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Despite the absence of a natural reservoir for Q fever in the desert of Southern California, six cases have been identified during the past 32 years. During that period of time, two areas have been used by northern sheep ranchers from Idaho and Wyoming to import sheep to an area in the Coachella Valley through 1985. Thereafter, because of housing development, the sheep area was moved to Blythe along the Colorado River. All but two of these patients probably acquired infection by Coxiella burnetii by living or working in close proximity to these grazing areas but not directly involved with the sheep. The shift of infected patients from the Coachella Valley to Blythe (100 miles distant) seems to support that supposition. All patients with acute Q fever developed antibodies primarily to phase II antigen, whereas the only person with chronic Q fever developed phase I antibodies. All patients presented with granulomatous hepatitis. One also had a pulmonary infiltrate, and the single individual with chronic Q fever also had a mitral valve prosthesis, although echocardiography could not define endocarditis. All patients with acute infections responded to 3-5 weeks of therapy with doxycycline, whereas the patient with chronic disease failed 3 years of therapy with combination regimens. Further studies at the Eisenhower Medical Center on the prevalence of infection in Blythe, CA, and elsewhere are anticipated.

Objectives: To evaluate the results of rotator cuff repair and to look for preoperative and/or intraoperative predictors of long-term outcomes., Patients and Methods: All patients who underwent open rotator cuff repair surgery for a full-thickness tear between 1990 and 1996 and who were subsequently followed-up for at least 4 years were contacted. The surgical technique and postoperative rehabilitation program were standardized. We recorded factors potentially associated with outcomes (age, sex, dominant hand, pain, symptom duration, and active range-of-motion limitation)., Results: Of the 56 patients identified, 26 men and 24 women with a mean age of 58.52 years were included in the study. Mean symptom duration was 12 months (range, 3-48 months). Before surgery, mean active range of motion of the shoulder was 144.6 degrees for forward elevation, 135.2 degrees for abduction, and 39.4 degrees for lateral rotation with the elbow at the side. The size of the tear measured during surgery was 1-5 cm. Mean time to recovery of shoulder power (75% of the value before the tear) as assessed by the patients was 10 months. After a mean follow-up of 6 years, a significant reduction in pain was noted (from 2.18/3 to 0.98/3; P < 0.001), although two-thirds of the patients reported occasional pain. Six patients were dissatisfied. Range of motion had improved in one-fourth of the patients. Constant's score after surgery was 65/100. Persistent difficulty in taking objects down from high shelves was noted. None of the preoperative or intraoperative factors studied predicted the long-term outcomes., Conclusion: In this series of patients, rotator cuff repair reduced pain severity. Nearly a year was needed to achieve the final result. Only a minority of patients experienced an improvement in range of motion.

We developed and validated an enzyme immunoassay for immunoreactive pregnanediol-3-glucuronide (iPdG) in feces to monitor reproductive status in desert and Rocky Mountain bighorn sheep (Ovis canadensis). Fecal iPdG concentrations were strongly correlated (r = 0.71) with serum progesterone concentrations in paired fecal and blood samples collected from 34 free-ranging desert bighorn sheep. In bimonthly fecal samples collected from 12 captive ewes, fecal iPdG profiles were similar between desert and Rocky Mountain bighorn sheep and we selected a pregnancy detection cutoff value of iPdG > or = 1.8 ng/mg feces. Fecal iPdG concentrations always exceeded this cutoff value when samples were collected from about day 60 of pregnancy to a few days before parturition, but values < 1.8 ng/mg (false negatives) were common for samples collected during the first 60 days of gestation. Although we tested a small number of known pregnant and non-pregnant ewes, the accuracy of the assay was 100% when two samples, collected 2 wk apart, were evaluated for any given ewe. Based on these data, this direct enzyme immunoassay for fecal progesterone metabolites has promise as a diagnostic tool to monitor hormone excretion and pregnancy in a free-ranging ungulate species.

A cell line (BHFTE) was derived from a tongue explant of a bighorn sheep fetus (Ovis canadensis nelsoni). The cells have been maintained through 23 serial passages, and the modal number of chromosomes was calculated to be 55. Monolayer cultures were shown to be susceptible to various viruses, including bluetongue virus (BTV). Of 5 BTV serotypes (2, 10, 11, 13, and 17) tested, each produced a cytopathic effect (CPE) on initial passage at 33 C. A field isolate (serotype 10) of BTV from a black-tailed deer (Odocoileus hemionus columbianus) in its second passage in Vero-M cells also produced CPE when inoculated into BHFTE cells. Antigens of BTV were demonstrated by direct immunofluorescence in the cytoplasm of BHFTE cells inoculated with homogenates of chicken embryos injected with clinical specimens from a domestic sheep and an Arabian oryx (Oryx gazella leucoryx). A suspension of BTV-infected gnats (Culicoides spp.) produced CPE and BTV-specific fluorescence on the first passage in cells inoculated with a suspension of blood from sheep experimentally infected with BTV. Additionally, selected bovine viruses induced CPE in the cells. The cell line, which is free of mycoplasma and bovine viral diarrhea virus contamination, may be useful in diagnostic medicine and research involving the ruminant species.