The incidence of male-to-female transmission of HIV infection was studied in a population of 198 sexual partners of hemophiliacs who tested HIV positive since 1984. The follow-up observation period was 1987-1992. Transmission occurred in 20 (10%) cases. The analysis of risk factors for transmission was performed in a subgroup of 57 hemophiliacs with seronegative sexual partners as compared to eight transmitters. Transmitters showed a significantly more advanced immune depletion at enrollment as well as at the end of the observation period. Furthermore, transmitters had a more advanced disease at the end of the study (75% vs. 29% CDC IV; p < 0.01). Also virus cultures were more frequently positive in the transmitters than in the non-transmitters (71% vs. 42%). Regular sexual counseling was offered to all couples. After 1987, no new seroconversions were detected. However, two seroconversions in female partners of hemophiliacs outside the initial study population were observed. Both transmissions occurred during a period of severe clinical and immunological deterioration. This study shows that sexual partners of HIV-infected hemophiliacs with more advanced disease are at higher risk of infection with HIV. The frequency of male-to-female transmission of HIV in long-term monogamous sexual relationships practicing safer sex is low. Overall, disease awareness and counseling for safer sex seem to be effective in reducing transmission rates.

Adult↗

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Tick-borne encephalitis in southwestern Germany.

In Baden-Württemberg in 1994 and 1995 approximately 390 persons fell ill after infection with the tick-borne encephalitis (TBE) virus. Detailed clinical data were available from 300 patients for further analysis. TBE mostly manifested as meningitis (50%) or meningoencephalitis (38%) and more rarely as encephalomyelitis and/or radiculitis (12%). Four patients with encephalomyelitis died.

Adolescent↗

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Serodiagnosis of neuroborreliosis: comparison of reliability of three confirmatory assays.

The sensitivity and specificity of three confirmatory assays for the serodiagnosis of neuroborreliosis were investigated. Samples from 96 patients with proven neuroborreliosis, 80 healthy volunteers, 20 patients with neurosyphilis and 20 patients with recent infections with Epstein-Barr virus (EBV) were tested for borrelial antibodies by immunoblotting, Borrelia burgdorferi sensu lato sonicate EIA following pre-absorption of cross-reactive antibodies (Abs-EIA) and by a so-called RECO-EIA using the following recombinant borrelial proteins as antigens: a 14 kDa-internal flagellin fragment, the outer surface protein C (23 kDa) and the high molecular mass protein p83 (83 kDa). The immunoblots were evaluated according to the criteria published by Engström et al. and Hauser et al. An evaluation of IgM and/or IgG antibodies revealed a considerably higher sensitivity for the RECO-EIA (94%) compared to the Abs-EIA (82%, P < 0.0001). Evaluation of the immunoblot according to the criteria of Hauser was significantly more sensitive than according to the criteria of Engström (89 vs 51%, P = 0.0003). A higher sensitivity was demonstrated for IgM (54 vs 22%) and IgG antibodies (64 vs 24%). When both findings from RECO-EIA and immunoblotting were considered, positive findings in the first step assay (sonicate EIA without pre-absorption) were confirmed in 97% of patients. When samples were tested for IgM antibodies, the specificities of the three confirmatory assays did not differ significantly, but in the case of IgG antibodies, the immunoblot (Hauser: P = 0.013; Engström: P = 0.004) and the RECO-EIA (P = 0.02) were more specific than the Abs-EIA. It is concluded that the immunoblot (evaluated according to Hauser) and the RECO-EIA are both suitable as confirmatory assays in the serological diagnosis of neuroborreliosis. Monoclonal antibodies are mandatory tools in the evaluation of the immunoblot.

Absorption↗

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Laboratory findings in tick-borne encephalitis--correlation with clinical outcome.

Infection with the tick-borne encephalitis virus (TBEV) can result in various neurological complications. At present, there are little data available on laboratory findings that might help predict the clinical course and prognosis of tick-borne encephalitis (TBE). In the present study 100 patients with TBE were examined in respect to various laboratory parameters potentially characteristic for the disease and indicative for the prognosis in TBE. Pleocytosis, impairment of the blood-CSF barrier and intrathecal synthesis of immunoglobulins (IgM > IgG, IgA) were common findings in most patients. On admission to the hospital, 84% of the patients presented with an intrathecal synthesis of TBEV-specific IgM and/or IgG antibodies in the CSF. At follow-up, intrathecal synthesis of TBEV-specific antibodies was demonstrated in all patients studied within 15 days after the first examination, but changes of CSF parameters did not correlate with the clinical course of disease. In contrast to those with moderate course of disease, patients with severe courses of TBE displayed higher cell counts in the CSF and lower concentrations of neutralizing antibodies in serum, and more frequently revealed an intrathecal synthesis of total IgG. TBE-specific oligoclonal IgG antibodies in the CSF were demonstrated only in three patients with prior, incomplete, vaccination against TBE. The severe course of disease in individual patients with TBE may result from a slow or low production of neutralizing antibodies. In these patients, the more intense damage of the CNS tissue is reflected by higher cell counts in the CSF. At onset of disease the presence of a low concentration of neutralizing antibodies in serum and a high cell count in the CSF might indicate an unfavorable course of TBE.

