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Pneumonia remains a major cause of morbidity and mortality in the immunocompromised host. The type and timing of immunosuppression will predispose the patient to infections with certain pathogens. This article discusses the types of immunosuppression and their infectious and noninfectious implications. Key points of the most commonly involved pathogens are mentioned. Finally, an approach to diagnosis and empiric therapy is discussed.

Objectives: To evaluate cross-clade recognition of p55 antigen by cytotoxic T lymphocytes (CTL) in persons infected with diverse clades of HIV-1; to facilitate the development of a CTL-inducing vaccine to prevent transmission of multiple clades of HIV-1., Design: Experiments were designed to evaluate whether persons in Uganda and the United Kingdom, infected with diverse clades of HIV-1, have CTL capable of recognizing and killing autologous target cells infected with recombinant vaccinia viruses (rVV) expressing the Gag protein from A, B, C and D clade HIV-1. The extent of cross-reactivity within such individuals, each infected with characterized virus, might reflect the type of cross-reactive immune response inducible by a monovalent vaccine., Methods: Asymptomatic HIV-positive individuals were fully tissue-typed by ARMS (amplification of refractory mutation system) polymerase chain reaction. rVV expressing the Gag protein from identified A, B, C and D viruses were prepared. CTL were cultured and tested for cytolytic activity on autologous rVV-infected or peptide-pulsed B cells., Results: Ugandan patients had inducible CTL responses recognizing A, B, C and D clade HIV-1 Gag. The majority of UK patients had inducible CTL responses that recognized two or more clades. No patient showed any HIV-2 cross-reactivity. Cross-reactive responses were characterized in three Ugandan patients., Conclusions: Most patients tested mounted cross-reactive CTL responses that recognized Gag proteins from clades of HIV-1 other than those with which they were infected.

The purpose of this experimental work was to study the possibility of stress ulcer in fetal Surgery. Firstly an experimental model of production of stress ulcer by hypovolemic shock was worked out: by removing a volume of blood equivalent to 2% of body weight out of the femoral artery, a stress ulcer was was regularly induced in 25 female rabbits in the fundic area within 3 hours. In 10 pregnant rabbits and in the fetuses a stress ulcer could not be produced by the same method. This observation suggests the hypothesis that the reactions of the gastric wall are modified by the specific hormonal situation of the pregnant rabbit. This assumption ought to be elucidated by further investigations.

Major trauma to the upper extremity may lead to ischemic contracture of various muscle groups, sometimes including the intrinsic muscles of the hand. The clinical consequence of such necrotic fibrosis of the intrinsics is clawing of the digits with marked stiffness. After a short anatomical review of the fascias of the intrinsics, indications and operative techniques are discussed, in parallel with clinical cases. Intrinsic fasciotomy thus appears to be a major step in the prevention of digital clawing, when associated with early physiotherapy.

The presence of antibodies against bovine herpesvirus 1 (BHV-1), bovid herpesvirus 6 (BHV-6), herpesvirus of Cervidae type 1 (HVC-1), reindeer herpesvirus, bovine herpesvirus 2 (BHV-2) and bovid herpesvirus 4 (BHV-4) was investigated in wild ruminants of France and Belgium between 1981 and 1986. There were no animals serologically positive for BHV-4. Antibodies against BHV-2 were demonstrated in roe deer (Cervus capreolus) (less than 1%) and chamois (Rupicapra rupicapra) (1%) in France. Animals seropositive to the four related viruses (BHV-1, BHV-6, HVC-1, reindeer herpesvirus) were detected in red deer (Cervus elaphus) in France and Belgium (1% and 11%, respectively), in roe deer (less than 1%) from France, in chamois (4%) in France and in ibex (Capra ibex) (4%) from France. The presence of antibodies against HVC-1, especially in red deer from Belgium, may suggest that wild ruminants in continental Europe are now infected with this virus, which previously has been isolated only in Scotland.

A case is presented wherein a severely malformed permanent central incisor was reshaped utilizing a visible light cured composite resin restorative material and retained for two years pending the commencement of active orthodontic therapy. The orthodontic implications of this case are discussed as are the histological and restorative dentistry aspects. The need for a combined, interdisciplinary approach to such problems is emphasized.

A complete automation of the determination of triglycerides is described which replaces the manual extraction and the final determination with an autoanalyzer chain, based on the method of Royer et al. For the automation of triglyceride extraction, we have modified the sampler, by incorporating a magnetic stirrer under the sample table. The sample table has two rows of holes. The sera, which are taken from the inner row and diluted with sulphuric acid, are reacted quantitatively with the extraction reagent in the beakers of the outer row, which contain a magnetic follower. After stirring, the upper phase is quantitatively removed and the determination is started. The problem of phasing the individual steps of the analysis is thus solved.