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A letter to the editor is presented in response to the article "Efficacy and Safety of Recombinant Human Activated Protein C for Severe Sepsis," by G. R. Bernard, J. L. Vincent and P. F. Laterre in the March 8, 2001 issue.

Seizures and epilepsy after traumatic brain injury (TBI) negatively affect quality of life and longevity. Antiseizure medication (ASM) prophylaxis after severe TBI is associated with improved outcomes; these medications are rarely used in mild TBI. However, a paucity of research is available to inform ASM use in complicated mild TBI (cmTBI) and no empirically based clinical care guidelines for ASM use in cmTBI exist. We aim to identify seizure prevention and management strategies used by clinicians experienced in treating patients with cmTBI to characterize standard care and inform a systematic approach to clinical decision making regarding ASM prophylaxis. We recruited a multidisciplinary international cohort through professional organizational listservs and social media platforms. Our questionnaire assessed factors influencing ASM prophylaxis after cmTBI at the individual, institutional, and health system–wide levels. Ninety-two providers with experience managing cmTBI completed the survey. We found a striking diversity of ASM use in cmTBI, with 30% of respondents reporting no/infrequent use and 42% reporting frequent use; these tendencies did not differ by provider or institutional characteristics. Certain conditions universally increased or decreased the likelihood of ASM use and represent consensus. Based on survey results, ASMs are commonly used in patients with cmTBI who experience acute secondary seizure or select positive neuroimaging findings; we advise caution in elderly patients and those with concomitant neuropsychiatric illness. This study is the first to characterize factors influencing clinical decision making in ASM prophylaxis after cmTBI based on multidisciplinary multicenter provider practices. Prospective controlled studies are necessary to inform standardized guideline development. [ABSTRACT FROM AUTHOR]

Objective:. This study aimed to compare operative time, blood loss, and transfusion requirement in patients receiving a high tranexamic acid (TXA) dose of greater than 10 mg/kg versus those receiving a low dose of 10 mg/kg or less. Methods:. PubMed, Cochrane Central, and Embase were queried to perform a systematic review with meta-analysis. Studies reporting outcomes of TXA use in craniosynostosis surgery were included. TXA dosing, operative time, blood loss, and transfusion requirement were the primary outcomes studied. Other variables studied included age and types of craniosynostosis. Results:. In total, 398 individuals in the included articles received TXA for craniosynostosis surgery. TXA loading doses ranged from 10 mg/kg to 50 mg/kg. Overall, administration of TXA was not associated with changes in operative time, but was associated with decreased blood loss and transfusion requirement on meta-analysis. Comparison of high dose TXA (>10 mg/kg) versus low dose (10 mg/kg or less) showed no statistical differences in changes in operative time, blood loss, or transfusion requirement. Conclusions:. Overall, TXA reduced blood loss and transfusion requirement in patients undergoing surgery for craniosynostosis. There was no difference in outcomes between high dose and low dose regimens amongst those receiving TXA. Low dose TXA appears adequate to achieve clinical efficacy with a low adverse event rate.

Alien Hand Syndrome (AHS) is characterized by intermittent and involuntary movements of a single limb that is not associated with motor dysfunction. AHS may be the initial presentation of serious underlying pathology, such as stroke localized to the non-dominant parietal lobe, corpus callosum damage, or neurodegenerative disease. AHS occurs at a low prevalence in the general population yet represents significant underlying disease burden, necessitating early identification. In this case report, we present an 88-year-old right-handed male with involuntary movement of his left forearm and hand three hours prior to presentation. His symptom corresponded to findings on MRI of the brain, which showed acute infarcts of the right temporal lobe, right parietal cortex, and right parietal subcortex. Infarction of the right parietal cortex accounted for his AHS. The multifocal nature of the infarcts elevated the index of suspicion for an embolic source. [ABSTRACT FROM AUTHOR]

