained using a stereotaxic head-positioning method. This same method was also used for positron emission tomographic imaging. There was no significant effect of aging on PaCO2 values, hematocrit, arterial blood pressure, cholesterol and triglyceride levels, and blood glucose levels. In most cerebral cortex gyri, the cerebral metabolic rate of oxygen significantly decreased with age according to a linear pattern, with the same magnitude (about -6% per decade) in all four lobes and on both sides. This effect of age on cortical cerebral metabolic rate of oxygen persisted when the possible influence of cortical atrophy, gender, and head size were partialled out. In contrast, the white matter, deep gray nuclei, thalamus, and cerebellum were not significantly affected. The cerebral blood volume declined with a similar pattern to cerebral metabolic rate of oxygen, while changes in cerebral blood flow were less significant, presumably because of larger variance of data across subjects.(ABSTRACT TRUNCATED AT 250 WORDS)


Neurocognitive effects of aluminum.

The neurocognitive effects of aluminum (Al) were studied in 35 hemodialysis patients. Higher Al levels were associated with a decline in visual memory. As Al levels increased, patients with lower vocabulary scores (a measure of premorbid intelligence) showed a decline in attention/concentration, frontal lobe functions, and on several neurocognitive measures, while those with higher vocabulary scores revealed no Al-related decline. These results suggest that individuals with lower verbal intelligence may possess less well-developed compensatory strategies to overcome the neurocognitive effects associated with Al. These data also indicate that Al is neurotoxic and, therefore, potential sources of environmental Al should be identified and eliminated.


Parietal pseudothalamic pain syndrome. Clinical features and anatomic correlates.

We studied six patients who developed spontaneous hemibody pain following lesions of the parietal lobe. The pain was characterized as burning or icelike, and was associated with impairment of pin and temperature appreciation. Computed tomographic scanning showed that the common area of involvement in all cases was the white matter deep to both the caudal insula and the opercular region of the posterior parietal cortex. We suggest that disruption of the interconnections between these cerebral cortical areas (including the second somatosensory representation, SII) and the thalamus, particularly the intralaminar and ventroposterior nuclei, may be responsible for producing a thalamocortical disconnection syndrome with spontaneous pain as its clinical manifestation.


Neurologic signs in Alzheimer's disease. Results of a prospective clinical and neuropathologic study.

Neurologic signs and their neuropathologic correlates were examined in a sample of 56 patients with autopsy-proved Alzheimer's disease (13 men, 43 women; mean age at death, 83.1 years; range, 67 to 96 years) from a prospective longitudinal study. Full-range regular rigidity with cog-wheeling was found in 20 patients and was significantly associated with lower neuron counts in the substantia nigra and with the presence of Lewy bodies in the brain stem and neocortex. Twelve patients with myoclonus had a younger age at onset, a lower age at death (mean, 78.6 years), and lower neuron counts in the serotoninergic dorsal raphe nucleus and in the noradrenergic locus coeruleus than did the patients without myoclonus. Generalized motor seizures were reported in six patients, and they had significantly lower counts of pyramidal cells in cortical layers III through IV of the parietal cortex (area 7) and slightly decreased pyramidal cell numbers in the parahippocampal gyrus (area 28). The 19 patients with a positive grasp reflex had an earlier onset of illness and a significantly inferior performance on the Mini-Mental State examination and Cambridge Cognitive Examination tests. They, and 25 patients with a positive snout reflex, had significantly lower counts of large pyramidal cells in layers III through V of the frontal cortex (area 32). These results indicate that different neurologic symptoms in Alzheimer's disease can be related to disproportionate neuronal degeneration in functionally different brain areas.


Matching-to-sample deficits in patients with senile dementias of the Alzheimer and Lewy body types.

Using a computerized matching-to-sample task, nonverbal visual recognition memory was studied in two groups of patients suffering from senile dementia of the Alzheimer type or the recently described senile dementia of the Lewy body type. The patients' cognitive abilities had been shown to be similar according to a number of standard psychometric tests. The two groups did not differ with respect to simultaneous matching-to-sample performance, although both were impaired relative to control. The group with senile dementia of the Lewy body type was severely impaired, relative to the group with senile dementia of the Alzheimer type, when delays (delayed matching to sample) were introduced. The findings suggest that short-term mnemonic processes, mediated by temporal lobe structures, could be more severely affected in senile dementia of the Lewy body type.


Contributions of the left intralaminar and medial thalamic nuclei to memory. Comparisons and report of a case.

A patient complained of memory disturbance after a small left thalamic infarction. Neuropsychological testing revealed her memory to be normal provided that she was allowed to rehearse or use semantic encoding strategies. When these strategies were prevented, her performance was impaired. Mapping of the lesion demonstrated involvement of the caudal intralaminar nuclei (centre médian and parafascicular nuclei), and portions of the medial nuclei (medioventral [reuniens], centromedial, and the most inferior aspect of the mediodorsal nucleus). The majority of mediodorsal nucleus, the mammillary bodies, the mammillothalamic tract, and the anterior thalamic nuclei, were spared. A comparison among our patient's performances and those of alcoholic Korsakoff patients, patient NA, and amnestic patients with circumscribed diencephalic lesions suggests that there are two distinct behavioral and anatomic types of memory impairment associated with diencephalic lesions. The severe amnesia associated with damage to the mammillary bodies, midline nuclei, mammillothalamic tract, and/or dorsomedial nucleus of the thalamus (eg, Korsakoff and NA) is characterized by encoding deficits that never approximate normal performance. The memory disturbance associated with damage to the intralaminar and medial nuclei of the thalamus is milder and is characterized by severe distractibility.


Gist recall in multiple sclerosis.

This study examined gist recall (memory for important story ideas) in patients with multiple sclerosis. Twelve patients with clinically probable or definite multiple sclerosis and 10 neurologically intact control subjects were read prose passages from the Wechsler Memory Scale-Revised Logical Memory subtest. The idea units from these passages contained low, medium, and high information content to the stories. In comparison with the control subjects, the patients recalled fewer total elements over immediate and delayed conditions. However, similar to controls, they recalled more ideas that were of high rather than low or medium importance. These results suggest that semantic sensitivity to important ideas of narratives is a relatively preserved feature in multiple sclerosis.


Humoral and cellular immunologic study of cerebrospinal fluid in a patient with Behçet encephalitis.

To study the immunopathogenesis of neuro-Behçet syndrome, we performed serial cerebrospinal fluid (CSF) examinations in a patient with Behçet's syndrome and involvement of the central nervous system. Before and after immunosuppressive treatment, we measured the CSF indexes of immunoglobulins (Ig), and the third (C3) and the fourth (C4) component of complement, and quantified immune complexes and lymphocyte subsets in CSF and peripheral blood. During active encephalitis, humoral abnormalities were intrathecal production of IgM and, to a lesser degree, IgG and IgA, presence of immune complexes in CSF but not in peripheral blood, intrathecal C3 production, and elevated CSF C3 and C4 concentrations; lymphocyte subset analysis showed an increased CSF CD8+ T-cell percentage, in combination with slightly increased PB CD3+ and CD8+ T-cell subsets. After effective immunosuppressive treatment, humoral and cellular CSF values were normal. We conclude that intrathecally produced immunoglobulins, immune complexes, and C3 as well as CD8+ T cells are likely to participate in the development of Behçet encephalitis.


Central nervous system involvement in the eosinophilia-myalgia syndrome.

A patient with eosinophilia-myalgia syndrome developed progressive central nervosa system involvement that did not improve despite discontinuation of L-tryptophan therapy. Neurologic impairment was manifested initially by spastic monoparesis, which was improved by treatment with methyl-prednisolone and hydroxyurea. Recurrence of weakness was accompanied by gait ataxia, dysphagia, and complaints of a gradual decline in memory and concentration. Neuropsychological testing identified a broad pattern of cognitive deficits suggestive of a subcortical dementia, and magnetic resonance imaging demonstrated multiple high-signal lesions in the white matter. Cognitive deficits appear to be underrecognized in patients with the eosinophilia-myalgia syndrome. The response of our patient's initial symptoms to corticosteroid therapy suggests a possible role for autoimmune mechanisms in the pathogenesis of central nervous system involvement in the eosinophilia-myalgia syndrome. Neuropsychological evaluation should be performed in patients with cognitive complaints to delineate the full spectrum of central nervous system impairment associated with the eosinophilia-myalgia syndrome.


Longitudinal neurophysiologic studies in a patient with metachromatic leukodystrophy following bone marrow transplantation.

We describe a girl with late infantile metachromatic leukodystrophy. The patient has been followed up with serial neurologic and neurophysiologic examinations for 8 years following bone marrow transplantation, which she underwent when she was 4 3/4 years old. Her older sister died from metachromatic leukodystrophy at the age of 8 years, whereas our patient has retained significant cognitive and motor skills. Serial neurophysiologic studies initially demonstrated continued deterioration after the bone marrow transplantation, but since then, most results have remained stable or improved. Although, to our knowledge, there have been no previous serial studies of metachromatic leukodystrophy, individual case studies suggest that these findings in our patient are very unusual. With the advent of possible treatment for this condition, there is a need for further serial neurophysiologic studies to characterize the natural progression and the possible detection of progression or reversal with treatment.


The importance of visual feedback on the accuracy of jaw and finger positioning in man.

The anatomical position of the mandible means that direct visual feedback is not possible. To clarify the role of visual information, several jaw- and finger-positioning tasks were designed, both in a 'free-movement' and an 'isolated' (arm or head fixed) state, with or without a visual feedback display of the target position. The subjects had to position the mandible or the index finger of the preferred hand on to a movable metal bar and to maintain a defined position coinciding with the target level provided on an oscilloscope screen. The position signal was tape recorded and computer analysed off-line. Digital filtering differentiated between the drift and the oscillations around the target (root mean square). The results demonstrated a lack of precision in the free-movement, finger-positioning task after withdrawal of visual feedback. For jaw opening and closing muscles, position control was less impaired when a visual feedback display was abolished. It was suggested that the efficiency of jaw positioning is not primarily determined by visual feedback.


