Albert Einstein College of Medicine, Yeshiva University: Open Journal Systems
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Antigenic Variation in Viruses
No full textPersistent virus Infections represent an immunologlcal paradox, in that viruses persist in the face of normal immune responses. The classical serological studies on viruses causing acute Infections established a remarkable degree of antigen and structural uniformity within each virus type. The obvious exception has been Influenza which, because of changes in specific antigenic determinants, is able to generate a variety of antigenic variants which can elude the immune responses of hosts previously infected with slightly differing viruses. The phenomenon of high mutability and antigenic variation previously associated uniquely with influenza virus, appears to be a more general one. Recent studies indicate that many viruses, long thought to be antlgenlcally stable, areknown to exist in multiple antigenic forms, both in the laboratory and in nature. Data will be presented here that this is true as well of measles virus, thought previously to be the most antlgenlcally stable of any ofthe common acute viruses. The biological implications and possible role of viral antigenic changes in human disease, particularly in relation to persistent infections, will be discussed in this article
Hepatic Fibrosis in Schistosomiasis
Get PDFSchistosomiasis, a disease affecting over 200,000,000 human beings, is caused by infection with one of several s cies of the Schistosoma trematodes. The in fectious form for mammals is the cercaria developed by passage through snails. The major cause of death in those infected results from distortion of the hepatic circulation caused by a unique kind of fibrosis In the liver. The fibrosis occurs In relation to the formation of numerous highly cellular and collagenous granulomata as part of a cell-mediated immune response to eggs deposited by worms In the portal tract. After a period of tlme, the granulomata disappear as new formation of broad bands of collagen appear in the liver. Because of the nature of those bands the condition is called pipestem fibrosis. The fibrosis distorts liver architecture and with that the circulation of blood in the liver. Prevention of the disease by ecological controls directed largely against the snail vector, would seem to be most important. Falling that, the disease itself is treated largely by use of a number of chemothera utic agents directed against the Schistosoma. The present a icle reviews the modes of treatment now In use, and describes possible means of preventing or versing the deposition of collagen that constitutes the fibrosis. Research on analogs of proline and lysine Inhibit collagen biosynthesis or stimulate collagen d radation Is described. Possible new approaches for prevention of maturation and mating of worms lodged In portal tracts is considered as a means of preventing egg formation and the consequent host immune response that causes fibrosis.
Seeing In The Dark: How Backyard Stargazers are Probing Deep Space and Guarding Earth from interplanetary Peril
Get PDFReconsideration of the New York State Laws Rationalizing the Supervision and the Working Conditions of Residents
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Successful Endoscopic Clipping of Appendiceal Orifice Bleeding: A Technical Maneuver to Convert an Emergency to an Elective Procedure
Get PDFObjective: We report a rare case of an elderly man with appendiceal bleeding successfully treated with endoscopic placement of hemoclips. Methods: We describe the patient’s clinical presentation, laboratory test results, imaging, and treatment. Results: An 89-year-old man presented with two episodes of bloody diarrhea that occurred two hours apart. Colonoscopy revealed active bleeding from the appen- diceal orifice. Hemostasis was achieved with epinephrine injections followed by placement of five hemoclips to effectively close the appendiceal orifice. An abdominal computed tomography (CT) showed an irregular thick- ening of the appendix wall, raising the possibility of an appendiceal mass. On hospital day 4, the patient underwent appendectomy and partial cecectomy. Pathology revealed focal ulceration of the mucosa without malig- nancy. The remainder of the patient’s hospital course was uneventful.Conclusion: The endoscopic methods used in our case proved effective in achieving hemostasis and allowed the patient to be stabilized prior to surgery. It is unclear whether longer monitoring would reveal any possible long-term complications after endoscopic closure of the appendix. It would be of interest to further investigate this approach to assess the long-term safety and efficacy of this procedure.