Foraging behavior of necrophagous flies commonly leads to distortion of human bloodstains and production of artifacts that confound reconstruction efforts at crime scenes. Currently there is no reliable method for detection of fly-derived stains or distinction of the artifacts from human bloodstains. To overcome these deficiencies, a confirmatory test was developed based on immunological detection of cathepsin D found in digestive fluids of Musca domestica and Protophormia terraenovae. Anti-serum (anti-md3 serum) was generated toward a 17-amino acid synthetic peptide based upon predicted antigenic amino acid sequences for the propeptide and mature enzyme of cathepsin D proteinase from larvae of M. domestica. The serum was used to test the hypothesis that digestive artifacts produced by an array of necrophagous flies associated with human decomposition could be detected with the immunoassay. Anti-md3 serum was able to bind artifacts from 27 species of flies representing 9 families. The antiserum reacted with both regurgitate and defecatory stains, but not transfer patterns. Stains from 4 fly species displayed no reactivity with anti-serum in dot blot assays. Anti-md3 serum did not bind to either human or bovine blood stains on filter paper. However, when both types of blood were spiked with synthetic md3 peptide the antiserum was able to bind. Dot blot assays displayed positive reactions with stains produced from larvae and teneral adults of Sarcophaga bullata, and with artifacts as old as 7-years after deposition. These observations indicate that the immunoassay permits distinction of artifacts from a wide range of species from human bloodstains, from multiple development stages, and from artifacts that remain at crime scenes for many months to years after deposition. Further work is needed to determine whether the detection of fly artifacts using the antiserum is suitable for non-laboratory conditions. Keywords: Insect stains, Regurgitate, Defecatory stains, Immunodetection, Bloodstains, Forensic entomology

Alien Hand Syndrome (AHS) is characterized by intermittent and involuntary movements of a single limb that is not associated with motor dysfunction. AHS may be the initial presentation of serious underlying pathology, such as stroke localized to the non-dominant parietal lobe, corpus callosum damage, or neurodegenerative disease. AHS occurs at a low prevalence in the general population yet represents significant underlying disease burden, necessitating early identification. In this case report, we present an 88-year-old right-handed male with involuntary movement of his left forearm and hand three hours prior to presentation. His symptom corresponded to findings on MRI of the brain, which showed acute infarcts of the right temporal lobe, right parietal cortex, and right parietal subcortex. Infarction of the right parietal cortex accounted for his AHS. The multifocal nature of the infarcts elevated the index of suspicion for an embolic source.

Immune thrombocytopenic purpura (ITP) is a common cause of symptomatic thrombocytopenia in children, most of whom present with cutaneous and mucosal bleeding. Complications, such as intracranial hemorrhage and occult hemorrhage from various sites, are rare, and retinal hemorrhage is exceptionally rare. Our institutional clinical practice guidelines for managing ITP in the pediatric emergency department (PED) include routine funduscopy. The aim of this retrospective case series is to provide evidence-based recommendations for a tertiary care PED work-up of ITP, with special emphasis on the guidelines for funduscopy. The medical records of all pediatric patients diagnosed with ITP over a 4-year period (2013-2016) who had a platelet count < 50,000/mm3 were retrieved and reviewed. Seventy-five patients with thrombocytopenia (platelet count < 50,000/mm3) were diagnosed as having ITP in the PED. Sixty-one (79%) of these patients underwent funduscopy and retinal hemorrhage was ruled out in all of them, indicating that retinal hemorrhage as a complication of ITP is very rare.Conclusion: Our data suggest that funduscopy should not be performed routinely on pediatric ITP patients, but rather be reserved for those who present with concurrent anemia or visual complaints. What is Known: • Many internal institutional protocols in Israel call for retinal hemorrhage bleeding surveillance in work up of ITP. Our study found no case of ITP with retinal bleeding. What is New: • Many internal institutional protocols in Israel call for retinal hemorrhage bleeding surveillance in work up of ITP. Our study found no case of ITP with retinal bleeding. [ABSTRACT FROM AUTHOR]