Mathematical definition of the curve of Spee in permanent healthy dentitions in man.

The intrinsic morphology of the mandibular curve of Spee (i.e. independent from reference planes) was studied in 50 men and 45 women with sound dentitions. Left and right curves were reconstructed by a second-order quadratic interpolation of buccal cusp tips. Gender differences were found in both sides, while side differences were found only in the male sample. Male and female curves had similar concavities, but the position of the interpolating second-order quadratic curve relative to the dental arch was significantly different. The right and left male sides showed different concavities, the right-hand side being flatter than the left. Male curves appeared larger than female ones, and the left-hand side was significantly larger than the right regardless of gender. The reported second-order quadratic curves could be used as reference for prosthetic and orthodontic reconstructions.


Changes in protein kinase C activity in rat calvarial bone cells cultured in a low-calcium environment.

This enzyme activity was examined in bone cells cultured for 8-10 days; the calcium concentration was 1.87 +/- 0.05 (n = 10) mM in the control medium and 0.34 +/- 0.02 (n = 10) mM in the low-calcium medium. The activity was significantly lower in the low-calcium group than in the control (p less than 0.01). The cytosolic fraction decreased more than the membranous fraction. After restoration to a regular calcium environment, the protein kinase C activity recovered rapidly to near the control value. The extent of recovery was greater in the membranous than in the cytosolic fraction. These results suggest that the enzyme was inhibited in bone cells placed in a low-calcium environment, while the sensitivity in the membrane was enhanced.


The effect of dietary factors on intradentinal dye penetration in the rat.

Fluorescent dye injected systemically into rats penetrated the dentinal tubules of molar teeth in a dynamic fashion. The presence of dye was established using histological and fluorescence microscopy techniques. The rate of intradentinal dye penetration was dependent on dietary factors: it was high in rats chronically fed Purina rat chow and low in rats fed a cariogenic, high-sucrose diet. In addition, parotidectomized rats showed low levels of intradentinal dye penetration, even though they were maintained on Purina chow. One and 2 ml of plasma from Purina-fed rats were effective in stimulating the dye penetration in intact and parotidectomized rats, whereas 2 and 4 ml of plasma from rats fed a high-sucrose diet were ineffective when infused in either intact or parotidectomized animals. The results suggest that rats fed Purina chow have a significantly higher titre of a circulating, dye penetration stimulating factor than animals fed a high sucrose diet. This circulating factor could be the equivalent of the parotid hormone isolated from porcine tissue. It is suggested that dietary factors may affect secretion of a parotid hormone and thereby regulate the rate of dentinal fluid movement. There is therefore the prospect of a functional relationship between diet, the regulation of dentinal fluid flow by an endocrine system and dental health.


Serum antibody responses in human periodontitis to cellular components of Capnocytophaga.

Serum levels of IgM, IgG and IgG-antibody subclasses directed against cell envelopes, lipopolysaccharides and cytoplasmic fractions from Capnocytophaga sputigena, C. gingivalis and C. ochracea were examined in age-, race- and sex-matched periodontally healthy (n = 25) subjects and subjects with adult periodontitis (n = 25). The envelopes and cytoplasmic fractions were obtained by ballistic disintegration of the cells and ultracentrifugation. Cell envelopes were treated with DNase, RNase and lysozyme. Lipopolysaccharides were obtained by hot phenol-water extraction and treated with DNase and RNase. The relative levels of the antibodies in response to the cell fractions were measured by the streptavidinbiotin micro enzyme-linked immunosorbent assay. Both groups showed IgM and IgG antibodies to each fraction of the three Capnocytophaga species, but the frequency of positive IgG subclass responses varied. The IgG4 responses were lower than the other subclasses. There were no significant differences between the IgM antibody levels of the two groups. However, the adult periodontitis group had significantly lower IgG antibody titres to the cell envelopes and cytoplasmic fractions of C. gingivalis and C. ochracea, and lipopolysaccharide of C. gingivalis. These results were reflected in the depressed levels of IgG1 and/or IgG2 to these cellular fractions from the same bacterial species. The adult periodontitis group also showed a lower level of IgG1 to the cytoplasmic fractions of C. sputigena without any depression in the total IgG antibody level. There were no significant differences between the groups in IgG3 and IgG4 antibody levels to any of the cellular fractions.(ABSTRACT TRUNCATED AT 250 WORDS)


Stimulation by interleukin-1 of interleukin-6 production by human periodontal ligament cells.

Interleukin-1(IL-1), a cytokine present in the gingiva and crevicular fluid of patients with periodontitis and in the periodontal ligament (PDL) of experimentally moved teeth, has multiple biological activities, including the ability to elicit bone resorption. Interleukin-6, also found in the gingiva of patients with periodontitis, may induce osteoclastic bone resorption through an effect on osteoclastogenesis. Here IL-6 production and its gene expression in response to recombinant IL-1 beta were examined in primary cultures of PDL cells. IL-1 beta stimulated IL-6 production by these cells in a dose- and time-dependent manner; this increase in IL-6 production was much higher than that in human gingival fibroblasts. In situ hybridization, using a synthetic oligonucleotide DNA probe of the IL-6 gene, revealed that most PDL cells expressed IL-6 mRNA in response to IL-1 beta treatment. The finding that IL-6 is produced by PDL cells and is regulated by IL-1 beta has revealed a potentially important mechanism for controlling alveolar bone resorption.


Plasminogen activators in normal and malignant oral epithelium in vivo and in vitro.

Urokinase-type (uPA) and tissue-type (tPA) plasminogen activators were identified by fibrinolytic autography in the sulcus epithelium of human gingival mucosa but not in the orthokeratinized gingival epithelium. Fibrinolytic activity was present only over blood vessels in frozen sections of oral squamous cell carcinomas, the malignant epithelial cells showing no plasminogen activator activity. Plasminogen activators could not be demonstrated in either the sulcus or gingival epithelium by immunofluorescence, but both uPA and tPA were found in occasional squamous carcinoma cells. Fibrinolytic activity of culture fluids from epithelial explants grown in vitro from human gingival mucosa showed marked variation, but activity was much higher in the culture supernatants than in the cell lysates. Fibrinolytic activity of culture fluids from epithelial explants of squamous cell carcinomas was low both in supernatants and lysates. Zymogram overlays of sodium dodecyl sulphate-polyacrylamide electrophoretic gels from culture supernatants showed that the low fibrinolytic activity of culture supernatants of oral squamous cell carcinomas was due to the associated presence of plasminogen activator inhibitors. The fibrinolytic activity in the zymogram was due predominantly to uPA but some lysis was due also to tPA.


Changes in the lectin-binding of capillaries in rat salivary glands after streptozotocin-induced diabetes.

The lectin-horseradish peroxidase conjugate of GSA I-B4 (Griffonia simplicifolia isolectin) has some binding affinity with capillary walls in sections of the major salivary glands from normal rats. After inducing diabetes with streptozotocin a conspicuous increase in the staining intensity with GSA I-B4 was already evident in parotid capillaries at 3 weeks and this increase persisted at 3 and 6 months. In submandibular capillaries, however, an increased uptake of GSA I-B4 was evident only at 6 months after inducing diabetes. The reasons for these different time scales in the two glands are not known but the increased uptake of GSA I-B4, which is due to an increase in carbohydrate-containing sites with available terminal alpha-D-galactose, is considered to reflect a pathological change.


The collaborative corneal transplantation studies (CCTS). Effectiveness of histocompatibility matching in high-risk corneal transplantation. The Collaborative Corneal Transplantation Studies Research Group.

The Collaborative Corneal Transplantation Studies (CCTS) were designed to evaluate the effect of donor-recipient histocompatibility matching and crossmatching on the survival of corneal transplants in high-risk patients. Corneas were allocated to the 419 patients in the double-masked Antigen Matching Study on the basis of serologically defined HLA-A, -B and HLA-DR antigen match. ABO blood group compatibility was determined but not used for recipient selection. The 37 patients in the Crossmatch Study were randomly assigned to receive a cornea from either a positively or negatively crossmatched donor. All patients received topical steroid therapy according to a standard protocol. Matching for HLA-A, -B and HLA-DR antigens had no effect on overall graft survival, the incidence of irreversible rejection, or the incidence of rejection episodes. At 3 years after surgery, the estimated proportion of eyes with graft failure was 41% for the ABO-incompatible group and 31% for the ABO-compatible group (relative risk, 1.43; 95% confidence interval, 1.00 to 2.06). The estimated proportion of eyes with failure from rejection by 3 years was 30% for the ABO-incompatible group and 16% for the ABO-compatible group (relative risk, 1.98; 95% confidence interval, 1.25 to 3.13). The positive group in the Crossmatch Study had fewer graft failures, rejection failures, and rejection episodes than the negative group; however, these differences were not statistically significant. These studies demonstrate that, for high-risk patients who are immunosuppressed by topical steroid therapy and followed up according to the CCTS protocol: (1) neither HLA-A, -B nor HLA-DR antigen matching substantially reduces the likelihood of corneal graft failure; (2) a positive donor-recipient crossmatch does not dramatically increase the risk of corneal graft failure; and (3) ABO blood group matching, which can be achieved with relatively little effort and expense, may be effective in reducing the risk of graft failure.


A randomized, prospective, double-masked clinical trial of Optisol vs DexSol corneal storage media.