Adolescent↗

PubMedDate not supplied

Enrichment of X-spermatozoa and in vitro penetration through cervical mucus.

Using the Sephadex Gel-filtration method (Steeno - 1975) we carried out a review of the data on the possibility of enriching X-spermatozoa. The testing procedure followed consisted of determining Y-chromatin positive spermatozoa after staining with quinacrine-mustard. We were able to confirm the data recorded by Steeno, according to which an enrichment of about 80-90% can be achieved after penetration through the Sephadex Gel filter. In addition to these investigations we also carried out tests with the enriched X-spermatozoa material to determine in vitro penetration through cervical mucus. No decline in the progressive motility of the spermatozoa was observed. After the Gel-filtration sufficient numbers of these were still able to cover penetration distances of 60 mm/hour. The enrichment effect of the X-spermatozoa declined at the beginning of in vitro penetration, but there was no further change in the subsequent course of penetration.

Cervix Mucus↗

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Hypocarotenemia in patients fed enterally with commercial liquid diets.

We have found that 12 patients requiring permanent enteral feeding secondary to cerebrovascular accident with adequate Vitamin A nutritional status had serum concentrations of various carotenoids which were only 8-17% of sex- and age-matched healthy controls. Their serum retinol levels were normal, but only 61% of their controls despite receiving two to three times the recommended daily allowance (RDA) in retinol equivalents. Commercial enteral formulas were found to contain only negligible quantities of the carotenoids and were the cause of the hypocarotenemia. To assess the ability of these patients to absorb beta-carotene, nine tube-fed patients were given 15 mg of beta-carotene (2.5 times the RDA) in a single dose. Serum concentration time curves showed that only four patients absorbed significant quantities of the beta-carotene and absorption was delayed compared to previously studied subjects taking enteral formulas as meals. These studies suggest that the efficiency of absorption of the fat soluble vitamins may be lower in tube-fed patients and that patients receiving long-term tube feeding are denied the possible protective effects of the carotenoids normally contained in the American diet.

Adult↗

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Wound healing following intrastromal photorefractive keratectomy with the Nd:YLF picosecond laser in the cat.

BACKGROUND: We studied the histopathology of the stromal wound healing response in the cat cornea following intrastromal photorefractive keratectomy (IPRK) with the Nd:YLF picosecond laser. METHODS: Intrastromal PRK was performed in the anterior stroma of cat corneas with the Nd:YLF picosecond laser. The cats were sacrificed at predetermined intervals ranging from immediately to 6 months postoperatively. Effects of the laser treatment on the epithelium, Bowman's layer, stroma, and the endothelium were evaluated using light and scanning electron microscopy. No anti-inflammatory agents were used. RESULTS: Intrastromal PRK resulted in no perceptible damage to the corneal epithelium or Bowman's layer either acutely or at 6 months. The corneal stroma showed multiple cavitations immediately after intrastromal PRK, which collapsed over several hours, followed by thinning of the cornea over 2 weeks. At 1 month, the stromal collagen was abnormal with surrounding hypercellularity. The endothelium showed no injury, acutely or at 6 months. No thermal effects on stromal collagen were observed at 6 months, and disruption of the lamellar pattern was not apparent after the cavitation bubbles were reabsorbed. CONCLUSION: Intrastromal PRK can effectively remove stromal tissue without acute damage to the adjacent lamellae, epithelium, or endothelium. There is a transient cellular wound healing response associated with a transient stromal collagen abnormality at 2 weeks to 1 month, which was not apparent 2 months after the procedure.

Animals↗

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Electroconvulsive therapy and the catatonic dilemma.

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Adult↗

PubMedDate not supplied

[Determination of the frequency of Y-chromatin positive spermatozoa in relation to the parameters of spermiograms].

The percentage of y chromatin positive spermatozoa had been determined using the fluorescence microsopce technique. After staining procedure with Atebrin we counted 44.1 (+/- 3.9)% y poistive sperms, after staining with Quinacrine mustard the amount was 48,4 (+/- 4,3)%. With statistical methods we examined the correlation of the percentage y sperms to the single parameters of the semen analysis. So the sperm count, the motility, morphology, pH and fructose of seminal plasma had been compared with their influence upon the X-Y relationship of spermatozoa. In conclusion of our results there was no considerable variability in the X-Y sperm ratio by the different parameters of the semen analysis.

Cell Count↗