In this paper we test the performance of the Regional Estimates of VEgetation Abundance from Large Sites (REVEALS) model using pollen records from multiple small sites. We use Holocene pollen records from large and small sites in southern Sweden to identify what is/are the most significant variable(s) affecting the REVEALS-based reconstructions, i.e. type of site (lakes and/or bogs), number of sites, site size, site location in relation to vegetation zones, and/or distance between small sites and large sites. To achieve this objective we grouped the small sites according to (i) the two major modern vegetation zones of the study region, and (ii) the distance between the small sites and large lakes, i.e. small sites within 50, 100, 150, or 200 km of the large lakes. The REVEALS-based reconstructions were performed using 24 pollen taxa. Redundancy analysis was performed on the results from all REVEALS-model runs using the groups within (i) and (ii) separately, and on the results from all runs using the groups within (ii) together. The explanatory power and significance of the variables were identified using forward selection and Monte Carlo permutation tests. The results show that (a) although the REVEALS model was designed for pollen data from large lakes, it also performs well with pollen data from multiple small sites in reconstructing the percentage cover of groups of plant taxa (e.g. open land taxa, summer-green trees, evergreen trees) or individual plant taxa; however, in the case of this study area, the reconstruction of the percentage cover of Calluna vulgaris, Cyperaceae, and Betula may be problematic when using small bogs; (b) standard errors of multiple small-site REVEALS estimates will generally be larger than those obtained using pollen records from large lakes, and they will decrease with increasing size of pollen counts and increasing number of small sites; (c) small lakes are better to use than small bogs if the total number of small sites is low; and (d) the size of small sites and the distance between them do not play a major role, but the distance between the small sites and landscape/vegetation boundaries is a determinant factor for the accuracy of the vegetation reconstructions. [ABSTRACT FROM AUTHOR]

We present the major results from studies of fire history over the last 11000 years (Holocene) in southern Sweden, on the basis of palaeoecological analyses of peat sequences from three small peat bogs. The main objective is to emphasize the value of multiple, continuous sedimentary records of macroscopic charcoal (macro-C) for the reconstruction of local to regional past changes in fire regimes, the importance of multi-proxy studies, and the advantage of model-based estimates of plant cover from pollen data to assess the role of tree composition and human impact in fire history. The chronologies at the three study sites are based on a large number of C dates from terrestrial plant remains and age-depth models are achieved using Bayesian statistics. Fire history is inferred from continuous records of macro-C and microscopic charcoal counts on pollen slides. The Landscape Reconstruction Algorithm (LRA) for pollen-based quantitative reconstruction of local vegetation cover is applied on the three pollen records for plant cover reconstruction over the entire Holocene. The results are as follows: (1) the long-term trends in fire regimes are similar between sites, i.e., frequent fires during the early Holocene until ca. 9 ka BP, low fire frequency during the mid-Holocene, and higher fire frequency from ca. 2.5 ka BP; (2) this broad trend agrees with the overall fire history of northwestern and western Europe north of the Mediterranean area, and is due to climate forcing in the early and mid-Holocene, and to anthropogenic land-use in the late Holocene; (3) the LRA estimates of plant cover at the three sites demonstrate that the relative abundance of pine played a primordial role in the early and mid-Holocene fire history; and (4) the between-site differences in the charcoal records and inferred fire history are due to local factors (i.e., relative abundance of pine, geomorphological setting, and anthropogenic land-use) and taphonomy of charcoal deposition in the small peat bogs. It is shown that continuous macro-C records are most useful to disentangle local from regional-subcontinental fire history, and climate-induced from human-induced fire regimes, and that pollen-based LRA estimates of local plant cover are more adequate than pollen percentages for the assessment of the role of plant composition on fire history. [ABSTRACT FROM AUTHOR]

Abstract: For over a century, venom samples from wild snakes have been collected and stored around the world. However, the quality of storage conditions for “vintage” venoms has rarely been assessed. The goal of this study was to determine whether such historical venom samples are still biochemically and pharmacologically viable for research purposes, or if new sample efforts are needed. In total, 52 samples spanning 5 genera and 13 species with regional variants of some species (e.g., 14 different populations of Notechis scutatus) were analysed by a combined proteomic and pharmacological approach to determine protein structural stability and bioactivity. When venoms were not exposed to air during storage, the proteomic results were virtually indistinguishable from that of fresh venom and bioactivity was equivalent or only slightly reduced. By contrast, a sample of Acanthophis antarcticus venom that was exposed to air (due to a loss of integrity of the rubber stopper) suffered significant degradation as evidenced by the proteomics profile. Interestingly, the neurotoxicity of this sample was nearly the same as fresh venom, indicating that degradation may have occurred in the free N- or C-terminus chains of the proteins, rather than at the tips of loops where the functional residues are located. These results suggest that these and other vintage venom collections may be of continuing value in toxin research. This is particularly important as many snake species worldwide are declining due to habitat destruction or modification. For some venoms (such as N. scutatus from Babel Island, Flinders Island, King Island and St. Francis Island) these were the first analyses ever conducted and these vintage samples may represent the only venom ever collected from these unique island forms of tiger snakes. Such vintage venoms may therefore represent the last remaining stocks of some local populations and thus are precious resources. These venoms also have significant historical value as the Oxyuranus venoms analysed include samples from the first coastal taipan (Oxyuranus scutellatus) collected for antivenom production (the snake that killed the collector Kevin Budden), as well as samples from the first Oxyuranus microlepidotus specimen collected after the species' rediscovery in 1976. These results demonstrate that with proper storage techniques, venom samples can retain structural and pharmacological stability. This article is part of a Special Issue entitled: Proteomics of non-model organisms. Biological significance: [•] These results show that with proper storage venoms are useful for decades. [•] These results have direct implications for the use of rare venoms. [Copyright &y& Elsevier]