We compared Optisol and DexSol, two chondroitin-sulfate-based media for corneal storage at 4 degrees C, by transplanting 31 donor cornea pairs (one cornea stored in Optisol and its mate in DexSol for 20 to 134 hours) into 31 pairs of recipients (62 patients). All grafts were clear 1 year after transplantation except for one primary donor failure (Optisol group). Optisol-stored corneas were significantly thinner than DexSol-stored corneas after cardinal suture placement (0.64 mm vs 0.76 mm) and at the end of surgery (0.69 mm vs 0.78 mm); at all points afterward through 1 year the two groups did not differ. The activity of two lysosomal enzymes released into the media during storage, alpha-mannosidase and alpha-glucosidase, was lower in the Optisol group. Epithelial status and all endothelial morphometric parameters, except the figure coefficient at 1 year, did not differ between the two groups before surgery and 3, 6, and 12 months after surgery. Mean endothelial cell loss at 1 year was 15% for the Optisol group and 21% for the DexSol group (P = .22). Thus, Optisol-stored corneas were thinner during surgery than DexSol-stored corneas and there was less lysosomal enzyme activity in the Optisol medium after tissue storage. There were no significant differences in postoperative clinical or endothelial morphometric parameters, however.


Changing trends in the indications for penetrating keratoplasty.

The indications for penetrating keratoplasty have changed over the past several years. Nine hundred ninety-nine penetrating keratoplasty specimens from 1981 through 1990 were analyzed. Overall, keratoconus was the most common indication for penetrating keratoplasty (24.2%). This was followed by pseudophakic bullous keratopathy (23.0%), regraft (13.1%), scarring (8.2%), and Fuchs' endothelial dystrophy (5.8%). Pseudophakic bullous keratopathy was the most common indication for penetrating keratoplasty in each year from 1984 through 1989 with a peak in 1987 (33%). Since 1987, the number of pseudophakic bullous keratopathy cases has decreased; and in 1990, keratoconus (33.1%) surpassed pseudophakic bullous keratopathy (24.1%) as the most common indication for penetrating keratoplasty. This decreasing incidence of pseudophakic bullous keratopathy may reflect the discontinued use of closed-looped anterior chamber and iris-plane intraocular lenses most commonly associated with this complication.


Computer-assisted corneal topography in parents of patients with keratoconus.

Recently developed computer-assisted devices allow detection of early topographic abnormalities of the cornea, including mild or abortive forms of keratoconus. To address the possibility that keratoconus is an inherited condition, we examined both parents of 12 randomly selected patients with keratoconus whom we were following up. Of the 12 sets of parents, at least one parent in each of seven sets had abnormal corneal characteristics. Using previously determined quantitative criteria (eg, central corneal steepening, greater steepening inferiorly than superiorly, and asymmetry between the two eyes) to distinguish normal from keratoconic corneas we found evidence of keratoconus in at least one of the 14 parents. The remaining five patients had parents with normal corneal characteristics. These data support the hypothesis that keratoconus is sometimes an inherited condition, exhibiting, at least in some families, autosomal dominant inheritance with incomplete penetrance.


Unexpected cyclotropia simulating disruption of fusion.

Fifteen patients with diplopia associated with prior scleral buckling, prior penetrating keratoplasty, severe corneal scarring, monocular aphakia, long-standing strabismus, or prior vertical offsets of the horizontal recti were thought to have disruption of fusion because diplopia could not be eliminated with prisms. They were each found to have a substantial symptomatic cyclotropia unassociated with an obvious dysfunction of an oblique muscle. In 13 patients, diplopia resolved after the cyclotropia was corrected surgically.


'V' esotropia and excyclotropia after surgery for bilateral fourth nerve palsy.

Six patients had residual diplopia at near in the downgaze position after surgery for bilateral fourth nerve palsy. They all showed a large excyclotropia in the downgaze position that was associated with a "V"-pattern esotropia and could not fuse in the reading position because of the size of the excyclotropia. They were treated with bilateral recessions of the inferior recti, which resulted in an expansion of the single binocular field of vision in downgaze, with an elimination of diplopia in the reading position. None experienced a deterioration in their alignment in the primary position.


Radiation therapy of acquired immunodeficiency syndrome-related Kaposi's sarcoma of the eyelids and conjunctiva.

We retrospectively studied 42 men with acquired immunodeficiency syndrome-related Kaposi's sarcoma of the conjunctiva or eyelids who were treated with radiation. Forty-nine sites were treated, 35 (71%) of which involved the eyelids, 12 (24%) the conjunctiva, and two (4%) both the eyelids and conjunctiva. Group 1 consisted of 31 sites treated with a single dose of 800 cGy and group 2 consisted of 18 sites treated with a multiple-fraction regimen and total doses between 1500 and 3600 cGy. The response and recurrence rates in the two groups were similar. One patient from group 2 died within 1 month of treatment and was not included in the analysis. The lesions improved in all cases. A complete response was obtained in 10 (32%) of the 31 lesions in group 1, compared with four (22%) of 18 lesions in group 2. A partial response was obtained in 21 (68%) of 31 lesions in group 1, compared with 13 (72%) of 18 lesions in group 2. Expected minor reactions in the treatment field, primarily loss of cilia, were comparable in the two groups. No serious complications were noted. Recurrence occurred in seven (22%) of the 31 sites in group 1 (six patients) and seven (39%) of the 18 sites in group 2 (six patients). The results suggest that a single treatment of 800 cGy is a safe and effective palliative therapy for ophthalmic acquired immunodeficiency syndrome-related Kaposi's sarcoma.


Ischemic macular edema. Recognition and favorable natural history in branch vein occlusion.

Eyes with macular edema caused by retinal branch vein occlusion underwent masked evaluation of fluorescein angiography to determine complete macular perfusion vs incomplete macular perfusion (capillary dropout, ischemia). Cases evaluated as incomplete macular perfusion showed a greater frequency of improvement (91%) in visual acuity than did perfused cases (29%) (P = .003) after a mean follow-up of 39 months. Ischemic edema is often transient, and is associated with a good outcome in visual acuity (median final visual acuity was 20/30). Perfused macular edema has a poorer prognosis for visual acuity (median final visual acuity was 20/80). Macular ischemia is usually associated with a broken foveal capillary ring. Previous animal research on ischemic brain edema has shown that following brain ischemia, an intracellular and an extracellular hypertonic environment lead to intracellular and extracellular edema (cytotoxic edema), which is often followed by vascular protein leakage (vasogenic edema). A similar occurrence in ischemic retina could explain the transient edema reported herein, with good outcome in visual acuity following the spontaneous resolution of edema.


Endophthalmitis caused by gram-negative organisms.

The medical records of 52 patients (53 eyes) with culture-proven gram-negative endophthalmitis between January 1982 and December 1990 were reviewed. Pseudomonas aeruginosa (23% [12/53]) and Haemophilus influenzae (19% [10/53]) were the most frequent isolates in this series. Overall, 26 (49%) of 53 treated patients achieved 20/400 or better visual acuity. Fifty-two (98%) of the original 53 gram-negative isolates were sensitive to the aminoglycoside antibiotics. To determine their sensitivity to recently developed antibiotics, 35 of the isolates were again grown on culture media and their sensitivities to ceftazidime, ciprofloxacin, and imipenem were obtained. Only ceftazidime demonstrated in vitro efficacy for all the organisms tested.


Intraocular lymphoma. Immunopathologic analysis of vitreous biopsy specimens.

Immunologic analysis of cell surface markers (immunophenotyping) has become a standard procedure in the evaluation of systemic lymphomas. However, attempts to apply these techniques to intraocular lymphoma have not been uniformly successful. We successfully immunophenotyped five consecutive cases of intraocular lymphoma using immunoperoxidase surface marker analysis of cytocentrifuged specimens in two cases and flow cytometry in three. In all five cases, a monoclonal B-cell population was unequivocally present. Contrary to previous reports, we found surface marker analysis of vitreous biopsy specimens to be helpful in the diagnosis and treatment of intraocular lymphoma. Not only did it support the cytologic diagnosis but it allowed comparison of the immunophenotype of vitreous infiltrates with that of previous or subsequent lymphomatous lesions from nonocular sites.


Maternal cigarette smoking during pregnancy. A risk factor for childhood strabismus.

Strabismus is a common ophthalmologic disorder in children that can result in permanent visual loss. A population-based case-control study was conducted to investigate the association between childhood strabismus and prenatal risk factors including maternal smoking. All incident cases of strabismus diagnosed during a 21-month period, from January 1, 1985, to September 30, 1986, in nine metropolitan area pediatric ophthalmology centers were selected for study (n = 377). Controls were children born on the same day and in the same hospital as the cases (n = 377). Data collection included an interview with the biologic mother and abstraction of obstetric and neonatal birth records. Cigarette smoking was associated with esotropia and but not exotropia for those women who smoked throughout pregnancy (odds ratio, 1.8, 95% confidence interval, 1.1 to 2.8, and odds ratio, 1.4, 95% confidence interval, 0.6 to 3.1, respectively). The relative risk for strabismus was not elevated for women who quit smoking before pregnancy or during pregnancy, nor was there evidence of a dose response. The effect of maternal smoking on risk of esotropia was modified by birth weight and gestational age. The association of maternal smoking throughout pregnancy and esotropia was strongest for children who weighed less than 2500 g (odds ratio, 8.2, 95% confidence interval, 1.1 to 62.7) and 3500 g or more at birth (odds ratio, 5.6, 95% confidence interval, 2.1 to 15.4). Exposure to secondary smoke during pregnancy increased the risk of strabismus only when the mother smoked.


Interactions between light and vitreous fluid substitutes.

To determine the interactions between light and vitreous fluid substitutes, we studied the absorption and fluorescence properties of the following fluids that are commonly used in vitreoretinal surgery: Ringer's solution, balanced salt citrate-buffered solution, balanced salt bicarbonate-buffered solution, hydroxypropyl methylcellulose ophthalmic solution, hyaluronate sodium, perfluorocarbons, silicone oil, and fluorosilicone oil. The absorption spectra for all the fluids peaked in the UV-C (reference range <280 nm) and UV-B (reference range from 315 to 280 nm) regions of the spectrum, with little or no absorption in the visible region of the spectrum (from 400 to 700 nm). Emission of almost all of the fluids occurred mainly in the 300- to 360-nm region, with fairly low-quantum efficiency. The limited light absorption properties of the fluids calls for caution during transpupillary and intraocular laser photocoagulation to avoid excessive retinal damage, mainly when the laser power is increased during treatment. Transmission of incoherent light (environmental and ophthalmic artificial light) through highly transparent vitreous fluid substitutes may lead in time to dangerous light exposure, particularly in aphakic eyes. The emitted fluorescence in these fluids generates a minimal risk of long-term damage.


Biochemical abnormalities in vitreous of humans with proliferative diabetic retinopathy.

Vitreous changes in diabetes can exacerbate proliferative diabetic retinopathy. These changes may be due to the effects of diabetes on vitreous collagen. Vitreous samples from 19 patients with proliferative diabetic retinopathy and 23 patients without diabetes were analyzed for collagen crosslinks, as well as for the early glycation products, glucitolyllysine and glucitolylhydroxylysine. Fluorometry was performed to measure advanced glycation end products. Vitreous collagen derived from diabetic patients was found to have significantly higher levels of the crosslink dihydroxylysinonorleucine (3.15 vs 1.24 mol/mol collagen, P<.01) than that of control subjects. Early glycation products were elevated in diabetic vitreous (1.65 vs 0.54 mol/mol collagen, P<.05). Levels of advanced glycation end products were 20 times higher in diabetic vitreous compared with the vitreous of controls. These diabetes-induced alterations of human vitreous may be of particular importance given the role of vitreous in proliferative diabetic retinopathy and vision loss.


Endocanalicular laser-assisted dacryocystorhinostomy. An anatomic study.

In human cadaver specimens, a laser fiberoptic was advanced through the canalicular systems to create fistulas between the nasolacrimal sac and nose. A 400- to 600-microns, blunt-tipped quartz fiberoptic was then advanced through the upper and/or lower canaliculus to the medial aspect of the nasolacrimal sac. After 10 to 15 laser pulses (10 W for 0.1 second), a 2.5 x 2.5-mm fistula was created between the lacrimal sac and the nose just anterior and inferior to the middle turbinate. Additional laser pulses can further enlarge the fistula. Endocanalicular laser-assisted dacryocystorhinostomy has potential advantages compared with endonasal laser-assisted dacryocystorhinostomy, including the following: laser energy is directed away from the eye; the technique resembles standard nasolacrimal probing; and nasal endoscopy and instrumentation may prove unnecessary.


Ophthalmology in Laos.

Laos, a small, landlocked nation of 4 million persons, has only recently begun modernization of its medical services, now a national priority. Five ophthalmologists and 11 cataract surgeons are responsible for the entire country. Tertiary care is available only at two centers; the first eye hospital opened in 1990. Several voluntary organizations have recently become involved in assisting with the development of services.


Facial trauma. Assessment and treatment.

Management of facial trauma requires immediate attention to patency of the airway and to circulation. This article outlines an assessment procedure for patients with facial injuries and presents treatment guidelines.


The normal development of teeth.

Even though a dental assessment is not often a part of a child's regular medical check up, an understanding of the normal dental development and its variations is a valuable diagnostic tool. Dental health is a part of total health, and there is a need for increased communication between medical and dental practitioners to achieve this goal (Figure 32).


A management approach for temporomandibular disorders.

Conservative, non invasive and reversible treatment is possible and highly successful for most temporomandibular disorder patients. Unfortunately, at this time it is not possible to provide preventive therapy or predict an 'at risk' group. Perpetuating and aggravating factors can sometimes be identified and eliminated in patients suffering from a TMD. TMD treatment can also be of benefit for chronic headache patients. A logical approach to the management of TMJ disorders has been outlined that emphasises the principle of 'escalation of therapy'. This has the advantage of avoiding overtreatment and maintaining patient confidence if initial attempts fail.


Oral ulceration.

Oral ulceration is a common problem. The presentation is often very similar, irrespective of the underlying cause. This paper illustrates some of the more commonly encountered forms of oral ulceration.


Lifestyle change and cardiovascular disease. Principles and practice.

Changes in patients' lifestyles can be approached in a practical fashion by working through the relevant 'stages of change'. Helping patients to change their lifestyles does not have to be a very time-consuming process for the clinician, but it does require planning, and attention to those factors that are important at each stage of the process. Although this paper has a focus on lifestyle change for the reduction of CVD risk factors, the same principles can apply to lifestyle change and disease prevention for other disorders.


Aerosol devices in the treatment of asthma. Technical and clinical factors.

Inhaled medications are capable of producing the best bronchial effect with fewest systemic side effects. Proper inhalation technique is critical if these devices are to be effective. Specific aspects of both the system and the inhaler technique used are critical in achieving optimal performance. Observation of each patient's inhaler technique is advised--it is not enough to merely give instructions or to simply discuss the therapy. Both efficacy and side effects are dose dependent; high doses of topical bronchodilators and anti-inflammatory drugs are appropriate for some patients. Protection against side effects may be achieved by gargling mouth and throat after use, or by using a spacing (holding) chamber. Long-term compliance with medication will be best if the number of doses used, and the side effects, are minimised.


Certification of asthma death by general practitioners.

Although asthma may be a prominent feature in many cases of terminal illness, it is often incorrectly named as the cause of death. It is difficult to assess asthma death in the older age groups where psychosocial factors are prominent. This review looks at the certification by general practitioners of 50 consecutive cases of asthma death.


Pain in the face.

The outstanding cause of pain in the face is dental disease, but various neuralgias and infections such as maxillary sinusitis require consideration. A careful history and examination is the basis of diagnosis.


The hearing of the patients treated with hemodialysis: a long term follow-up study.

Sensorineural hearing loss is frequently found in the patients under the treatment with hemodialysis, but the responsible etiological factor(s) still remains controversial. The purpose of the present study was to determine by a long term follow-up study whether hemodialysis per se or other factors induce sensorineural hearing loss. Thirty-seven patients with the observation periods of 4 years or longer were selected for the analysis. Hearing tests were performed soon after the initiation of hemodialysis and every 3 to 12 months thereafter. Significant hearing loss was found in 16 cases (31 ears) at the first test. Although 3 cases (5 ears) of the initially normal group and one case (2 ears) of the group with already existing hearing loss exhibited significant hearing loss, the change in the hearing level was quite minimal in remaining 67 ears during the observation period. Although the cochlea in patients under the treatment with hemodialysis is susceptible to various insults, we conclude that hemodialysis per se does no harm to the cochlea and the hearing can be maintained at the pre-hemodialysis level in the majority of the cases.


Basic study on the effect of nasally administered salmon calcitonin preparation on the nasal ciliary epithelium.

Nasal administration of drugs is an administration method which is worthy of attention. In such therapy, local administration should not damage the nasal mucous membranes. In the present study, we conducted an investigation by the tissue culture test method of the functional and morphological effects of new nasal calcitonin preparation, which is being developed as a nasal spray agent for osteoporosis, on the nasal ciliary epithelium. The nasal septal mucous membranes of C3H-strain mice were used, and 5 types of nasal calcitonin preparations with a microcrystalline cellulose base and additives added were used. The various drugs were added to nasal mucous membrane slices in RPMI-1640 culture medium; ciliary activity before addition and 0.5, 2, and 4 hr after was electrophotometrically measured; and morphological observation was then carried out by SEM. In the various additive groups, virtually no effect on ciliary activity was observed, and the same results were obtained when 3 and 9 times the estimated clinical spray dosage was added. Moreover, in morphological observation by SEM, in the various additive groups, no morphological changes in samples of nasal ciliary specimens were observed after 4 hr of culturing at the maximum administered dosage (9 times the estimated clinical spray dosage). Based on these findings, it was concluded that the series of calcitonin preparations with various additives had no hazardous effect on the nasal ciliary epithelium.


NaOH cell maceration/scanning electron microscopic studies on the architecture of the lamina propria of the mouse palate.

NaOH cell-maceration/SEM method was applied to the oral surface of the mouse palate to demonstrate the three-dimensional architecture of the lamina propria. In the caudal part of the hard palate, the lamina propria was characterized by the conspicuous parallel ridges which ran side by side in sagittal direction. In the boundary between the hard palate and the soft palate the parallel ridges interrupted abruptly, in the soft palate the ridges were extremely undeveloped to show the shrunken cloth-like appearance. Furthermore, the conical connective tissue papillae were lined up along the boundary. These findings suggest that the boundary between the hard plate and the soft palate is clear not only in the bony structure but in the lamina propria, and that the parallel ridges in the hard palate play an important role in ensuring from the excessive extending force during mastication.


Adherence of Haemophilus influenzae to middle ear mucosa injured by killed H. influenzae.

Repetitive acute otitis media is due to recurrent bacterial infection of middle ear superimposed on chronic otitis media with effusion. Endotoxin, one of the constituents of Haemophilus influenzae, is present in some cases in the middle ear effusion of otitis media with effusion and has been demonstrated experimentally to damage the middle ear mucosa. The aim of this study was to determine the effect of killed H. influenzae on the adherence of H. influenzae and H. parainfluenzae to the middle ear epithelial cells. The numbers of adherent organisms per epithelial cell in ears inoculated previously with killed H. influenzae or with normal saline (0.9% NaCl) were compared. Prior middle ear inoculation of killed H. influenzae enhanced the adherence of H. influenzae to middle ear epithelial cells, but it had little effect on the adherence of H. parainfluenzae. H. influenzae adhered to middle ear epithelial cells in greater numbers than H. parainfluenzae. Results demonstrate that a middle ear pathogen adheres to middle ear epithelial cells presumably damaged by killed H. influenzae, whereas a non-pathogen does not. These findings might partly explain the increased susceptibility of an ear with chronic otitis media with effusion to recurrent infection with H. influenzae.