Pretherapy patients with chronic lymphocytic leukemia (CLL) from US Intergroup trial E2997 were analyzed with single nucleotide polymorphism microarrays to detect acquired chromosomal anomalies. The four CLL-typical anomalies (11q-, +12, 13q-, and 17p-) were found at expected frequencies. Acquired anomalies in other regions account for 70% of the total detected anomalies, and their number per participant has a significant effect on progression-free survival after adjusting for the effects of 17p- (and other covariates). These results were compared with those from a previous study of more than 50,000 participants from the GENEVA consortium of genome-wide association studies, which analyzed individuals with a variety of medical conditions and healthy controls. The percentage of individuals with acquired anomalies is vastly different between the two studies (GENEVA 0.8%; E2997 80%). The composition of the anomalies also differs, with GENEVA having a higher percentage of acquired uniparental disomies and a lower percentage of deletions. The four common CLL anomalies are among the most frequent in GENEVA participants, some of whom may have CLL-precursor conditions or early stages of CLL. However, the patients from E2997 (and other studies of symptomatic CLL) have recurrent acquired anomalies that were not found in GENEVA participants, thus identifying genomic changes that may be unique to symptomatic stages of CLL. [Copyright &y& Elsevier]

We present a quantitative reconstruction of local forest history at two sites, Stavsåkra (hemiboreal zone) and Storasjö (southern boreal zone), in southern Sweden (province of Småland) to evaluate possible causes of contrasting Holocene fire histories in mid- and late Holocene. The Landscape Reconstruction Algorithm (LRA) is applied to evaluate between-site differences in the relative abundance of deciduous trees and Pinus (pine) and landscape/woodland openness during the Holocene. The LRA estimates of local vegetation abundance are compared with other proxies of local vegetation, that is, plant and beetle remains. The LRA results suggest that Pinus was a major tree taxon in the woodlands of Storasjö during mid- and late Holocene, while Tilia (linden) and Betula (birch) were dominant at Stavsåkra. The contrasting fire histories are shown to be strongly related to between-site differences in tree composition during mid-Holocene, 4000–2000 bc in particular. The archaeological/historical and beetle data indicate contrasting land uses from c. 1000 bc (late Bronze Age/early Iron Age), grazing in open Calluna heaths at Stavsåkra and woodland grazing at Storasjö. Between-site differences in fire history during late Holocene were likely due to different land-use practices. Between-site differences in tree composition in mid-Holocene are best explained by local climatic and geological/geomorphological differences between the hemiboreal and southern boreal zones of Småland, which might also be the primary cause of between-site differences in land-use histories during late Holocene. Maintenance of biodiversity at the landscape scale in the study area requires that existing old pine woodlands and Calluna heath are managed with fire and cattle grazing. Further climate warming might lead to higher probabilities of climate-induces fire, in particular in pine-dominated woodlands. [ABSTRACT FROM AUTHOR]

BCL6 translocations are common in B-cell lymphomas and frequently have chromosomal breaks in immunoglobulin heavy chain (IgH) switch regions, suggesting that they occur during class-switch recombination. We analyze 120 BCL6 translocation breakpoints clustered in a 2156-bp segment of BCL6 intron 1, including 62 breakpoints (52%) joined to IgH, 12 (10%) joined to Ig light chains, and 46 (38%) joined to non-Ig partners. The BCL6 breaks in Ig-BCL6 translocations prefer known activation-induced cytosine deaminase (AID) hotspots such as WGCW and WRC (W = A/T, R = A/G), whereas BCL6 breaks in non-Ig rearrangements occur at CpG/CGC sites in addition to WGCW. Unlike previously identified CpG breaks in pro-B/pre-B-cell translocations, the BCL6 breaks do not show evidence of recombination activating gene or terminal deoxynucleotidyl transferase activity. Both WGCW/WRC and CpG/CGC breaks at BCL6 are most likely initiated by AID in germinal center B-cells, and their differential use suggests subtle mechanistic differences between Ig-BCL6 and non-Ig-BCL6 rearrangements. [ABSTRACT FROM AUTHOR]