Incidence of attic retraction after staged intact canal wall tympanoplasty for middle ear cholesteatoma.

Incidence of retraction pocket and recurrent cholesteatoma in the attic after surgery for middle ear cholesteatoma using the staged intact canal wall technique were investigated in 95 ears of 91 patients, all of which had various degrees of bone defect in the tympanic scutum. Surgical procedures employed in the second stage for prevention of attic retraction were classified into three types: Type I, no scutumplasty; Type II, scutumplasty; Type III, scutumplasty plus mastoid obliteration. In 83 ears followed up for more than 1 year after the second stage, such retraction troubles occurred in 2 of 13 ears (15%) in Type I, 8 of 20 ears (40%) in Type II, and 24 of 50 ears (48%) in Type III. Incidence of retraction troubles was higher in Types II and III, probably because these procedures were indicated in ears with large scutum defects. Dislocation and atrophy of the graft materials, together with bone resorption around the bone defect were the main reasons for failure in scutumplasty. Dysfunction of the eustachian tube and traction of the eardrum by the scar tissue behind it may have also contributed to attic retraction. Mastoid obliteration with small blocks of hydroxyapatite was more effective in prevention of retraction troubles than that with pedicled temporalis muscle flap.


A visual suppression test using post-rotatory nystagmus.

The visual suppression test is one method for examining the function of visual fixation and visual influence on vestibular nystagmus. In this study the visual suppression test using post-rotatory nystagmus was investigated in 65 normal subjects and 142 clinical cases with cerebellar lesions. In 65 normal subjects the mean +/- standard deviation of visual suppression of the slow phase velocity on post-rotatory nystagmus was 69 +/- 11%. As to the stimulation for visual suppression test, the post-rotatory method using rotatory stimulation is milder than caloric stimulation. This method is far simpler to analyze than the visual suppression test using pendular rotatory nystagmus and other vestibulo-ocular reflex tests. In the 142 patients with cerebellar lesions, reduced or abolished visual suppression on post-rotatory nystagmus was seen in 89 patients with radiologically confirmed disturbances in the vestibulo-cerebellum. And this method could identify the lesion side in the cerebellum. These results showed a correlation between the visual suppression test using post-rotatory nystagmus and one using caloric nystagmus in 65 normal subjects and 142 clinical cases with cerebellar lesions.


Endolymphatic hydrops induced by noise exposure.

In animal with cochlear deafness induced by firecracker explosion, fibrous degeneration of the endolymphatic sac was observed 4 months after the disappearance of Preyer's reflex. Endolymphatic hydrops induced by noise exposure may develop as the results of degeneration of the endolymphatic sac due to cochlear deafness by acoustic trauma after the lapse of a long period of time.


Effects of increasing photoperiod length and anticoccidials on performance and health of roaster chickens.

Male broiler chickens were raised to 63 days of age under different lighting and anticoccidial treatments. A constant-light program was compared with two interrupted and increasing-light programs in which the photoperiod length was 6 hours between 7 and 14 days of age and then increased gradually to continual light by 49 days of age in the first program and more gradually to 18 hours by 49 days of age in the second program. By 63 days of age, the increasing-light programs significantly increased body-weight gain and decreased feed/grain ratio, but not significantly. The increasing-light programs reduced the incidence of skeletal disease from 7.56% to 2.88% in the first program and to 3.53% in the second program, reduced the incidence of acute death syndrome from 5.94% to 3.37% in the first program and to 4.65% in the second program, and reduced total mortality from 18.81% to 11.71% in the first program and to 11.38% in the second program. The lighting programs had no effect on the incidence of ascites and right heart failure, the ratio of right ventricular weight to total ventricular weight, the incidence of clinical and subclinical tibial dyschondroplasia, and the number of cartilaginous and osseous nodules in the lungs. The anticoccidials compared were monensin and amprolium/ethopabate, from 0 to 35 days of age. These treatments had no significant direct effects on any of the parameters measured.


The influence of diet on necrotic enteritis in broiler chickens.

Necrotic enteritis was reproduced in broiler chickens by mixing cultures of Clostridium perfringens in the feed. Mortality due to necrotic enteritis was higher among chickens fed rations based on wheat, rye, barley, and oat groats than among chickens fed corn-based rations. Addition of pentosanase to a wheat-based diet did not affect the level of mortality due to necrotic enteritis. Addition of pectin and guar gum to different rations severely reduced growth rate and eliminated necrotic enteritis from test birds. Addition of glucose to a corn-based diet caused a small increase in mortality due to necrotic enteritis.


Relationship of the enzyme-linked immunosorbent assay to indirect immunofluorescent antibody test for the detection of so-called chicken anemia agent antibodies in serum from broiler breeders.

Serum samples collected from breeder chickens ranging in age from 1 day to 55 weeks were tested for CAA antibodies by enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescent antibody (IFA) test. The relationship of ELISA to IFA test was determined. The sensitivity of the ELISA relative to the IFA test was 82.64%, and the specificity of the ELISA relative to the IFA test was 56.25%. Agreement between the ELISA and the IFA test was highly significant (Kappa = 0.74, Z = 5.78). We concluded that the ELISA is as good as the IFA test for detecting CAA antibody in sera from chickens.


Virulence factors of Escherichia coli associated with colisepticemia in chickens and turkeys.

Four hundred twenty turkey and 80 chicken Escherichia coli isolates from colisepticemic birds were examined for the following properties: heat-labile toxin (LT), heat-stable enterotoxin, verotoxin, colicinogenicity, hemolysin, and hydroxamate/aerobactin production. Twenty-four (5.7%) of the 420 turkey isolates and six (7.5%) of the 80 chicken isolates produced an LT that was cytotoxic for both Vero and Y-1 cells. In contrast, 48 (11.4%) of the turkey isolates and 18 (22.5%) of the chicken isolates produced a distinct LT that was cytotoxic only for Vero cells. In addition, 64 (80.0%) of the chicken isolates and 309 (74.0%) of the turkey isolates produced aerobactin. Colicinogenicity occurred in 51 (64.0%) of the chicken isolates, with 41 (51.0%) producing colicin V. By contrast, 254 (61.0%) of the turkey isolates produced a colicin, of which 176 (42.0%) produced colicin V. None of the chicken and turkey isolates produced hemolysin or heat-stable enterotoxin.


Use of a pilocarpine-based lavage procedure to study secretory immunoglobulin concentration in the alimentary tract of White Leghorn chickens.

A lavage procedure was used to study the kinetics of alimentary fluid IgA concentration in 15 specific-pathogen-free white leghorn chickens for 8 weeks post-hatch. Lavage solution was administered orally and collected from the distal alimentary tract following an intraperitoneal injection of pilocarpine. Concentrations of IgA, quantitated by enzyme-linked immunosorbent assay, were more than 0.04 mg/ml by 3 weeks and were negligible before this age. This level gradually increased over the next 5 weeks, peaking at nearly 0.4 mg/ml at 8 weeks of age. Alimentary lavage was easy to perform, required no necropsy or surgical manipulation, and facilitated repeated collection of alimentary fluid from live birds. Repeated lavage did not alter concentrations of IgA and IgG in alimentary fluid, and concentrations of IgA and IgG in alimentary fluid were stable during incubation at 37 C for 24-48 hr.


Pathogenicity differences of multiple isolates of Aspergillus fumigatus in turkeys.

Sixteen Aspergillus fumigatus isolates of environmental, mammalian, and avian origin were used to assess: 1) intra-air-sac inoculation as a viable challenge alternative to aerosol exposure, and 2) isolate variability in pathogenicity. Development of lesions, antibody response in survivors, mortality, and weight gains were assessed. Turkey poults were challenged with equal numbers of viable conidia. Total number of conidia given per experimental group varied markedly and did not influence mortality. Antibody response as measured by the enzyme-linked immunosorbent assay and agar gel immunodiffusion test was erratic, although most poults with high antibody scores had marked lesions and low weight. Lesions were characterized by necrogranulomatous pneumonia and airsacculitis with marked visceral involvement. The source of the isolate was not a factor in mortality, although this was biased by the high numbers of isolates from birds with aspergillosis. The single environmental isolate produced no mortality.


Cardiac muscle mass distribution in the domestic turkey and relationship to electrocardiogram.

Ventricular weights were measured in 20-week-old male and female heavy turkeys, and electrocardiograms (ECGs) were recorded in 10- and 20-week-old male and female heavy turkeys. Twenty-week-old males had heavier relative left ventricular and total ventricular weights than females of the same age. Left-to-right ventricular weight ratios were 4.4:1 in males and 4.5:1 in females. Heart rate was faster in young birds and in females, and that influenced the duration of the intervals of the ECG. Wave amplitudes were smaller in 10-week-old turkeys than in 20-week-old turkeys. There was no correlation between electrocardiographic parameters and ventricular weights of male and female turkeys. Two-dimensional ECGs were therefore found to be of minimal value for detecting turkeys with heavier ventricles.


Effects of corticosteroids on lymphocyte subpopulations and lymphokine secretion in chickens.

Various effects of glucocorticosteroids on the avian immune system were examined in chickens treated intramuscularly with 0.1 to 2.5 mg dexamethasone or prednisolone. Kinetic changes in body weight gain, percentages of lymphocyte subpopulations, and T-cell functions were examined following treatment with dexamethasone or prednisolone every other day. Chickens treated with dexamethasone or prednisolone showed a decrease in body-weight gain compared with age-matched, untreated chickens. In general, the total number of splenic lymphocytes of chickens treated with the two drugs was significantly lower than in controls in a dose-dependent manner. Flow cytometric analysis of splenic lymphocyte subpopulations revealed that the percentages of lymphocytes expressing CD8, gamma delta T-cell receptor, Ia, or IgM antigens and natural killer cells were lower in dexamethasone-treated chickens than in the controls, whereas the percentages of T lymphocytes bearing CD3, CD4, or alpha beta TCR antigens were higher. Furthermore, splenic T cells obtained from dexamethasone-treated chickens showed a significant depression in concanavalin A-induced lymphoproliferation and interleukin 2 and gamma-interferon production. The results characterize a variety of immunosuppressive effects of glucocorticoids on the avian immune system.


Economic effects of clinical chicken anemia agent infection on profitable broiler production.

An outbreak of anemia dermatitis syndrome caused by chicken anemia agent (CAA) occurred in 15 broiler flocks. An average of 29% of chickens in these flocks were derived from a common breeder flock. The breeder flock had no antibody to CAA at 20 weeks of age but had seroconverted by 31 weeks. Diseased broiler flocks were derived from eggs laid by the breeder flock between 25 and 30 weeks of age. CAA infection in the breeder flock was subclinical, with no apparent effects on mortality or performance. A strategic program of therapeutic and/or prophylactic antibiotic therapy was begun in affected broiler flocks as soon as the disease was diagnosed. Nevertheless, when the cost of therapy was taken into account, affected broiler flocks had a net income 17.3% to 19.6% lower than normal flocks. Average bird weights were 3.3% to 3.5% lower in affected flocks than in unaffected flocks, and affected flocks had a significantly greater proportion of lighter birds. Average mortality in affected flocks was 2.0% to 2.3% higher than in normal flocks, with peak mortality occurring in the third week of life. There was no apparent effect on feed-conversion ratio.


Production and characterization of monoclonal antibodies to budgerigar fledgling disease virus major capsid protein VP.

Eleven hybridoma cell lines producing monoclonal antibodies (MAbs) against intact budgerigar fledgling disease (BFD) virions were produced and characterized. These antibodies were selected for their ability to react with BFD virions in an enzyme-linked immunosorbent assay. Each of these antibodies was reactive in the immunofluorescent detection of BFD virus-infected cells. These antibodies immunoprecipitated intact virions and specifically recognized the major capsid protein, VP1, of the dissociated virion. The MAbs were found to preferentially recognize native BFD virus capsid protein when compared with denatured virus protein. These MAbs were capable of detecting BFD virus protein in chicken embryonated cell-culture lysates by dot-blot analysis.


Genetic variation in resistance of turkeys to experimental infection with Newcastle disease virus.

Seven hundred eighty male and female turkeys representing four genetic lines were challenged in four experiments with the Texas GB strain of Newcastle disease virus (NDV). The lines of turkeys included two randombred control lines (RBC1 and RBC2), a subline (E) of RBC1 selected for increased egg production, and a subline (F) of RBC2 selected for increased 16-week body weight. Mortality in turkeys of subline F (32.5%) was significantly higher than that in turkeys of line RBC2 (15.8%), subline E (17.5%), and line RBC1 (18.4%). At the end of each experiment, surviving birds were tested for antibody to NDV using the enzyme-linked immunosorbent assay (ELISA) and hemagglutination-inhibition (HI) test. Turkeys of subline E and line RBC1 had significantly lower ELISA antibody titers than those of subline F and line RBC2. Subline F had the highest HI antibody titers, followed in decreasing order by lines RBC2 and RBC1 and subline E. No apparent correlation was found between antibody response and mortality after NDV challenge.


Microbiological and histopathological effects of an induced-molt fasting procedure on a Salmonella enteritidis infection in chickens.

A study was undertaken to determine if a 2-week feed-removal protocol, as is used by industry to induce a molt in aging hens, would affect the course of a Salmonella enteritidis infection. White leghorn hens aged 69-84 weeks were deprived of feed to induce a molt, and on day 4 of the fast, the birds were orally infected with 5 x 10(6) S. enteritidis. S. enteritidis organisms were enumerated in the spleen on day 6 and from the alimentary tract on days 7, 14, 21, 28, and 35. Little difference was detected in numbers of S. enteritidis from spleens of molted and unmolted hens. Significantly more molted hens shed detectable intestinal S. enteritidis than unmolted hens on day 14 (one of two trials) and day 21 (one of two trials). Intestinal levels of S. enteritidis were increased 100- to 1000-fold in the molted birds on day 7 (one of two trials) and day 14 (two of two trials), and many of the hens exhibited bloody alimentary secretions. Histological examination of the intestinal tract of S. enteritidis-infected molted hens showed increased inflammation in the epithelium and lamina propria of colons and ceca, compared with unmolted infected hens.


An evaluation of inactivated infectious coryza vaccines containing a double-emulsion adjuvant system.

The efficacy of experimental inactivated infectious coryza vaccines produced by a commercial vaccine manufacturer was evaluated. The vaccines, containing as the adjuvant phase either a double-emulsion mineral oil system or aluminum-hydroxide gel, were administered to 6-week-old chickens as a single dose. Some vaccines were a monovalent product containing a Page serovar C Haemophilus paragallinarum strain, and others were a bivalent product containing both Page serovar A and serovar C strains. After 3 weeks, all chickens were challenged by infraorbital sinus inoculation of virulent H. paragallinarum, either Page serovar C (strain HP31) or Page serovar A (strain HP14). The monovalent serovar C double-emulsion-based vaccines gave significant protection against a serovar C challenge, with the level of protection varying from 60% to 100%. The monovalent serovar C aluminum-hydroxide-gel vaccine also gave significant protection (94%) against a serovar C challenge. The bivalent double-emulsion vaccine gave significant protection against challenge from both serovars (100% for serovar C and 83% for serovar A). Although no major adverse reactions were detected, some chickens receiving both the double-emulsion vaccines and the aluminum-hydroxide vaccine developed relatively minor granulomatous reactions at the site of injection.


The role of mice in the epizootiology of Salmonella enteritidis infection on chicken layer farms.

A microbiological survey of 10 mice-infested poultry farms was conducted to determine the role of mice in the epizootiology of S. enteritidis infection. Five of the farms were rated as clean of S. enteritidis and five as contaminated based on culture results of environmental samples for S. enteritidis. Of 2103 environmental samples and 715 mice and rats tested, 5.1% and 16.2%, respectively, were culture-positive for S. enteritidis. On contaminated farms, S. enteritidis was isolated from 24.0% of the mice and 7.5% of the environmental samples, which represented 75.3% of all Salmonella isolations from mice but only 18.0% of Salmonella isolations from environmental samples on these farms. S. enteritidis was not detected in mice on clean farms. Phage types 13a and 14b were the two most frequently isolated phage types from mice and environmental samples. Although only a single phage type was isolated from single free-standing poultry houses, multiple phage types were isolated from multi-house complexes. A bacterial count from the feces of one mouse yielded 2.3 x 10(5) S. enteritidis bacteria per fecal pellet. S. enteritidis persisted at least for 10 months in an infected mouse population.


Occurrence of Salmonella enteritidis in the U.S. commercial egg industry: report on a national spent hen survey.

In order to estimate the prevalence and distribution of Salmonella enteritidis in U.S. commercial egg-production flocks, a survey of spent laying hens was conducted over a 3-month period. Seven of the 10 largest spent-hen processing plants in the United States participated. Ceca were sampled twice weekly from birds presented for slaughter at these plants. Samples were cultured for Salmonella and S. enteritidis, and S. enteritidis isolates were phage-typed. Overall, 23,431 pooled cecal samples were collected from a total of 406 layer houses. Salmonella (any serotype) and S. enteritidis were recovered from 24% and 3% of the pooled samples, respectively. The distribution of S. enteritidis phage types was consistent with data reported by others. Regionally, the estimated prevalence of S. enteritidis-positive houses (i.e., at least one positive sample found in a house) for the Northern, Southeastern, and Central/Western regions was 45%, 3%, and 17%, respectively. Overall, the prevalence of Salmonella-positive houses was 86%.


Correlation between the ability of Haemophilus paragallinarum to acquire ovotransferrin-bound iron and the expression of ovotransferrin-specific receptors.

To investigate the mechanisms of iron acquisition in avian haemophili, strains of Haemophilus paragallinarum and H. avium were tested for siderophore production and utilization of transferrin iron for growth. No evidence of siderophore production was detected in either of these species using a functional screening assay. H. paragallinarum, but not strains of H. avium, was able to acquire iron from 30% saturated chicken and turkey transferrins but not from human, porcine, or bovine transferrins. In response to iron limitation, H. paragallinarum expressed four iron-regulated outer-membrane proteins of 53, 62, 66, and 94 kilodaltons (kDa). Only the 53- and 94-kDa proteins were detected in the H. avium strains. Using affinity methods, the 94- and 53-kDa proteins were isolated specifically by chicken or turkey transferrin, indicating that they may be equivalent to transferrin binding proteins (TBP1 and TBP2, respectively) isolated from other bacterial species. The isolation of the 62- and 66-kDa proteins in association with TBP1 and TBP2 under less stringent washing conditions only in H. paragallinarum implicates these proteins in the iron acquisition process.


Correlation of water activity and other environmental conditions with repeated detection of Salmonella contamination on poultry farms.