Background: An improved understanding of the regulation of the fetal hemoglobin genes holds promise for the development of targeted therapeutic approaches for fetal hemoglobin induction in the β-hemoglobinopathies. Although recent studies have uncovered trans-acting factors necessary for this regulation, limited insight has been gained into the cis-regulatory elements involved. Methods: We identified three families with unusual patterns of hemoglobin expression, suggestive of deletions in the locus of the β-globin gene (β-globin locus). We performed array comparative genomic hybridization to map these deletions and confirmed breakpoints by means of polymerase-chain-reaction assays and DNA sequencing. We compared these deletions, along with previously mapped deletions, and studied the trans-acting factors binding to these sites in the β-globin locus by using chromatin immunoprecipitation. Results: We found a new (δβ)0-thalassemia deletion and a rare hereditary persistence of fetal hemoglobin deletion with identical downstream breakpoints. Comparison of the two deletions resulted in the identification of a small intergenic region required for γ-globin (fetal hemoglobin) gene silencing. We mapped a Kurdish β0-thalassemia deletion, which retains the required intergenic region, deletes other surrounding sequences, and maintains fetal hemoglobin silencing. By comparing these deletions and other previously mapped deletions, we elucidated a 3.5-kb intergenic region near the 5′ end of the δ-globin gene that is necessary for γ-globin silencing. We found that a critical fetal hemoglobin silencing factor, BCL11A, and its partners bind within this region in the chromatin of adult erythroid cells. Conclusions: By studying three families with unusual deletions in the β-globin locus, we identified an intergenic region near the δ-globin gene that is necessary for fetal hemoglobin silencing. (Funded by the National Institutes of Health and others.) [ABSTRACT FROM PUBLISHER]

Abstract: A high-resolution, continuous 10,500 cal. yrs-long macroscopic charcoal record from a peat and lake sediment deposit at Storasjö, in the hemiboreal vegetation zone of southern Sweden, is presented. This record was compared with the microscopic charcoal record from the same core, and tentatively correlated with the macroscopic and microscopic charcoal records from another site (Stavsåkra), situated 30 km West of Storasjö. The charcoal records are also compared with regional climate proxy records with the aim to separate climate — from human-induced fire activity. The results suggest that the major signal of both microscopic and macroscopic charcoal records represents local fire history. The best record of local fire history was obtained from the continuous macroscopic charcoal analysis. A tentative correlation of the charcoal records between the sites indicates that most fire episodes of the early and middle Holocene are probably of regional character. Both sites exhibit three major phases of high fire activity 1) 8700–8300 BC, 2) 7250 BC to ca. 4000 BC, and 3) 750 BC to the 19th century. These three phases are separated by periods with lower or very low fire activity. This general trend is in good agreement with the pattern emerging for Europe from the analysis of the recently developed global charcoal database. Fire appears to have been controlled by climate during the early and middle Holocene and by humans during the late Holocene. Warmer and drier climate during the early and middle Holocene caused frequent and intensive fires, which suggests that natural fire activity might increase under predicted future climate scenarios. The results also suggest that fire was an important disturbance factor in the hemiboreal vegetation zone of Sweden and played an important role in the forest dynamics and characteristics of the flora and fauna of the region. [Copyright &y& Elsevier]

The predatory ecology of Varanus komodoensis (Komodo Dragon) has been a subject of long-standing interest and considerable conjecture Here, we investigate the roles and potential interplay between cranial mechanics, toxic bacteria, and venom. Our analyses point to the presence of a sophisticated combined-arsenal killing apparatus. We find that the lightweight skull is relatively poorly adapted to generate high bite forces but better adapted to resist high pulling loads. We reject the popular notion regarding toxic bacteria utilization. Instead, we demonstrate that the effects of deep wounds inflicted are potentiated through venom with toxic activities including anticoagulation and shock induction. Anatomical comparisons of V. komodoensis with V. (Megalania) priscus fossils suggest that the closely related extinct giant was the largest venomous animal to have ever lived. [ABSTRACT FROM AUTHOR]