Three flocks on 13 different broiler farms were monitored for Salmonella over three consecutive growout periods using the drag swab (DS) technique. One house was consistently negative for Salmonella contamination (7.7%); four houses were consistently positive (30.8%); and eight houses (61.5%) alternated between either a DS Salmonella-negative or -positive status. Simultaneously, numerous environmental parameters of the litter surface were measured, including water activity (Aw), ammonia, temperature, pH, moisture content (MC), ash content, and volatile solids. Analysis of these data as a corollary to either Salmonella-negative or -positive DS results revealed significant correlation coefficients for some of the parameters, especially Aw. The results suggest that there should be further exploration of remedial intervention based on control of some of the physical features of litter (e.g., controlling litter Aw and possibly MC and pH levels) in poultry houses.


Relationship of complement resistance and selected virulence factors in pathogenic avian Escherichia coli.

Complement resistance, antibiotic resistance profiles, and virulence profiles of 80 Escherichia coli isolates from the intestines of normal chickens (40 isolates) and chickens diagnosed as having colisepticemia (40 isolates) were compared. Differences were observed between the two groups for antibiotic resistance, siderophore production, presence of type 1 pili, complement resistance, motility, and size of plasmids. The systemic isolates were more likely to have siderophores and type 1 pili, and to be complement-resistant and motile than were the intestinal isolates. No differences between the two groups were observed for colicin production. Further comparison of the 10 most complement-resistant isolates from the systemic group and 10 most complement-sensitive isolates from the intestinal group revealed a correlation between an isolate's resistance to complement and its ability to kill embryos, express type 1 pili, and be motile. Virulence of avian E. coli strains appears to be correlated with complement resistance and the interaction of this resistance with the ability to produce type 1 pili and be motile.


Incidence of anemia and polycythemia in clinically ill Georgia broilers.

The incidence of anemia and polycythemia was established in clinically ill Georgia broilers that were tested for packed cell volume (PCV) during 1988 and 1989. More than 66% (324/488 = 66.4%) of PCV-tested broiler chicks were anemic, and less than 2% (8/488 = 1.6%) of PCV-tested chicks were polycythemic. The incidence of anemia was significantly (P less than 0.001) higher than expected (2.5%) at age 7 days (56.9%), 14 days (83.9%), 21 days (74.7%), 28 days (58.7%), and 35 days (57.9%). The incidence of polycythemia was significantly (P less than 0.001) higher than expected (2.5%) in 35-day-old broilers (21.1%) but was not significantly different from the expected rate in broilers at age 7 days (0%), 14 days (1.8%), 21 days (0.3%), and 28 days (4.3%). The established rates for anemia were much higher than we would have hypothesized. This led us to believe that either 1) an etiology for anemia is present in epizootic proportions in Georgia broilers, or 2) the standard method for establishing reference intervals for anemia in animals does not apply to broiler chicks.


Effects of ascorbic acid on stress and disease in chickens.

White leghorn chickens were given feed containing 100 mg of ascorbic acid (AA)/kg. One day later, treated chickens and a similar group of unmedicated control chickens were chilled for 1 hour at 6 C, exposed to an unusual sound, fasted, or subjected to rough handling. Heterophil:lymphocyte (H:L) ratios were determined one day later. The AA-treated birds had significantly lower H:L ratios than untreated controls. Chickens that received a diet containing AA had lower H:L ratios than controls (0.86 vs. 1.65) following administration of adrenocorticotropic hormone. Chickens fed a diet containing AA showed increased resistance to a combined Newcastle disease virus-Mycoplasma gallisepticum infection and to a secondary Escherichia coli infection, as well as to a primary E. coli challenge infection. The effects of AA and an antibacterial drug (furaltadone) were additive. In all experiments, the optimum dose of AA was 100 mg/kg of feed. There was a negative correlation between AA level in the diet and feed efficiency.


An atypical strain of Pasteurella gallinarum: pathogenic, phenotypic, and genotypic characteristics.

The pathogenicity of a strain of Pasteurella gallinarum isolated in Fresno County, Calif., was compared with the American Type Culture Collection (ATCC) strain. Broiler chickens were inoculated intranasally with 10(7) colony-forming units (CFU) and intramuscularly with 10(5) CFU of each strain. The only notable lesions were in chickens inoculated intramuscularly with 10(5) CFU of the Fresno strain, which developed severe myositis at the inoculation site, pericarditis, perihepatitis, airsacculitis, and synovitis. P. gallinarum was reisolated from these lesions. Phenotypic characteristics of the two strains were identical except in reactions in ONPG broth and fermentation of xylose. Protein-banding patterns for the two strains were identical except for a single band difference in the 35-kilodalton region. Restriction endonuclease analysis confirmed that the Fresno strain was a distinct one. Plasmid analysis revealed that the ATCC strain had two plasmids and the Fresno strain had none.


Adaptation of the Sensititre broth microdilution technique to antimicrobial susceptibility testing of Mycoplasma gallisepticum.

A technique is described for determining the antimicrobial susceptibility of Mycoplasma gallisepticum, using the Sensititre broth microdilution system. Fourteen M. gallisepticum field isolates and one reference isolate (R-strain) were tested in duplicate against seven antimicrobials. Isolates were susceptible to oxytetracycline, furaltadone, and lincomycin/spectinomycin, but not to amoxycillin and apramycin. Susceptibility to erythromycin and tylosin varied. These data are in agreement with those reported by other workers using more traditional methods, but this adaptation of the broth microdilution technique eliminates any variation attributable to the time-consuming preparation of antimicrobial dilutions associated with these methods.


Effects of Eimeria mitis on egg production of single-comb White Leghorn hens.

Single-comb white leghorn hens infected with either B4 or C2 strain of Eimeria mitis produced watery droppings as early as day 5 PI. E. mitis infection did not affect egg weight. However, specific gravities of the eggs produced by the hens infected with E. mitis were lower than those produced by the controls. Egg production was significantly reduced temporarily, but most birds returned to production within 14 days. Many of the birds that ceased to lay went through a complete-body molt (56% of the C2-infected hens and 20% of the B4-infected hens). Hens that ceased to lay regained considerable amounts of pigment in their skin, beaks, and shanks.


Dose-titration to confirm the level of fenbendazole for control of Raillietina cesticillus in broiler chickens.

A total of 452 broiler chickens, naturally infected with Raillietina cesticillus, were allotted into six treatment groups. One group was fed unmedicated broiler ration (Group 1), and the other five groups were fed broiler ration containing fenbendazole at 180 ppm for 3 days (38.5 mg/kg body weight [BW]), 240 ppm for 3 days (50.9 mg/kg BW), 120 ppm for 6 days (52.2 mg/kg BW), 180 ppm for 6 days (79.9 mg/kg BW), or 240 ppm for 6 days (104.3 mg/kg BW). Fenbendazole was 100.0% efficacious against R. cesticillus when administered in the diet at 240 ppm for 6 days; 99.9% at 240 ppm for 3 days and at 180 ppm for 6 days; 99.5% at 120 ppm for 6 days; and 96.9% at 180 ppm for 3 days. Fenbendazole treatment had no adverse effect on weight gain or feed intake.


Blood oxygen concentration of fast-growing and slow-growing broiler chickens, and chickens with ascites from right ventricular failure.

Percent hemoglobin oxygen saturation was measured with a pulse oximeter in 6-week-old slow-growing (light) and fast-growing (heavy) male broiler chickens and those with ascites from right ventricular failure (RVF). Pulse rate and percent oxygen saturation were read from the ulnar artery just proximal to the carpus. Percent oxygen saturation was significantly (P less than or equal to 0.0001) higher in light chickens (mean 91.6%) than in heavy chickens (mean 86.0%), and the percent oxygen saturation was significantly (P less than or equal to 0.0001) higher in both groups with normal hearts than in the group with RVF from valvular insufficiency (mean 62.1%). All RVF chickens and those with normal hearts were confirmed at necropsy. Light chickens were males with leg deformity or stunting and were 20-50% lighter than the heavy chickens.


Development and comparison of serologic methods for diagnosing chicken anemia virus infection.

This paper describes the development of an indirect immunoperoxidase assay (IIP) and an indirect enzyme-linked immunosorbent assay (ELISA) for detecting antibodies to chicken anemia virus (VAC). The IIP assay developed used CAV-infected MDCC-MSB1 cells for detecting antibody to CAV, whereas the ELISA utilized gradient-purified immunoadsorbed CAV as the target antigen. The IIP and ELISA were compared with the standard indirect immunofluorescent antibody (IFA) assay, which is more conventionally used to screen chicken serum for antibodies against CAV. Comparative test results of 185 field samples of chicken serum by these three methods were in agreement 84% of the time. Both IFA and IIP assays yielded fewer positive tests than did the ELISA. IFA and IIP assays were in agreement 93% of the time, as compared with 91% agreement of IIP and ELISA results, or 84% agreement for comparative IFA and ELISA results.


Suspected sodium toxicity in hand-reared great blue heron (Ardea herodias) chicks.

Sodium toxicity was suspected in hand-reared great blue heron (Ardea herodias) chicks fed herring frozen in brine (seawater). Affected chicks were lethargic with stiff legs that extended to the posterior, and breathing was labored. Chicks regurgitated food or refused to eat. All chicks that were fed herring exclusively and eight of the 10 chicks fed a mixed diet (herring and salmonids) died, whereas all chicks fed only salmonids survived. Renal lesions ranged from mild to marked generalized nephrosis, which was characterized by degeneration and necrosis of the proximal convoluted tubular epithelium and dilation of the distal convoluted tubules and collecting ducts. These observations suggest that fish frozen in brine is unsuitable food for hand-rearing of young herons.


Pen oxygen concentration and pulmonary hypertension-induced right ventricular failure and ascites in meat-type chickens at low altitude.

Percentage O2 and CO2 were measured in the air in environmentally controlled commercial poultry pens (altitude approximately 300 m) containing broiler or roaster chickens 14 to 56 days of age. Outside air (mean of 10 samples) measured 20.85% O2 and 0.041% CO2. Air in the pens had significantly lower O2 and higher CO2 than outside air; however, air in 25 pens with a high incidence of ascites (mean 20.50% O2, 0.264% CO2) was not different from the air in 25 pens with a low incidence of ascites (mean 20.49% O2, 0.319% CO2). The lowest pen O2 was 20.20%, which would not cause reduced hemoglobin saturation (percent oxygen) of the arterial blood of normal chickens.


Serological detection of Mycoplasma synoviae infection in turkeys.

The antibody response of turkeys experimentally infected with Mycoplasma synoviae was determined by the serum plate agglutination (SPA), hemagglutination-inhibition (HI), and microagglutination (MA) tests and the enzyme-linked immunosorbent assay (ELISA). No antibody response was detected until 2 weeks postinfection (PI) with the MA test (17% positive), 3 weeks PI with the SPA test (11% positive), 4 weeks with the HI test (21% positive), and 5 weeks PI with the ELISA, and even then, only 16% of the birds were positive. Although at least 89% of the birds were positive by culture, only 58% of the turkeys developed a detectable antibody response.


The effect of acetone on the viability of chicken anemia agent.

To study the effect of acetone on the viability of CAA, a sample of CAA with a known titer was treated with 90% acetone for 24 hours at room temperature. The remaining viable CAA was quantitated by titrating the treated preparation in MDCC-MSB1 cell culture. Results indicated that CAA is very resistant to inactivation by acetone.


Recurrent transient paresis in a turkey flock.

Recurring episodes of extreme leg weakness and associated mortality were documented in a turkey flock at 8 to 15 weeks of age. Flock mortality attributed to posterior paresis was approximately 12%, or 4800 of 40,000 turkeys. Four of six open-confinement units were affected. Gross and histological examinations revealed no significant lesions. Immunology and virology were uninformative. There were no significant differences in serum chemistry between clinically affected and normal turkeys. Testing of feed, water, soil, and tissues revealed no common toxicants. Isolation and supportive care for affected turkeys, both in the laboratory and in the field, frequently resulted in full recovery. Injection of a test group of affected turkeys with Type C botulism antitoxin appeared to enhance recovery. However, repeated attempts to detect botulism toxin in serum, liver, or cecal contents using mouse bioassay procedures were unsuccessful.


A comparison of the gland of Harder response and head-associated lymphoid tissue (HALT) morphology in chickens and turkeys.

The immunofunctional response of the gland of Harder (GH) was compared in chickens and turkeys using an in vivo assay previously developed for use in chickens. The GH were surgically removed (GHx) from leghorn chicks at 1 day of age and from poults at 2 days of age. Intact birds of each species served as controls. During the fourth week of age, both GH-intact and GHx chicks were exposed to killed Brucella abortus antigen by the ocular or intraperitoneal route. One week later, serum and tears were collected and assayed for antibodies to B. abortus. In addition, all birds were killed at the end of the trial period, and the heads were fixed and processed for histologic examination. Various components of the head-associated lymphoid tissue (HALT) including the GH, nasal glands, lacrimal glands, lacrimal ducts, eyelid conjunctiva, and nasal cavity mucosa/submucosa, were evaluated microscopically using a scoring system to estimate quantity and degree of development of immune tissue in those sites. Results of all analyses indicate that functional response and morphology of the HALT are comparable in turkeys and chickens.


Salmonella enteritidis infection in two species of psittaciformes.

In 1990, Salmonella enteritidis phage type 4 was recovered from two young (less than 20-week-old) lilac-crowned Amazon parrots (Amazona finschi Schlater), one in Tennessee and one in Kansas. The parrot from Tennessee was treated for a plugged naris and anorexia before the S. enteritidis infection was discovered. The parrot from Kansas exhibited signs of septicemia and died within 24 hours of examination. An apparently healthy green-cheeked conure (Pyrrhura molinae) on the same premises as the parrot from Tennessee was positive for S. enteritidis phage type 4 on a cloacal swab. These are the first reported cases of avian infection with S. enteritidis phage type 4 in the United States. Because several infectious agents were present simultaneously in the Amazon parrots, it was difficult to determine the precise role of S. enteritidis phage type 4 in the clinical presentations.


Association of cecal spirochetes with pasty vents and dirty eggshells in layers.

Feces-stained eggshells, diarrhea, and typhlitis were identified in two commercial laying flocks in Ohio. Hens with diarrhea had spirochetes in cecal lumina and crypts. On culture, the spirochetes were motile and non-hemolytic, did not produce indole, had 12 to 15 axial filaments, were 9.2 to 11.7 microns in length and 240 to 370 nm in diameter, and had a wavelength of 5.1 to 6.5 microns on transmission electron microscopy.


Epizootiological investigation of an outbreak of pullorum disease in an integrated broiler operation.

An integrated broiler company experienced a major outbreak of pullorum disease during 1990. The outbreak resulted in the distribution of Salmonella pullorum-infected birds to more than 150 roaster flocks in five states. Twenty-two parent (multiplier) breeder flocks became infected. An epizootiological investigation uncovered a grandparent male line breeder flock as the index flock supplying males to the affected parent flocks. Transmission apparently occurred vertically through the egg and horizontally by contact in the hatcheries and by placement of chicks on contaminated litter.


Breeder turkey hens seropositive and culture-negative for Mycoplasma synoviae.

Four flocks of clinically normal turkey breeder hens were shown to have suspect and positive Mycoplasma synoviae (MS) hemagglutination-inhibition (HI), enzyme-linked immunosorbent assay, and, in some cases, serum plate agglutination serology in the absence of MS isolation. In all cases, HI serology for Mycoplasma gallisepticum (MG) and M. meleagridis was negative. Acholeplasma laidlawii was isolated from some hens in each of these MS-seropositive culture-negative flocks. Immunoblotting was used to help determine if this positive MS serology was a result of cross-reactive antibodies to A. laidlawii or to some other Mycoplasma species. When sera from two of the flocks were reacted with MS antigen in immunoblotting, a strong and characteristic MS immunoblot profile was seen. Immunoblotting gave no evidence of a strong antibody response to A. laidlawii, M. iowae, or MG. This suggests the presence (or earlier presence) of MS in these flocks that is difficult to isolate by routine methods. Furthermore, this work shows that immunoblotting can be an important tool in the diagnosis of poultry diseases.


Necrotic enteritis in turkeys.

Three flocks of turkey hens (16,000 each) between 7 and 12 weeks of age experienced outbreaks of necrotic enteritis. Necropsy revealed a dilated duodenum and jejunum with mucosal surfaces covered with a diphtheritic membrane. Intestinal scrapings showed very few oocysts of Eimeria sp. Histopathological findings were compatible with necrotic enteritis but with deeper, more severe lesions than in broiler chickens. Clostridium perfringens was isolated by anaerobic culture from the intestinal contents. Mortality returned to normal after ampicillin or tetracycline was added to the drinking water.


Intestinal adenocarcinoma of the ileocecal junction in a chicken.

An 89-week-old male chicken was presented with signs of depression, emaciation, and weakness. At necropsy, a stricture was found at the ileocecal junction that resulted in blockage and dilation of the ileum proximal to the stricture. Histologically, neoplastic epithelial cells that contained mucin had invaded the intestinal wall and produced a fibrous connective tissue reaction. The lesion was diagnosed as scirrhous intestinal adenocarcinoma.


Sex and gender and the impaired therapist.

A brief review of the problem of impaired therapists is followed by a more comprehensive review of sexual relationships arising in and following psychotherapy. The prevalence of this latter problem is approximately 10%. Offenders are predominantly male, one half are said to be "ruthless" and "exploitative", whilst the remainder are often "lovesick". The author relates these phenomena to processes of repudiation of the relational/feminine self of the highly masculinised clinician. Characteristics of offenders and consequences for patients are presented and issues of detection, sanctions, legislation, and prevention are addressed. Studies suggest that the vast majority of patients are harmed by the experience and that neither improved training, licensing, personal therapy, nor supervision of therapists will guarantee against its occurrence.


Empathy--a retrospective on its development in psychotherapy.

The paper situates the notion of empathy broadly within the historical context of its origins and subsequent conceptual development, particularly in psychotherapy. It shows how the term is related to its wider usage in popular culture and in studies outside of psychoanalytic psychotherapy. The paper surveys the contributions of several psychoanalytic writers, from Freud to Kohut. This is followed by a critique of more recent psychoanalytic inquiries into empathy. The discussion explores reasons for some of the difficulties resting with a psychoanalytic approach. It is suggested that these are due in large measure to inherent difficulties in defining the term, but that they are accentuated by the language and polemics of psychoanalysis. More specific contributions are considered with a view to understanding the notions of aetiology, description, function and epistemology in regard to empathy within the psychoanalytic framework.


Eastern equine encephalitis in a flock of emus (Dromaius novaehollandiae).

Eastern equine encephalitis (EEE) was diagnosed in a flock of emus in southeastern Louisiana. The outbreak involved juvenile and adult breeders ranging in age from 20 to 36 months, with an attack rate of 76% and a case fatality rate of 87%. The diagnosis was confirmed by isolation and characterization of the viral agent, and by detection of EEE antibody in two recovered emus. High mortality was preceded by marked depression, hemorrhagic diarrhea, and emesis of blood-stained ingesta. On postmortem examination, hemorrhagic enteritis and multiple petechia of viscera were observed. Microscopic changes included severe necrosis of hepatocytes, intestinal mucosa, and necrotizing vasculitis of the spleen and lamina propria of the intestine. No nervous system lesions were observed. This outbreak occurred concurrently with EEE in horses and was attributed to unseasonably heavy rainfall with an abundance of arthropod vectors and proximity to free-living reservoir host species.