The impact of the follicular lymphoma (FL) histologic grade on outcomes after high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) is unknown. We evaluated 219 consecutive patients with grades 1–3 FL who underwent HDT and ASCT at our center. Overall survival (OS), progression-free survival (PFS), relapse and non-relapse mortality (NRM) was estimated for each grade after controlling for other predictive factors. The number of patients with grades 1, 2 and 3 FL was 106 (48%), 75 (34%) and 38 (17%), respectively. Five-year outcome estimates for the entire cohort included 60% OS, 39% PFS and 46% relapse (median follow-up=7.8 years). PFS and relapse were nearly identical among patients with grade 3 FL versus grades 1–2 FL after adjusting for other contributing factors (hazard ratio (HR)=0.90, P=0.68; HR=1.07, P=0.80, respectively). The hazard for mortality (HR=0.70, P=0.23) and NRM (HR=0.33, P=0.07) was non-significantly lower among patients with grade 3 FL compared to patients with grades 1–2 disease. Factors associated with inferior PFS included elevated lactate dehydrogenase (HR=1.52, P=0.03), chemoresistance (HR=1.82, P=0.02), 2 prior therapies (HR=1.8, P=0.03) and prior radiation (HR=1.99, P=0.003). These data suggest that the histologic grade of FL does not impact PFS or relapse following HDT and ASCT.Bone Marrow Transplantation (2007) 40, 1039–1044; doi:10.1038/sj.bmt.1705864; published online 8 October 2007 [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the most common cause of cancer death in women in the USA. Lung cancer arising during pregnancy is rare and has been reported only 15 times since the 1950s. However, the use of chemotherapy for lung cancer during pregnancy has not previously been reported. Methods: The history, treatment and outcome of a patient with stage IV non-small-cell lung carcinoma (NSCLC) diagnosed during pregnancy is presented. Previous published reports on lung cancer were retrieved by a literature search of Medline and Cancerlit. Results: A 31-year-old woman was diagnosed as having stage IV NSCLC with bilateral pulmonary involvement when 26 weeks pregnant. Her shortness of breath progressed to dyspnea at rest on 100% inspired oxygen. Therefore, she was treated with systemic chemotherapy using cisplatin and vinorelbine. Despite this treatment, her oxygenation declined further over the next 4 days and thus the baby was delivered via cesarean section after 27 weeks of gestation. Four cycles of vinorelbine and cisplatin have now been administered. Following this treatment, the patient has experienced a significant clinical improvement and no longer requires supplemental oxygen. No chemotherapy-related adverse effects have been noted in the baby. In the 15 previously reported patients with concurrent lung cancer and pregnancy, chemotherapy administration during pregnancy has not been described. Conclusions: Treatment of lung cancer with chemotherapy during pregnancy should be considered on an individual basis with regard to the stage of the cancer and the maturity of the fetus. To our knowledge, the case presented here is the first report of a woman receiving chemotherapy for lung cancer while pregnant.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: The periventricular subventricular zone (SVZ) contains stem cells and is an area of active neurogenesis and migration. Since inflammation can reduce neurogenesis, we tested whether Theiler's murine encephalomyelitis virus (TMEV) induces inflammation and reduces neurogenesis in the SVZ., Methods: We performed immmunohistochemistry for the hematopoietic cell marker CD45 throughout the central nervous system and then examined neuroblasts in the SVZ., Results: CD45+ activation (inflammation) occurred early in the forebrain and preceded cerebellar and spinal cord inflammation. Inflammation in the brain was regionally stochastic except for the SVZ and surrounding periventricular regions where it was remarkably pronounced and consistent. In preclinical mice, SVZ neuroblasts emigrated into inflamed periventricular regions. The number of proliferating phoshpohistone3+ cells and Doublecortin+ (Dcx) SVZ neuroblasts was overall unaffected during the periods of greatest inflammation. However the number of Dcx+ and polysialylated neural cell adhesion molecule (PSA-NCAM+) SVZ neuroblasts decreased only after periventricular inflammation abated., Conclusion: Our results suggest that after TMEV infection, the SVZ may mount an attempt at neuronal repair via emigration, a process dampened by decreases in neuroblast numbers.